WASHINGTON UNIVERSITY & BJC EPICENTER FOR PREVENTION OF HEALTHCARE ASSOCIATED INFECTIONS

华盛顿大学

• 批准号: 9305762
• 负责人: Victoria J. Fraser
• 金额: $ 50万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9305762
• 关键词: WASHINGTON; UNIVERSITY; BJC; EPICENTER; PREVENTION

The Washington University (WU) and BJC Prevention Epicenter (PE) works collaboratively with CDC and other PEs to perform research and to translate basic, epidemiology and technologic discoveries into new strategies to prevent and decrease healthcare associated infections (HAIs) and antimicrobial resistance (AR). The WU PE is internationally recognized for research productivity and leadership in HAI and AR prevention. WU has outstanding research infrastructure and ranks in the top medical centers in the U.S. BJC is a 13- hospital integrated healthcare delivery system including two “top 10” academic hospitals. For our core and 3 multicenter collaborative proposals, we organized a team of basic, translational and clinical investigators with expertise in infectious disease, healthcare epidemiology, microbiology, AR, microbiome, and metabolome sciences to work together performing translational studies to prevent HAIs and AR. We propose a broad 4 year research strategy in our core proposal focused on developing and testing novel strategies to: document and improve outpatient antibiotic prescribing practices, reduce surgical site infections (SSIs), identify changes in AR and gut microbiome following fecal microbiome transplant (FMT), and identify novel biomarkers to more rapidly diagnose urinary tract infections and avoid unnecessary antibiotics in asymptomatic bacteriuria. To achieve these goals in our core proposal, we propose the following Specific Aims: 1. Determine antibiotic prescribing practices among dentists in the US utilizing Express Scripts Inc, a large pharmacy benefits manager database; 2. Reduce SSI after colorectal surgery with an enhanced recovery bundle, and implementation and expansion of a comprehensive care package; 3. Enhance an existing mastectomy SSI risk prediction model for individual women using clinical information from the electronic health record (EHR) and integrate the enhanced risk prediction model into the EHR for use by surgeons to communicate individualized SSI risk and to optimize SSI preventive practices for women undergoing mastectomy; 4. Determine the impact of fecal microbiome transplant (FMT) administered to patients with recurrent Clostridium difficile infection (CDI) on intestinal multidrug resistant organism (MDRO) colonization from specimens collected for a double blinded, dose response, randomized controlled trial; 5. Identify metabolomic biomarkers of high-risk bacteriuria in hospitalized patients. We are also submitting 3 proposals to lead small, medium and large collaborative projects with the Duke, Univ. of Pennsylvania and Hektoen/Rush PEs as participants in our multicenter proposals.

华盛顿大学 (WU) 和 BJC Prevention Epicenter (PE) 与 CDC 和 其他 PE 进行研究并将基础、流行病学和技术发现转化为新的 预防和减少医疗保健相关感染 (HAI) 和抗菌素耐药性 (AR) 的策略。 WU PE 因其在 HAI 和 AR 预防方面的研究生产力和领导力而获得国际认可。 WU 拥有出色的研究基础设施，在美国顶尖的医疗中心中名列前茅。BJC 是排名第 13 位的 医院综合医疗服务系统包括两家“十强”学术医院。对于我们的核心和 3个多中心合作提案，我们组织了一个由基础、转化和临床研究人员组成的团队 传染病、医疗保健流行病学、微生物学、AR、微生物组和代谢组方面的专业知识 科学界共同开展转化研究以预防 HAI 和 AR。我们提出了一个广泛的 4 年 我们核心提案中的研究策略侧重于开发和测试新颖的策略，以：记录和 改善门诊抗生素处方实践，减少手术部位感染 (SSI)，确定以下方面的变化： 粪便微生物组移植 (FMT) 后的 AR 和肠道微生物组，并识别新的生物标志物 快速诊断尿路感染并避免在无症状菌尿中使用不必要的抗生素。 为了实现我们核心提案中的这些目标，我们提出以下具体目标： 1. 利用 Express Scripts Inc（一家大型公司）确定美国牙医的抗生素处方实践。 药品福利经理数据库； 2. 通过加速康复训练包减少结直肠手术后的 SSI，并实施和实施 扩大综合护理计划； 3. 利用临床数据增强现有的针对个体女性的乳房切除术 SSI 风险预测模型 来自电子健康记录 (EHR) 的信息并集成增强的风险预测模型 进入 EHR，供外科医生用于传达个性化 SSI 风险并优化 SSI 接受乳房切除术的妇女的预防措施； 4. 确定粪便微生物移植 (FMT) 对复发性患者的影响 艰难梭菌感染（CDI）对肠道多重耐药菌（MDRO）定植的影响 为双盲、剂量反应、随机对照试验收集的标本； 5. 鉴定住院患者高危菌尿的代谢组生物标志物。 我们还提交了 3 项提案，以领导小型、中型和大型合作项目 杜克大学。宾夕法尼亚州和 Hektoen/Rush PE 作为我们多中心提案的参与者。