CK20-004, WASHINGTON UNIVERSITY & BJC EPICENTER TO PREVENT HEALTHCARE ASSOCIATED INFECTIONS & ANTIBIOTIC RESISTANCE

CK20-004，华盛顿大学

• 批准号: 10402223
• 负责人: Victoria J. Fraser
• 金额: $ 169万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10402223
• 关键词: CK20; 004; WASHINGTON; UNIVERSITY; BJC

ABSTRACT The Washington University (WU) / BJC Prevention Epicenter (PE) works collaboratively with CDC & other PEs to perform research & translate discoveries into novel strategies to prevent healthcare-associated infections (HAI) & antimicrobial resistance (AR). The WU/BJC PE is widely recognized for HAI & AR research & leadership. WU has outstanding research infrastructure. BJC is an integrated healthcare delivery system with 15 hospitals, long-term care facilities, & outpatient practices. BJC includes two academic hospitals, Barnes-Jewish & St. Louis Children’s Hospitals & 13 suburban & rural hospitals. We organized a research team with expertise in ID, epidemiology, informatics, microbiology, critical care, microbiome, & metabolism to study HAI & AR in diverse settings. We developed a high impact 5-yr proposal with novel strategies to: Evaluate & predict inappropriate antimicrobial use & AR regionally & nationally; Reduce surgical site infections; Test novel initiatives to improve outpatient antibiotic prescribing; Identify metagenomic & metabolite differences between hospital & community associated C. difficile; Reduce AR organism reservoirs in hospitals. To achieve these goals, we propose the following Specific Aims: Aim 1 A: Evaluate the use, effectiveness, and safety of antimicrobials in community-acquired pneumonia (CAP) with national administrative data. Aim 1 B: Develop aggregate antimicrobial resistance measures in sepsis caused by Gram-negative bacilli (GNB) using BJC electronic health record data. Aim 2: The impact of an existing Anesthesia Control Tower (ACT) intervention to improve intraoperative care on infectious outcomes. Aim 3 A: Stewardship initiative to limit post-discharge prophylactic antibiotic use after mastectomy. Aim 3 B: Improve antimicrobial stewardship practices in elderly patients with UTIs in assisted living facilities. Aim 4: Identify fecal microbiome and metabolite markers of community associated (CA) C. difficile colonization and infection (CDI). Aim 5: Define the prevalence of antibiotic resistant organisms (ARO) in the clinical ICU environment, relationship of ARO to ICU clinical culture isolates and measure the impact of an environmental hygiene intervention on ARO concentration in ICU sink drains, the surrounding environment and bioaerosols. We are also submitting 3 proposals to lead Small, Medium & Large Multicenter Collaborative Projects with Duke, U Penn, Hektoen / Rush, University of Maryland, and Iowa PEs as potential participants.

抽象的 华盛顿大学 (WU) / BJC Prevention Epicenter (PE) 与 CDC 和其他机构合作 PE 进行研究并将发现转化为预防医疗保健相关的新策略 感染（HAI）和抗菌素耐药性（AR）。 WU/BJC PE 在 HAI 和 AR 研究方面得到广泛认可 和领导力。吴大学拥有出色的研究基础设施。 BJC 是一个综合医疗保健服务系统 拥有 15 家医院、长期护理机构和门诊诊所。 BJC 包括两家学术医院， Barnes-Jewish 和圣路易斯儿童医院以及 13 家郊区和乡村医院。我们组织了一项研究 拥有感染性疾病、流行病学、信息学、微生物学、重症监护、微生物组和新陈代谢方面专业知识的团队 在不同的环境中研究 HAI 和 AR。我们制定了一项高影响力的五年提案，其中包含新颖的策略： 评估和预测区域和全国范围内的不当抗菌药物使用和 AR；减少手术部位感染； 测试改善门诊抗生素处方的新举措；识别宏基因组和代谢差异 医院和社区之间相关的艰难梭菌；减少医院内的 AR 生物宿主。 为了实现这些目标，我们提出以下具体目标： 目标 1 A：评估抗菌药物在社区获得性肺炎中的使用、有效性和安全性 (CAP) 与国家行政数据。 目标 1 B：针对革兰氏阴性杆菌引起的脓毒症制定总体抗菌药物耐药性措施 (GNB) 使用 BJC 电子健康记录数据。 目标 2：现有麻醉控制塔 (ACT) 干预对改善术中的影响 关注感染结果。 目标 3 A：采取管理举措，限制乳房切除术后出院后预防性使用抗生素。 目标 3 B：改善辅助生活中老年尿路感染患者的抗菌药物管理实践 设施。 目标 4：识别群落相关 (CA) 艰难梭菌的粪便微生物组和代谢标志物 定植和感染（CDI）。 目标 5：确定临床 ICU 环境中抗生素耐药微生物 (ARO) 的流行率， ARO 与 ICU 临床培养分离物的关系并测量环境卫生的影响 对 ICU 水槽排水管、周围环境和生物气溶胶中 ARO 浓度的干预。 我们还提交了 3 项提案，以领导小型、中型和大型多中心合作项目 杜克大学、宾夕法尼亚大学、Hektoen / Rush、马里兰大学和爱荷华大学的 PE 是潜在参与者。