Hospital-Acquired Infections in the Elderly

老年人医院获得性感染

• 批准号: 7265222
• 负责人: KEITH S KAYE
• 金额: $ 12.6万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7265222
• 关键词: Activities of Daily Living; Admission activity; Adult; Adverse event; Age; Aminoglycosides; Attention; Award; Bacillus (bacterium); Charge; Chronic Obstructive Airway Disease; Clinical Investigator; Comorbidity; Congestive Heart Failure; Data; Databases; Development; Drug Exposure; Elderly; Epidemiologist; Future; Glucose; Health; Hospital Costs; Hospitalization; Hospitals; Hour; Immune response; Infection; Infection Control; Infection Control Practitioners; Infection prevention; Intervention; Intervention Studies; Interview; Kidney Failure; Medical Surveillance; Methods; Modeling; Morbidity - disease rate; Multi-Drug Resistance; Nosocomial Infections; Numbers; Nursing Homes; Obesity; Operative Surgical Procedures; Outcome; Patients; Persons; Physicians; Pneumonia; Population; Postoperative Period; Preventive Intervention; Publishing; Purpose; Renal Glycosuria; Research Infrastructure; Research Personnel; Resistance; Risk; Risk Factors; Serum; Site; Surgical Models; Surgical complication; Telephone; Testing; Time; Urinary tract infection; Vancomycin resistant enterococcus; antimicrobial drug; career; day; design; disability; drug resistant bacteria; functional status; human old age (65+); implantable device; improved; methicillin resistant Staphylococcus aureus; model development; mortality; older patient; patient oriented research; patient safety; programs; prospective; residence

DESCRIPTION (provided by applicant): The overall purpose of this award application is to support the patient-oriented research program and career development of a beginning clinical investigator in hospital-acquired infections in the elderly. Long-term objective: Elderly (> 65 years old) adults are particularly vulnerable to nosocomial infections. Despite significant morbidity associated with surgical site infection (SSI) and infections caused by multi-drug resistant bacteria (MDRB), investigators have paid relatively little attention to these infections in elderly hospitalized patients. The broad objectives for this application are to identify risk factors and interventions to improve outcomes of elderly hospitalized persons. Specific aims: 1) Create risk models for the development of SSI and MDRB in the elderly and to test a prior hypotheses regarding particular risk factors; and 2) quantify the impact of SI and nosocomial MDRB on health outcomes in the elderly. Health outcomes (mortality, duration of hospitalization and hospital costs) will be assessed for the 90-day period following surgery (for SSI) and infection (for MDRB). In addition, the impact of SSI on ADL disability will also be assessed. Methods: The project will utilize 10 study hospitals and an infection control infrastructure that includes 3 physician epidemiologists and over 20 infection control practitioners. Patients with SSI and nosocomial infection and colonization due to MDRB are currently identified through prospective surveillance and have been and will continued to be prospectively entered into electronic databases at study hospitals. Additional study data will be obtained from patient charts and hospital databases. For the study of SSI, elderly patients with SSI will be studied as cases and will be compared to elderly operative patients without SSI. ADL disability will be assessed preoperatively through chart review and postoperatively by phone interview 90 days after surgery. For the study of MDRB, elderly patients with an initial episode of nosocomial MDRB will be studied as cases and will be compared to elderly patients without infection or colonization due to MDRB. For the risk model analysis, patients colonized or infected with MDRB will be included as cases; and for the health outcomes analysis, only patients with infections due to MDRB will be studied as cases. The risk factor identified for SSI and MDRB and the impact of SSI and MDRB on health outcomes will be used to design and implement future preventive interventions.

描述（由申请人提供）：该奖项申请的总体目的是支持以患者为导向的研究项目和老年人医院获得性感染的临床研究者的职业发展。长期目标：老年人（> 65 岁）特别容易受到医院感染。尽管与手术部位感染（SSI）和多重耐药细菌（MDRB）引起的感染相关的发病率很高，但研究人员对老年住院患者的这些感染关注相对较少。该应用程序的主要目标是确定风险因素和干预措施，以改善老年住院患者的治疗结果。 具体目标： 1) 创建老年人 SSI 和 MDRB 发展的风险模型，并检验有关特定风险因素的先前假设； 2) 量化 SI 和医院 MDRB 对老年人健康结果的影响。将评估手术（SSI）和感染（MDRB）后 90 天的健康结果（死亡率、住院时间和住院费用）。此外，还将评估 SSI 对 ADL 残疾的影响。 方法：该项目将利用 10 家研究医院和感染控制基础设施，其中包括 3 名流行病学家和 20 多名感染控制从业人员。目前，通过前瞻性监测来识别患有 SSI 以及 MDRB 引起的院内感染和定植的患者，并且已经并将继续前瞻性地输入研究医院的电子数据库中。额外的研究数据将从患者图表和医院数据库中获得。对于SSI的研究，将以患有SSI的老年患者作为病例进行研究，并将其与没有SSI的老年手术患者进行比较。 ADL 残疾将在术前通过图表审查进行评估，并在术后 90 天通过电话访谈进行评估。对于MDRB的研究，将首次发生院内MDRB的老年患者作为病例进行研究，并将其与未因MDRB感染或定植的老年患者进行比较。对于风险模型分析，MDRB定植或感染的患者将作为病例纳入；对于健康结果分析，仅将因 MDRB 感染的患者作为病例进行研究。确定的 SSI 和 MDRB 风险因素以及 SSI 和 MDRB 对健康结果的影响将用于设计和实施未来的预防干预措施。