Prevention Epicenter of Emory and Collaborating Healthcare Facilities (PEACH II)

我们提出的研究解决了由多重耐药引起的医疗保健相关感染， 从院前竞技场到急性短期 长期护理设施。我们有能力在最大程度上从事研究活动， 使用Emory的临床数据仓库，建立了亚特兰大大都市区的医疗保健系统 研究与多个州的养老院网络联系在一起， 其他预防中心、格鲁吉亚新发感染项目和格鲁吉亚卫生部 健康PEACH研究人员在MDRO中获得国家认可，并为预防 在过去的震中使命。PEACH II将推进跨学科研究， 人类因素工程学、微生物组学和环境生态学以及传播信息学 中断的努力，在不同的设置范围。我们建议推进预防 Epicenter的研究使命通过（1）与埃默里大学和合作机构的广泛合作 具有专业知识的科学家为Epicenter工作做出贡献，（2）合作观察和临床 试验，包括研究实施、数据使用协议、伦理批准和实验室规范， 在整个医疗保健中利用对不同（包括服务不足）患者人群的访问 频谱，以及（3）扩大与其他预防中心和新发感染的合作 程序站点。为了实现后一个目标，我们提出了四个核心项目：核心项目1：InPART Rx - 住院医师抗生素使用率基准化以减少不必要的处方; T1：急性护理 核心项目2：FAIR -一项临床试验， 粪便微生物群移植治疗住院患者的抗生素耐药感染; T1 -急性护理环境， 优先领域：减少AR感染，了解和减少传播（源头控制， 环境），区域控制，医疗保健中流行病学重要病原体，无症状 定植和微生物组;核心项目3：预警-预测可能定植的入院 用抗生素耐药性细菌触发检测和分离; T-1：急性护理和急性后护理， 区域控制AR的优先领域;创新的检测和应对;核心项目4：CHAMPIONS - 急性期后护理中预防感染的人为因素和微生物学协作方法; T1： 长期护理，优先领域：减少AR感染。了解和减少传播- 区域控制和长期护理设施。其他可选合作项目 围绕手部卫生有效性的目标创新多种急性护理环境， 在长期急性护理和疗养院的紧急抵抗和改善败血症管理， 多个院前环境。

Our proposed research addresses healthcare-associated infections caused by multidrug-resistant organisms (MDROs) across the healthcare spectrum from pre-hospital arena, into acute short-term though long-term care facilities. We have capacity to engage in research activities at the largest healthcare system in the Atlanta metropolitan area using Emory’s Clinical Data Warehouse, established research ties to a multi-state network of nursing homes, and long-standing research collaborations with other Prevention Epicenters, the Georgia Emerging Infections Program and Georgia Department of Health. PEACH investigators have national recognition in MDROs and have contributed to the Prevention Epicenters mission in the past. PEACH II will be advancing transdisciplinary research incorporating human factors engineering, microbiome and environmental ecology, and informatics into transmission interruption efforts, in a diverse spectrum of settings. We propose to advance the Prevention Epicenter’s research mission through (1) engagement with a broad range of Emory and partner institute scientists with expertise to contribute to Epicenter work, (2) collaborative observational and clinical trials including study conduct, data use agreements, ethics approvals, and laboratory practices by leveraging access to diverse (including underserved) patient populations across the healthcare spectrum, and (3) expand collaborations with other Prevention Epicenters and Emerging Infections Programs sites. Towards this latter aim, we are proposing four Core Projects: Core Project 1: InPART Rx - Inpatient Provider Antibiotic Rate Benchmarking to Reduce Unnecessary Prescribing; T1: in Acute Care settings, Priority Areas of Stewardship, decreasing AR infections; Core Project 2: FAIR – A clinical trial of Fecal Microbiota Transplant for Antibiotic-Resistant Infections in Inpatients; T1 – in Acute Care settings, Priority Areas: Decreasing AR infections, Understanding and decreasing transmission (source control, environment), Regional control, Epidemiologically important pathogens in healthcare, Asymptomatic colonization, and Microbiome; CORE PROJECT 3: PRE-ALERT - Predicting Admissions Likely Colonized with Antibiotic Resistant Bacteria to Trigger Detection and Isolation; T-1: Acute care and Post-acute care, Priority Areas of Regional control of AR; Innovative detect and response; Core Project 4: CHAMPIONS – Collaborative Human Factors and Microbiology Approaches to Prevent Infections in Post-acute Care; T1: in Long-Term Care, Priority Areas: Decreasing AR infections. Understanding and decreasing transmission- environment; Regional control and long-term care facilities. Additional optional collaborative projects target innovations around hand hygiene effectiveness multiple acute care settings, containment of emergence resistance in long term acute care and nursing homes and improving sepsis management in multiple pre-hospital settings.