Intermountain Program on Antibiotic Resistance and microbial Threats (IMPART)

项目总结 我们热切地建议更新我们的疾控中心预防中心，名为 抗生素耐药性和微生物威胁(传授)。我们的提案汇集了一批特殊的 具有进行大规模观察性研究的非凡能力的研究人员，以及领导 或共同领导干预研究，范围从小型飞行员到多社区随机试验 犹他大学是我们项目的枢纽，山间健康是一家大型地区性综合医疗机构 系统，作为主要节点。退伍军人事务部(VA)盐湖城医疗系统是另一个关键 我们预防中心站点的合作伙伴，在包含 整个退伍军人健康系统。我们为疾控中心预防震中计划提供的资源将广泛 有利于其改善医疗安全和预防医疗相关感染的使命。我们有 积累了翻译研究的经验和多学科方法的专长，使 对提高抗生素使用质量、抗击抗生素耐药性和增强 在整个护理过程中，卫生系统对微生物威胁的反应。此外，我们还开发了一种 支持全面流行病学分析的计算环境 退伍军人事务部(退伍军人事务部)健康系统以及山间医疗保健和华盛顿大学 犹他州健康公司(Utah Health)。我们提出的研究对政策制定和 实施。核心项目1评估门诊管理的替代实施战略和 促进AS最佳做法的传播。核心项目2解决了一个长期存在争议的问题 在卫生保健流行病学界，即积极监测和接触预防的作用 (CP)预防由地方性多药耐药生物(MDRO)引起的医疗相关感染 如耐甲氧西林金黄色葡萄球菌(MRSA)。在某些情况下部分CP取消实施的一段时间 为应对新冠肺炎的出现而触发的退伍军人管理局设施为研究其影响创造了机会 这一自然实验的。核心项目3将长期传染病传播途径的流行病学分析联系起来 为开发和实施改进做法的新方法提供便利。核心项目4 面对新冠肺炎的全球卫生挑战，以加强对未来疫情的准备和 增加对如何控制季节性和新型病毒的医疗传播的了解。我们是 致力于积极参与其他预防中心网站的协作项目和工作 与国家、州和地方各级的公共卫生实体密切合作。我们还承诺做出贡献， 在预防犯罪中心主持下设立的方案领域和病原体工作组 震中计划。对于我们的所有活动，与疾控中心的卫生优先事项密切一致的将是 以及疾控中心工作人员大量的方案参与。

PROJECT SUMMARY We enthusiastically propose to renew our CDC Prevention Epicenter, entitled “InterMountain Program in Antibiotic Resistance and microbial Threats (IMPART). Our proposal assembles an exceptional group of investigators who have an extraordinary capacity to conduct large-scale observational studies, as well as lead or co-lead interventional studies that range in scope from small pilots to multi-community randomized trials The University of Utah is the hub for our program, with Intermountain Health, a large regional integrated health system, serving as a major node. The Veterans Affairs (VA) Salt Lake City Healthcare System is another key partner for our Prevention Epicenter site, operating within a programmatic network that encompasses the entire VA health system. The resources that we bring to the CDC Prevention Epicenter Program will be broadly beneficial to its mission to improve healthcare safety and prevent healthcare-associated infection. We have accumulated the experience in translational research and expertise in multi-disciplinary methods to make significant contributions to improve the quality of antibiotic use, combat antibiotic resistance, and enhance health system response to microbial threats across the continuum of care. Moreover, we have developed a computational environment to support comprehensive epidemiological analysis of infections within the Department of Veterans Affairs (VA) Health System, as well as Intermountain Healthcare and University of Utah Health (UHealth). Our proposed research has a high level of significance for policy-making and implementation. Core Project 1 evaluates alternative implementation strategies for outpatient stewardship and advances dissemination of best practices for AS. Core Project 2 tackles a longstanding source of controversy in the healthcare epidemiology community, namely, the role of active surveillance and contact precautions (CP) in preventing healthcare-associated infection due to endemic multi-drug resistant organisms (MDRO) such as methicillin-resistant Staphylococcus aureus (MRSA). A period of partial CP deimplementation in some VA facilities, triggered in response to the emergence of COVID-19, creates the opportunity to study the impact of this natural experiment. Core Project 3 links an epidemiological analysis of transmission pathways in LTC facilities to the development and implementation of novel approaches to improve practice. Core Project 4 confronts the global health challenge of COVID-19, to enhance preparedness for future epidemics and increase understanding of how to control healthcare spread of both seasonal and novel viruses. We are committed to active engagement with other Prevention Epicenter sites on collaborative projects and to work closely with public health entities at national, state, and local levels. We also pledge to contribute to programmatic domains and pathogen-specific workgroups set up under the auspices of the Prevention Epicenter Program. For all of our activities, close alignment with the health priorities of CDC will be established, along with substantial programmatic involvement of CDC staff.