Midwest Virtual Laboratory of Pathogen Transmission in Healthcare Settings (MVL-PATHS)

中西部医疗机构病原体传播虚拟实验室（MVL-PATHS） 项目摘要 耐药性（AMR）病原体已成为一个重大的公共卫生威胁。此外，COVID-19 这场大流行进一步揭示了医疗保健环境中的差异。通过开发和实施新的 数学和计算模型，长期目标是优化AMR控制和预防 干预措施，提高卫生公平性。中心假设是，数学和 计算模型将提供优化和有效的指导方针，以减少AMR病原体传播的威胁 并减少医疗机构中的健康差距。该项目的基本原理是填补 为劳动力能力建模，并为医疗保健研究开发新一代数学模型。的 中心假设将通过追求三个具体目标来测试，即开发和采用：（i）一个健康模型 了解AMR肠杆菌科的来源、分布和传播的方法，重点是扩展- 产超广谱β-内酰胺酶（ESBL）E.大肠杆菌，（ii）一种新的实时建模方法，以确定AMR 无症状传播者和医院中受污染的医疗设备的病原体传播，（iii）一种新的 基于代理的嵌套建模方法，以确定照顾者作为疾病传播媒介的影响， 有限的工作人员和专业护理对养老院护理质量的影响。我们将努力实现这些目标 使用数学和计算建模技术的创新组合。这些包括 最近开发的技术，包括人类行为的模型和更成熟的技术， 应用于健康公平性和AMR病原体传播的研究很少。劳动力发展 这项建议的目的是（一）提高数学和计算建模的研究能力， 公共卫生劳动力和（ii）增加受过培训的初级建模专业人员的数量， 在模拟医疗机构中病原体传播方面经验丰富，部分与健康差异有关。 这项工作的预期成果是成功培训五名博士前研究员，并建立一个虚拟的 增强数学模型的实验室，以确定减少AMR病原体传播威胁的策略 减少健康差距。结果将立即产生重要的积极影响，因为虚拟 医疗保健专业人员也可以使用实验室来进一步调查疾病传播的驱动因素， 以及时和具有成本效益的方式估计多种控制和预防战略的相对效益。在 此外，该项目的研究成果将扩大和加强国家一级的卫生工作， 耐药性，并将直接影响疾病预防控制中心及其公共卫生合作伙伴的能力，以减少成本，发病率 和与医疗相关的感染的死亡率。

Midwest Virtual Laboratory of Pathogen Transmission in Healthcare Settings (MVL-PATHS) Project Summary Antimicrobial Resistant (AMR) pathogens have become a significant public health threat. Also, the COVID-19 pandemic has further revealed disparities in healthcare settings. By developing and implementing novel mathematical and computation models, the long-term goals are to optimize AMR control and preventive interventions and to improve the health equity. The central hypothesis is that the outputs of mathematical and computation models will provide optimized and effective guidelines to reduce the threat of AMR pathogen spread and reduce health disparities in healthcare settings. The rationale underlying this project is to fill the critical gap in modeling workforce capacity and develop a new generation of mathematical models for healthcare research. The central hypothesis will be tested by pursuing three specific aims to develop and employ a, (i) One Health modeling approach to understand the source, distribution and spread of AMR Enterobacteriaceae with a focus on Extended- spectrum beta-lactamase (ESBL)-producing E. coli, (ii) a novel Real-Time modeling approach to identify AMR pathogen transmission by asymptomatic spreaders and contaminated medical devices in hospitals, (iii) a novel Agent-Based Nested modeling approach to identify the effects of caregivers as vectors of disease spread, and effects of limited staffing and specialized care on equitable quality of care in nursing homes. We will pursue these aims using an innovative combination of mathematical and computational modeling techniques. These include both recently developed techniques of including human behavior in models and more-established techniques that have been applied very little to the study of health equity and AMR pathogen spread. The workforce development objectives of this proposal are to (i) enhance mathematical and computational modeling research capabilities of the public health workforce and (ii) increase the number of junior modeling professionals that are trained and experienced in modeling transmission of pathogens in healthcare settings partly incorporated with health disparities. The expected outcomes of this work are the successful training of five predoctoral fellows and creating a virtual laboratory of enhanced mathematical models to identify strategies for reducing the threat AMR pathogen spread and reducing health disparities. The results will have an important positive impact immediately because the virtual laboratory can also be used by healthcare professionals to further investigate the drivers of disease spread and estimate the relative benefits of multiple control and prevention strategies in a timely and cost-effective manner. In addition, the research outputs of this project will expand and strengthen national one-health efforts to combat resistance and will have a direct impact on CDC and its public health partners’ ability to reduce the costs, morbidity and mortality of healthcare associated infections.