Hospital-Associated Respiratory Virus Infections: Molecular Epidemiology, Clinical Outcomes, and Cost-Effectiveness of Interventions

医院相关呼吸道病毒感染：分子流行病学、临床结果和干预措施的成本效益

• 批准号: 10553208
• 负责人: Joshua Glenn Petrie
• 金额: $ 10.62万
• 依托单位: MARSHFIELD CLINIC RESEARCH FOUNDATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-01-02 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10553208
• 关键词: Acute; Adult; Bioinformatics; Categories; Clinical; Cost Effectiveness Analysis; Dangerousness; Data; Development; Diagnosis; Diagnostic; Diagnostic tests; Disease Outbreaks; Doctor of Philosophy; Effectiveness of Interventions; Epidemiologic Methods; Epidemiology; Etiology; Future; Goals; Health Benefit; Health Care Costs; Healthcare; Hospitalization; Hospitals; Incidence; Infection; Infection Control; Infection prevention; Influenza; Intervention; Intervention Studies; Knowledge; Laboratories; Lead; Measures; Mentors; Methodology; Methods; Michigan; Mission; Modeling; Molecular; Molecular Epidemiology; Morbidity - disease rate; National Institute of Allergy and Infectious Disease; Outcome; Outcomes Research; Patient-Focused Outcomes; Patients; Prevention; Prevention strategy; Productivity; Public Health; Research; Research Personnel; Savings; Sensitivity and Specificity; Specimen; Techniques; Technology; Testing; Time; Training; Universities; Viral; Virus; Virus Diseases; Work; advanced analytics; career; career development; case control; clinical epidemiology; community burden; community setting; cost; cost effective; cost effectiveness; epidemiology study; flu transmission; health care settings; implementation intervention; implementation strategy; improved; infection burden; innovation; mathematical model; molecular diagnostics; mortality; multidisciplinary; next generation sequencing; novel; pathogen; pediatric patients; prevent; programs; respiratory; respiratory infection virus; respiratory virus; screening; skills; transmission process; viral transmission; whole genome

PROJECT SUMMARY / ABSTRACT Hospital-associated respiratory virus infections (HA-RVI) lead to increased morbidity, mortality, and healthcare costs, but these infections are often under- or misdiagnosed particularly for respiratory viruses other than influenza. HA-RVI are preventable through appropriate treatment and infection control measures, but incomplete diagnosis leads to missed opportunities for intervention. Taking advantage of these opportunities for intervention might require additional diagnostic testing and expanded infection control measures. The degree to which these approaches would be cost-effective is unclear. Therefore, there is a need to define the burden and clinical impact of respiratory viruses in the hospital setting to inform optimal diagnostic, treatment and infection prevention strategies. The overall objective of this project is to support Josh Petrie, PhD in the development of expertise in healthcare epidemiology, state-of-the-art molecular methods, and advanced modeling techniques. This objective will be completed through focused training and career development activities in healthcare epidemiology, next generation sequencing, bioinformatics, cost-effectiveness analysis, and mathematical modeling that is overseen by an excellent team of mentors. The skills developed by the training and career development objectives will be strengthened by mentored research to accomplish the following Specific Aims: (1) Define the epidemiology and burden of community-acquired and hospital- associated respiratory virus infections and compare clinical impact by viral species; (2) Improve the sensitivity and specificity of case definitions to identify hospital-associated influenza cases by integrating clinical, epidemiologic, and molecular data; and (3) Determine the cost-effectiveness of increased respiratory virus screening and expanded infection control measures to reduce HA-RVI using mathematical models. Completion of the training and research programs will represent the next step on Dr. Petrie's path toward achieving his long term goal of establishing an independent research program that uses multidisciplinary laboratory and analytic methodologies to investigate the transmission of influenza and other respiratory viruses. The expected research outcomes of the proposed project are, 1) identification of respiratory viruses that, in addition to influenza, are responsible for the greatest number of HA-RVI and result in the most severe clinical outcomes; 2) development of methodology for improved identification of HA-RVI through integration of clinical, epidemiologic, and molecular data; and 3) determination of cost-effective diagnostic testing and intervention implementation strategies for HA-RVI prevention. The proposed research is significant because it is expected that the outcomes of this work and future studies that build upon it, will lead to reductions in morbidity, mortality, and healthcare costs associated with HA-RVI. This research is innovative both in its focus on a large panel of important respiratory viruses and its use of cross-disciplinary methodology that allows for new avenues of research.

项目摘要 /摘要 与医院相关的呼吸道病毒感染（HA-RVI）导致发病率，死亡率和医疗保健增加 成本，但是这些感染通常不足或误诊，特别是针对呼吸道病毒 流感。可以通过适当的治疗和感染控制措施来预防HA-RVI，但 诊断不完整会导致干预的机会。利用这些机会 为了干预，可能需要进行其他诊断测试和扩大感染控制措施。这 这些方法将具有成本效益的程度尚不清楚。因此，有必要定义 呼吸道病毒在医院环境中的负担和临床影响，以告知最佳诊断，治疗 和预防感染策略。该项目的总体目标是支持Josh Petrie博士 发展医疗保健流行病学，最先进的分子方法和先进的专业知识 建模技术。该目标将通过重点培训和职业发展完成 医疗保健流行病学的活动，下一代测序，生物信息学，成本效益分析， 和数学建模由一群出色的导师团队监督。由 培训和职业发展目标将通过指导的研究来增强 以下具体目的：（1）定义社区经验和医院的流行病学和负担 相关的呼吸病毒感染并比较病毒物种的临床影响； （2）提高灵敏度 案例定义的特异性，通过整合临床，鉴定与医院相关的流感病例， 流行病学和分子数据； （3）确定增加呼吸道病毒的成本效益 使用数学模型筛选和扩大感染控制措施，以减少HA-RVI。完成 培训和研究计划将代表彼得里博士实现他的道路的下一步 建立使用多学科实验室和的独立研究计划的长期目标 研究流感和其他呼吸道病毒传播的分析方法。预期 拟议项目的研究结果是：1）识别呼吸道病毒，除了 流感，负责最大数量的HA-RVI，并导致最严重的临床结果； 2）通过整合临床，开发方法来改善HA-RVI的识别， 流行病学和分子数据； 3）确定具有成本效益的诊断测试和干预 HA-RVI预防的实施策略。拟议的研究很重要，因为这是预期的 这项工作和未来研究的结果将导致发病率的降低， 死亡率和与HA-RVI相关的医疗费用。这项研究具有创新性，重点是 重要的呼吸病毒小组及其使用跨学科方法论，该方法允许新的 研究途径。

项目成果

The variant-specific burden of SARS-CoV-2 in Michigan: March 2020 through November 2021.

• DOI: 10.1002/jmv.27982
• 发表时间: 2022-11
• 期刊: JOURNAL OF MEDICAL VIROLOGY
• 影响因子: 12.7
• 作者: Petrie, Joshua G.;Eisenberg, Marisa C.;Lauring, Adam S.;Gilbert, Julie;Harrison, Samantha M.;DeJonge, Peter M.;Martin, Emily T.
• 通讯作者: Martin, Emily T.

Improving antibiotic use for sinusitis and upper respiratory tract infections: A virtual-visit antibiotic stewardship initiative.

改善鼻窦炎和上呼吸道感染的抗生素使用：虚拟访问抗生素管理计划。

• DOI: 10.1017/ice.2022.19
• 发表时间: 2022
• 期刊: Infection control and hospital epidemiology
• 影响因子: 4.5
• 作者: Wasylyshyn,AnastasiaI;Kaye,KeithS;Chen,Julia;Haddad,Haley;Nagel,Jerod;Petrie,JoshuaG;Gandhi,TejalN;Petty,LindsayA
• 通讯作者: Petty,LindsayA

Investigating Epidemiologic and Molecular Links Between Patients With Community- and Hospital-Acquired Influenza A: 2017-2018 and 2019-2020, Michigan.

• DOI: 10.1093/ofid/ofad061
• 发表时间: 2023-02
• 期刊: OPEN FORUM INFECTIOUS DISEASES
• 影响因子: 4.2
• 作者: Wan, Tiffany;Lauring, Adam S.;Valesano, Andrew L.;Fitzsimmons, William J.;Bendall, Emily E.;Kaye, Keith S.;Petrie, Joshua G.
• 通讯作者: Petrie, Joshua G.

Severe Acute Respiratory Syndrome Coronavirus 2 Total and Subgenomic RNA Viral Load in Hospitalized Patients.

• DOI: 10.1093/infdis/jiab215
• 发表时间: 2021-10-28
• 期刊: The Journal of infectious diseases
• 作者: Dimcheff DE;Valesano AL;Rumfelt KE;Fitzsimmons WJ;Blair C;Mirabelli C;Petrie JG;Martin ET;Bhambhani C;Tewari M;Lauring AS
• 通讯作者: Lauring AS

Health Care-Acquired Viral Respiratory Diseases.

• DOI: 10.1016/j.idc.2021.07.007
• 发表时间: 2021-12
• 期刊: INFECTIOUS DISEASE CLINICS OF NORTH AMERICA
• 影响因子: 4.4
• 作者: Petrie, Joshua G.;Talbot, Thomas R.
• 通讯作者: Talbot, Thomas R.