Extra-nasal Colonization and Epidemiology of Community-Associated MRSA

社区相关 MRSA 的鼻外定植和流行病学

• 批准号: 8441538
• 负责人: Kyle Jeanne Popovich
• 金额: $ 12.94万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8441538
• 关键词: Admission activity; Adult; Affect; Age; Age-Years; Anterior nares; Award; Biometry; Centers for Disease Control and Prevention (U.S.); Chicago; Clinical; Clinical Investigator; Clinical Microbiology; Communicable Diseases; Communities; Community Hospitals; Computational algorithm; County; County Hospitals; Development; Disease; Environment; Epidemic; Epidemiologic Studies; Epidemiologist; Epidemiology; Funding; Future; Gel; Goals; HIV; Health; Health care facility; Healthcare; High Prevalence; Hospitals; Illinois; Individual; Infection; Infection Control; Infection prevention; Integration Host Factors; International; Intervention Studies; Investigation; Knowledge; Lead; Manuscripts; Master of Science; Medicine; Mentors; Mentorship; Michigan; Monobactams; Nature; Nose; Nosocomial Infections; Oral; Pathogenesis; Patients; Pattern; Peer Review; Physiologic pulse; Play; Pneumonia; Policies; Population; Prevalence; Prevention; Prevention Measures; Prevention strategy; Preventive Intervention; Public Health Schools; Publishing; Relative (related person); Research; Research Infrastructure; Research Methodology; Research Personnel; Resistance; Resources; Role; Sepsis; Site; Staphylococcus aureus; System; Testing; Universities; Virulence Factors; Work; abstracting; base; career; career development; cohort; cooking; demographics; editorial; electronic data; epidemiologic data; experience; instructor; interdisciplinary approach; interest; meetings; member; methicillin resistant Staphylococcus aureus; patient population; professor; research and development; skills; surveillance strategy; transmission process; young adult

DESCRIPTION (provided by applicant): Dr. Kyle Popovich, Clinical Instructor in the Department of Medicine at Rush University (RUMC), seeks support for research and career development to establish a career as an independent clinical investigator in the field of hospital epidemiology. Her research interest is community-associated methicillin-resistant S.aureus (CA-MRSA); she has been the first author on 4 peer-reviewed manuscripts, has published 2 review articles and co-authored and been the sole author of 2 editorials on CA-MRSA, and has presented 6 abstracts of her work in oral scientific sessions at national meetings. Dr. Popovich will work under the mentorship of Dr. Robert Weinstein, an international leader in healthcare epidemiology; Mary Hayden, MD (co-mentor), Director, Division of Clinical Microbiology, RUMC and an accomplished researcher in hospital epidemiology; and Dr. Bala Hota (co-mentor), an investigator with expertise in biostatistics and computer algorithms for infection surveillance. In addition to this core interdisciplinary mentorship team, 4 advisory members will critically evaluate research and career development-Dr. Scott Fridkin of the CDC; Dr. Sharon Welbel, Hospital Epidemiologist in the Cook County Health and Hospitals System; Dr. Carol Kauffman, Professor of Medicine (Infectious Diseases), University of Michigan; and Dr. Gordon Trenholme, Director, Section of Infectious Diseases, RUMC. Dr. Popovich is acquiring new skills in research methodology and biostatistics by currently taking classes toward a Masters of Science in Epidemiology at the University of Illinois at Chicago, School of Public Health. She is working in a well-funded, nurturing environment that has produced major epidemiologic and intervention studies of healthcare-associated infections. The strong existing infrastructure for collaborative research between Cook County Hospital and RUMC and the interdisciplinary approach of Dr. Popovich's proposal will allow her to develop the essential skills and experience needed to become an independent researcher capable of applying for an R-01 at the end of the award period. In prior studies, Dr. Popovich demonstrated that CA-MRSA strains are replacing traditional hospital MRSA strains as causes of nosocomial infection. The CA-MRSA epidemic is currently disproportionately affecting particular patient populations (e.g., younger adults). This proposal is an extension of this and has 2 aims: (1) determine the extent to which CA-MRSA strains colonize extra-nasal sites and (2) determine the extent to which exclusive extra-nasal CA-MRSA colonization occurs among patients age = 30. Hypotheses are: (1) prevalence of extra-nasal colonization with CA-MRSA strains is higher than that of non-CA-MRSA strains and (2) a cohort of patients age = 30 will have a 3.5 fold greater prevalence of extra-nasal CA-MRSA colonization in comparison to a patients age>30. To test these hypotheses, colonization surveillance and an established electronic data warehouse will be used. Findings will inform a future project (R-01) examining the origin of CA-MRSA strains causing nosocomial infections and testing infection prevention strategies for reducing spread of the CA-MRSA epidemic. Relevance: While originally affecting individuals without prior healthcare exposures, the community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) epidemic has emerged as a cause of invasive infection in the hospital, with particular populations being disproportionately affected. The goal of this project is to further characterize the epidemiology and colonizaiton dynamics of CA-MRSA strains in order develop and test prevention strategies in hospital settings.

描述（由申请人提供）：Kyle Popovich 博士是拉什大学 (RUMC) 医学系的临床讲师，寻求研究和职业发展支持，以建立医院流行病学领域独立临床研究者的职业生涯。她的研究兴趣是社区相关的耐甲氧西林金黄色葡萄球菌（CA-MRSA）；她是 4 篇同行评审手稿的第一作者，发表了 2 篇评论文章，并作为共同作者和唯一作者发表了 2 篇有关 CA-MRSA 的社论，并在全国会议的口头科学会议上提出了 6 份工作摘要。波波维奇博士将在医疗保健流行病学国际领军人物罗伯特·韦恩斯坦博士的指导下工作； Mary Hayden，医学博士（联合导师），RUMC 临床微生物学部主任，也是一位出色的医院流行病学研究员； Bala Hota 博士（共同导师）是一位在生物统计学和感染监测计算机算法方面拥有专业知识的调查员。除了这个核心的跨学科导师团队之外，还有 4 名顾问成员将批判性地评估研究和职业发展——Dr.美国疾病控制和预防中心 (CDC) 的斯科特·弗里德金 (Scott Fridkin)； Sharon Welbel 博士，库克县卫生和医院系统医院流行病学家；卡罗尔·考夫曼 (Carol Kauffman) 博士，密歇根大学医学教授（传染病）；以及 RUMC 传染病科主任 Gordon Trenholme 博士。波波维奇博士目前正在伊利诺伊大学芝加哥分校公共卫生学院攻读流行病学理学硕士学位，正在学习研究方法和生物统计学方面的新技能。她在一个资金充足、培育良好的环境中工作，该环境已经开展了有关医疗保健相关感染的主要流行病学和干预研究。库克县医院和 RUMC 之间强大的现有合作研究基础设施以及波波维奇博士提议的跨学科方法将使她能够发展成为一名能够在年底申请 R-01 的独立研究员所需的基本技能和经验。奖励期限。在之前的研究中，Popovich 博士证明 CA-MRSA 菌株正在取代传统的医院 MRSA 菌株，成为医院感染的原因。 CA-MRSA 流行病目前对特定患者群体（例如年轻人）的影响尤为严重。该提案是对此的延伸，有 2 个目标：(1) 确定 CA-MRSA 菌株在鼻外部位定植的程度；(2) 确定年龄患者中唯一鼻外 CA-MRSA 定植的程度= 30。假设是：(1) CA-MRSA 菌株鼻外定植率高于非 CA-MRSA 菌株，(2) 一组年龄 = 30 岁的患者将出现与年龄 > 30 岁的患者相比，鼻外 CA-MRSA 定植率高出 3.5 倍。为了检验这些假设，将使用殖民监测和已建立的电子数据仓库。研究结果将为未来的项目（R-01）提供信息，该项目检查引起医院感染的 CA-MRSA 菌株的起源，并测试减少 CA-MRSA 流行病传播的感染预防策略。 相关性：社区相关的耐甲氧西林金黄色葡萄球菌 (CA-MRSA) 流行病最初影响的是未曾接受过医疗保健的个人，但现已成为医院侵袭性感染的一个原因，特别是特定人群受到的影响尤为严重。该项目的目标是进一步表征 CA-MRSA 菌株的流行病学和定植动态，以便在医院环境中制定和测试预防策略。