Epidemiology of emerging pathogens among hospitalizeds patients

住院患者中新出现病原体的流行病学

• 批准号: 8463959
• 负责人: ANTHONY D HARRIS
• 金额: $ 17.08万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8463959
• 关键词: Accounting; Acinetobacter baumannii; Address; Admission activity; Antibiotic Resistance; Antibiotics; Award; Bacteria; Categories; Centers for Disease Control and Prevention (U.S.); Clinical; Communicable Diseases; Comorbidity; Comparative Genomic Analysis; Control Groups; Data; Disease Outbreaks; Environment; Environmental Pollution; Epidemiologic Methods; Epidemiologic Studies; Epidemiologist; Epidemiology; Event; Floor; Freezing; Frequencies; Funding; Future; Genes; Genetic; Genome; Genomic Islands; Genomics; Goals; Gram-Negative Bacteria; Head; Hospitals; Imipenem; Incidence; Infection; Infection Control; Infectious Agent; Intensive Care Units; Intervention; Intervention Studies; Journals; Knowledge; Laboratories; Lead; Length of Stay; Link; Location; Maryland; Measurement; Medical; Medical center; Methodology; Methods; Minisatellite Repeats; Molecular; Morbidity - disease rate; Mutation; Nature; New England; Nosocomial Infections; Organism; Outcome; Outcome Measure; Outcome Study; Paper; Pathogenicity; Patient Discharge; Patients; Patients' Rooms; Pharmaceutical Preparations; Phenotype; Physicians; Population; Prevalence; Principal Investigator; Process; Property; Pseudomonas aeruginosa; Public Health; Publishing; Pulsed-Field Gel Electrophoresis; Research; Research Personnel; Resistance; Risk Factors; Severity of illness; Site; Specimen; Sputum; State Medicine; Surface; Surgical Intensive Care; Techniques; Time; Universities; Work; base; cohort; comparative genomics; cost effective; design; effective intervention; environmental intervention; epidemiology study; genome analysis; insight; mortality; multidisciplinary; pathogen; population based; prevent; prospective; public health relevance; rectal; relational database; sound; success; transmission process

DESCRIPTION (provided by investigator): Acinetobacter baumannii has emerged from an organism of questionable pathogenicity to an infectious agent of importance to hospitals worldwide causing increased patient morbidity and mortality. The reasons for the emergence of A. baumannii are unknown and no interventions have been successful at curbing this emergence. For these reasons, A. baumannii is a significant public health problem. To our knowledge, no cohort similar to the one described in this application has been created to investigate the epidemiology of A. baumannii. This knowledge is essential in order to develop and implement new, cost-effective infection control strategies aimed at reducing nosocomial infection and the worldwide spread of A. baumannii. The long-term objective of this renewal application is to continue to understand the epidemiology of emergent Gram- negative bacteria and antibiotic-resistant bacteria with a focus in this application on A. baumannii. The aims of this renewal are: Aim 1) Construct a prospective cohort of intensive care unit (ICU) patients to quantify the proportion of A. baumannii acquisition that is attributable to patient-to-patient transmission. Aim 2) Culture several environmental sites in the hospital rooms of patients colonized and infected with A. baumannii to determine sites of frequent contamination and determine whether terminal cleaning between patients is effective. Aim 3) Identify potential genetic factors that contribute to high transmissibility of A. baumannii using genomic sequencing and comparative genomic techniques. This application is a competitive renewal of an ongoing ICU cohort. The cohort consists of patients admitted to the ICU who have peri-rectal surveillance cultures obtained. The peri-rectal cultures can be used to analyze in a retrospective fashion many bacterial species. The peri-rectal cultures are linked to demographic, comorbidity, laboratory, and medication data that are contained in a relational database. Thus the cohort serves as a rich mechanism of understanding the epidemiology of a number of different emerging bacteria and hospital pathogens.

描述（由研究者提供）：鲍曼不动杆菌已从一种致病性可疑的生物体发展成为对全世界医院具有重要意义的传染原，导致患者发病率和死亡率增加。鲍曼不动杆菌出现的原因尚不清楚，并且没有任何干预措施能够成功遏制这种出现。由于这些原因，鲍曼不动杆菌是一个重大的公共卫生问题。据我们所知，尚未创建与本申请中描述的队列类似的队列来研究鲍曼不动杆菌的流行病学。这些知识对于制定和实施旨在减少医院感染和鲍曼不动杆菌在全球范围内传播的新的、具有成本效益的感染控制策略至关重要。此更新应用程序的长期目标是继续了解新出现的革兰氏阴性细菌和抗生素耐药细菌的流行病学，重点是鲍曼不动杆菌。此次更新的目的是： 目标 1) 构建重症监护病房 (ICU) 患者的前瞻性队列，以量化可归因于患者间传播的鲍曼不动杆菌感染比例。目标2）对鲍曼不动杆菌定植和感染的患者病房内的几个环境位点进行培养，以确定频繁污染的位点并确定患者之间的最终清洁是否有效。目标 3) 使用基因组测序和比较基因组技术鉴定导致鲍曼不动杆菌高传播性的潜在遗传因素。该应用程序是对正在进行的 ICU 队列的竞争性更新。该队列由入住 ICU 并获得直肠周围监测培养物的患者组成。直肠周围培养物可用于回顾性分析许多细菌种类。直肠周围培养物与关系数据库中包含的人口统计、合并症、实验室和药物数据相关联。因此，该队列可以作为了解许多不同的新兴细菌和医院病原体的流行病学的丰富机制。

项目成果

Environmental contamination because of multidrug-resistant Acinetobacter baumannii surrounding colonized or infected patients.

定植或感染患者周围的多重耐药鲍曼不动杆菌造成环境污染。

• DOI: 10.1016/j.ajic.2010.09.005
• 发表时间: 2011-11
• 期刊: American journal of infection control
• 影响因子: 4.9
• 作者: Thom KA;Johnson JK;Lee MS;Harris AD
• 通讯作者: Harris AD

Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers.

医护人员的手术衣和手套上检测出耐甲氧西林金黄色葡萄球菌和耐万古霉素肠球菌。

• 发表时间: 2008-07
• 影响因子: 4.5
• 作者: Snyder, Graham M;Thom, Kerri A;Furuno, Jon P;Perencevich, Eli N;Roghmann, Mary;Strauss, Sandra M;Netzer, Giora;Harris, Anthony D
• 通讯作者: Harris, Anthony D

Predictive ability of positive clinical culture results and International Classification of Diseases, Ninth Revision, to identify and classify noninvasive Staphylococcus aureus infections: a validation study.

阳性临床培养结果和国际疾病分类第九版的预测能力，以识别和分类非侵入性金黄色葡萄球菌感染：一项验证研究。

• 发表时间: 2010-07
• 影响因子: 4.5
• 作者: Tracy, LaRee A;Furuno, Jon P;Harris, Anthony D;Singer, Mary;Langenberg, Patricia;Roghmann, Mary
• 通讯作者: Roghmann, Mary

Community-associated methicillin-resistant Staphylococcus aureus prevalence: how common is it? A methodological comparison of prevalence ascertainment.

社区相关的耐甲氧西林金黄色葡萄球菌患病率：有多常见？

• 发表时间: 2007-08
• 影响因子: 4.9
• 作者: Furuya, E Yoko;Cook, Heather A;Lee, Mei;Miller, Maureen;Larson, Elaine;Hyman, Sandra;Della;Mendonca, Eneida A;Lowy, Franklin D
• 通讯作者: Lowy, Franklin D

Genome sequence of Klebsiella oxytoca 11492-1, a nosocomial isolate possessing a FOX-5 AmpC ýý-lactamase.

产酸克雷伯氏菌 11492-1 的基因组序列，这是一种拥有 FOX-5 AmpC γ-内酰胺酶的医院分离株。

• 发表时间: 2012-06
• 影响因子: 3.2
• 作者: Hazen, Tracy H;Robinson, Gwen L;Harris, Anthony D;Rasko, David A;Johnson, J Kristie
• 通讯作者: Johnson, J Kristie