Epicenter IV: Harvard Pilgrim-UCI Center for HAI Prevention

震中 IV：哈佛 Pilgrim-UCI 医院感染预防中心

• 批准号: 9206710
• 负责人: Susan S. Huang
• 金额: $ 520万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9206710
• 关键词: Epicenter; IV; Harvard; Pilgrim; UCI

Abstract - Epicenter IV: Harvard Pilgrim-UCI Center for HAI Prevention (Core) We propose five core aims evaluating novel (T0-T1) strategies to detect and prevent healthcare- associated infections and the emergence of antibiotic resistance among healthcare-associated pathogens. These aims have high potential to lead to improvements in health outcomes, take advantage of prior work in these domains, and strengthen our infrastructure to respond to new topics CDC may ask the Epicenters to address. Projects covered include the following: 1) Detecting hospital outbreaks using statistical software to evaluate whether the benefit observed from universal decolonization ICUs was mediated by prevention of clusters. This T1 work will involve a secondary analysis of the completed REDUCE MRSA Trial. Two projects deal with prevention of antibiotic resistance: 2) Evaluating the impact of substituting nasal iodophor for mupirocin when paired with chlorhexidine for ICU universal decolonization. The Mupirocin-Iodophor Swapout trial will be a 120 hospital T2 cluster-randomized trial assessing the non-inferiority of iodophor on S. aureus clinical cultures and all-pathogen bloodstream infections. It will assess whether nasal antiseptics can mitigate the emergence of resistance seen with mupirocin use. 3) Re-engineering the hospital antibiogram to provide treating physicians with the likelihood that patient's pneumonia or a urinary tract infection is due to a multi-drug resistant pathogen. This T1 study will create a novel antibiogram that could aid empiric antibiotic selection and prevent extended spectrum antibiotics from being unnecessarily prescribed. Two final projects involve the development or improvement of national metrics for serious inpatient diseases. 4) Assessing the impact of nationally reported compliance with sepsis bundles on patient outcomes. This T0 work will critically evaluate metrics to prevent adverse outcomes associated with sepsis. 5) Developing an objective surveillance definition for non-ventilator hospital-acquired pneumonia. This T0 work will leverage our experience re-defining national metrics for ventilator-associated pneumonia and will similarly align explicit, computable definitions with clinical outcomes.

摘要 - Epicenter IV：Harvard Pilgrim-UCI 医院感染预防中心（核心） 我们提出了五个核心目标，评估检测和预防医疗保健的新颖 (T0-T1) 策略 - 相关感染以及医疗保健相关病原体中抗生素耐药性的出现。 这些目标很有可能改善健康结果，利用之前的工作 这些领域，并加强我们的基础设施以应对疾病预防控制中心可能要求震中的新主题 地址。涵盖的项目包括以下内容： 1) 使用统计软件检测医院疫情， 评估从普遍的非殖民化 ICU 中观察到的益处是否是通过预防来介导的 集群。这项 T1 工作将涉及对已完成的 REDUCE MRSA 试验进行二次分析。两个项目 处理抗生素耐药性的预防：2）评估替代鼻用碘伏的影响 莫匹罗星与氯己定配合用于 ICU 普遍去定植。莫匹罗星碘伏 Swapout 试验将是一项 120 家医院 T2 整群随机试验，评估碘伏对金黄色葡萄球菌的非劣效性。 金黄色葡萄球菌临床培养和全病原体血流感染。它将评估鼻腔消毒剂是否可以 减轻莫匹罗星使用时出现的耐药性的出现。 3）重新设计医院抗菌谱 向治疗医生提供患者肺炎或尿路感染是由于以下原因引起的可能性 多重耐药病原体。这项 T1 研究将创建一种新的抗菌谱，有助于经验性抗生素的使用 选择并防止不必要地使用广谱抗生素。两个最终项目 涉及制定或改进严重住院疾病的国家指标。 4）评估 全国报告的脓毒症捆绑治疗依从性对患者预后的影响。这部T0作品将 严格评估指标以预防与脓毒症相关的不良后果。 5）制定目标 非呼吸机医院获得性肺炎的监测定义。这项 T0 工作将利用我们的 经验重新定义呼吸机相关肺炎的国家指标，并将类似地调整明确的、 具有临床结果的可计算定义。