Selected Research Topics

• Identifying changes in antibiotic resistance and gut microbiome following fecal microbiome transplant
• Understanding the relationship between bacteria normally present in healthy human intestines (gut microbiome) and the spread of antibiotic-resistant bacteria.
• Measuring how the microbiome is changed following antibiotic therapy, and interventions to restore a healthy microbiome.
• Restoring or changing a person’s microbiome as a way to get rid of antibiotic-resistant germs.

Conducting a multicenter study different disinfection strategies on germ spread in and between hospital rooms.

• Conducting a study of use of biomarkers to guide antibiotic use.
• Identifying efficient strategies to track antibiotic use utilizing electronic medical records to allow hospitals to measure the effectiveness antibiotic stewardship.

Prevention Epicenter investigators’ activities have included:

• Measuring the impact of bathing patients with a skin antiseptic on a daily basis to prevent patient-to-patient transmission of MRSA and other germs.
• Studying genomic epidemiology of cross-transmission of KPC-producing Klebsiella pneumoniae in a long-term acute care hospital.
• Studying genomic epidemiology of an early, regional outbreak of KPC-producing Klebsiella pneumoniae.
• Monitoring short- and long-term clinical consequences of acquisition of MRSA in the healthcare setting.
• Identifying efficient methods for identifying MRSA carriers at the time of admission as a means to initiate appropriate infection control precautions more promptly and efficiently.
• Identifying efficient strategies to measure antimicrobial use utilizing electronic records as a means for hospitals to record the effectiveness of efforts to optimize antimicrobial use, which is a major contributor to the spread of multidrug-resistant organisms (MDROs) within healthcare facilities.
• Recognizing factors that contribute to MRSA and VRE transmission within healthcare facilities and identifying previously unrecognized factors can help inform new and more effective prevention strategies.
• Employing electronic monitoring tools to detect increases in MDRO transmission within healthcare facilities.
• Conducting a multicenter, randomized trial that compares three different strategies of preventing MRSA transmission and infection among intensive care unit patients and helps define the role of decolonization strategies in preventing MDRO transmission and infection.
• Studying MRSA transmission between healthcare facilities in a region, which 1) helps define how movement of patients between facilities within a region contributes to the MDRO problem and 2) may lead to novel prevention strategies that are focused not only on individual facilities but across the entire spectrum of healthcare delivery in a region.
• Measuring the impact of state and local government infection control mandates on the rates of MRSA colonization and infection.
• Measuring the burden of Klebsiella pneumoniae Carbapenemase (KPC)-producing Enterobacteriaceae colonization among adult intensive-care unit patients within a 26-hospital regional consortium.
• Measuring the impact of an intervention bundle designed to prevent spread of Klebsiella pneumoniae Carbapenemase (KPC)-producing Enterobacteriaceae in long-term acute care hospitals.

Prevention Epicenter investigators’ activities have included:

• Measuring the impact of bathing of patients with skin antiseptics on a daily basis to prevent BSIs.
• Identifying new methods for detecting BSIs by using electronic data systems, which will improve accuracy of reporting while greatly reducing the personnel time necessary for collecting the data (leaving more time to devote to prevention efforts).
• Gaining a better understanding of BSI burden that is related to healthcare, including a focus on BSIs that do not occur during hospitalization, to develop more comprehensive established prevention strategies.

Prevention Epicenter investigators’ activities have included:

• Improving methods for detecting and measuring SSIs, which will help standardize methods by which hospitals and other surgical settings identify patients who develop infections following surgical procedures, and will deliver inter-facility comparison of SSI rates that will be more meaningful and helpful in measuring the effectiveness of prevention programs within individual facilities.
• Investigating the use of national administrative claims databases in collaboration with the Centers for Medicare and Medicaid Services to create measures that identify hospitals with SSI rates that are unusually high or unusually low, which is helpful in identifying hospitals that may need assistance with their infection prevention programs as well as best practices from hospitals with very low rates.

Prevention Epicenter investigators’ activities have included:

• Identifying more efficient and effective ways to measure adverse effects of mechanical ventilation.
• Conducting a multicenter study of an intervention to decrease adverse effects of mechanical ventilation.

Prevention Epicenter investigators’ activities have included:

• Testing strategies for detecting CDI that minimize the burden of data collection for healthcare personnel and allow measurement of infection rates across a large number of facilities.
• Leading a state-based prevention collaborative involving 61 hospitals in an effort to better define the preventability of CDI and identify effective prevention strategies.

Prevention Epicenter investigators’ activities have included:

• Studying the use of data from electronic medical records to generate automated alerts (for clinicians) that identify patients who may have an unnecessary urinary catheter in place. This methodology could serve as a powerful prevention tool since the single most important strategy for preventing CAUTI is removal of catheters from patients who no longer need them.