This CDC-funded project evaluates new strategies to detect and prevent healthcare-associated infections (HAIs). These strategies include the development of new methods to predict which empirically treated patients are infected with antibiotic-resistant organisms, analyzing the use of statistical tools to limit outbreaks of HAIs, and the development of an electronically-computable surveillance definition for hospital-acquired pneumonia. More details about the Prevention Epicenters Program can be found here. This work will target common, high morbidity, and high cost complications of medical care, including infections caused by methicillin-resistant Staphylococcus aureus, non-ventilator hospital acquired associated pneumonia, and hospital-based outbreaks caused by different pathogens. We have developed an extensive network of partners in academic and community hospitals, nursing homes, outpatient clinics, and microbiology laboratory data systems that represent local, regional, and national collaborations to address both current and future research needs to reduce healthcare associated infections. Highlighted Epicenter projects are included below:
Intensive care units (ICUs) have one of the highest rates of healthcare-associated infections due the patients’ severity of illness and frequent use of medical devices. The previously conducted REDUCE MRSA Trial showed that ICUs using chlorhexidine (CHG) antiseptic for routine daily bathing and mupirocin antibiotic for nasal decolonization of all admissions experienced a significant reduction in (MRSA) clinical cultures and all-cause bloodstream infections. Nasal mupirocin has been shown to be important because CHG does not clear the nasal reservoir of S. aureus, one of the most common and virulent healthcare-associated pathogens.
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Over 36 million patients are hospitalized each year in the U.S. with the expectation of safe medical care. Nevertheless, healthcare-associated infections are a leading cause of preventable morbidity and mortality, and numerous hospital outbreaks are reported each year. The Joint Commission requires hospital infection prevention programs to perform outbreak detection. However, there are no standardized, validated outbreak detection methods or response strategies.
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CDC National Sepsis Survey using EHR Data
Sepsis is a leading cause of death, disability, and cost worldwide. Given sepsis’ high prevalence, it’s devastating morbidity and mortality, and ongoing high profile initiatives to improve sepsis detection and care there is a critical need for better measures of sepsis incidence, trends, and outcomes. The increasing national penetration of electronic health record (EHR) systems allows for the possibility of tracking sepsis using objective clinical markers of infection and organ dysfunction rather than subjective and changing administrative code assignments. The Epicenters developed EHR-based surveillance definitions for sepsis and demonstrated that they have superior sensitivity, similar positive predictive value, and more stable sensitivity over time compared to claims data. In this project, we extended this work by applying these definitions to a broad national network of hospitals in order to generate accurate and generalizable estimates of sepsis burden and epidemiology.
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Principal Investigator: Richard Platt, MD, MSc, Susan Huang, MD, MPH