The candidate's career objective is to develop a nationally and internationally known program in `Infection Prevention in Aging'. The candidate will achieve this objective by conducting patient-oriented research that improves outcomes from infectious diseases and reduces antimicrobial resistance in a vulnerable older population and by training a multidisciplinary group of students, residents, fellows, nurse investigators and junior faculty who wish to conduct patient-oriented and outcomes research in infection prevention. The majority of the candidate's professional life has been dedicated to the conduct of patient-oriented research in infection prevention, establish a steady stream of research funding and organize numerous career-development programs in aging research nationally. Translation of research findings into clinical practice, particularly in nursing homes, is challenging. Frail olde adults who receive care in institutional settings are a particularly high risk of poor outcomes. Training a multidisciplinary group of junior investigators is key to design evidence-based randomized studies to test innovative models and practices that reduce infections and antimicrobial resistance in nursing homes. Thus, the overall aims of this proposal are:
Aim 1 : To enhance the candidate's capacity to effectively mentor a multi-disciplinary group of mentees in patient-oriented research by bridging basic science, clinical and community-based participatory research programs Aim 2: To expand the candidate's clinical research program `Infection Prevention in Aging' in directions that create new and innovative opportunities for her and her mentees The candidate's research brings together expertise in geriatrics and aging research, microbiology and infectious diseases, epidemiology, outcomes research, nursing and others. Her work on reducing infections and antimicrobial resistance in vulnerable populations grows out of work originally funded by NIA, AHRQ, T. Franklin Williams Scholarship (now known as GEMSSTAR) and the Hartford foundation. Three federally funded grants will serve as the platform for this grant proposal: an NIA funded RO1 grant: Targeted Infection Control Program (TIP) to reduce antimicrobial resistance and infections in Nursing Homes, NIA funded concurrent RO1: Pathway from functional disability to antimicrobial resistance in Nursing Homes and an AHRQ award: `AHRQ Safety Program for long-term care: CAUTI'. These federally funded studies have created rich datasets and banked microbes that will be utilized to train mentees in patient-oriented research with extensions to molecular epidemiology and community-based participatory research. Resources supporting the training and development include the MICHR, University of Michigan Pepper Center, UM School of Public Health, UM Patient Safety Enhancement Program (PSEP), and UM Host Microbiome Initiative.

Public Health Relevance

Infections and antimicrobial resistance is common in institutionalized elderly population and often leads to poor outcomes. There is a paucity of trained researchers who can conduct patient-oriented research to inform policy, practice and outcomes in this setting. The overarching goal of this proposal is to train the next generation of multidisciplinary group of researchers who will advance the field of infection prevention in older adults and make healthcare safer. The widespread impact of this research will be in designing effective, efficient, and targeted infection control programs for frail older adults. We expect our results to shift the evolving paradigm of infection control and prevention in long-term care institutions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AG050685-03
Application #
9232068
Study Section
Clinical Aging Review Committee (NIA-C)
Program Officer
Salive, Marcel
Project Start
2015-08-01
Project End
2020-03-31
Budget Start
2017-04-01
Budget End
2018-03-31
Support Year
3
Fiscal Year
2017
Total Cost
$169,809
Indirect Cost
$12,578
Name
University of Michigan Ann Arbor
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Eke-Usim, Angela C; Rogers, Mary A M; Gibson, Kristen E et al. (2016) Constitutional Symptoms Trigger Diagnostic Testing Before Antibiotic Prescribing in High-Risk Nursing Home Residents. J Am Geriatr Soc 64:1975-1980
Ismail, Miriam D; Luo, Ting; McNamara, Sara et al. (2016) Long-Term Carriage of Ciprofloxacin-Resistant Escherichia coli Isolates in High-Risk Nursing Home Residents. Infect Control Hosp Epidemiol 37:440-7
Koo, Evonne; McNamara, Sara; Lansing, Bonnie et al. (2016) Making infection prevention education interactive can enhance knowledge and improve outcomes: Results from the Targeted Infection Prevention (TIP) Study. Am J Infect Control 44:1241-1246
Min, Lillian; Galecki, Andrzej; Mody, Lona (2015) Functional disability and nursing resource use are predictive of antimicrobial resistance in nursing homes. J Am Geriatr Soc 63:659-66
Manu, Erika R; Mody, Lona; McNamara, Sara E et al. (2015) Advance Directives and Care Received by Older Nursing Home Residents. Am J Hosp Palliat Care :
Mody, Lona; Crnich, Christopher (2015) Effects of Excessive Antibiotic Use in Nursing Homes. JAMA Intern Med 175:1339-41
Chopra, Vineet; Montoya, Ana; Joshi, Darius et al. (2015) Peripherally Inserted Central Catheter Use in Skilled Nursing Facilities: A Pilot Study. J Am Geriatr Soc 63:1894-9
Crnich, Christopher J; Jump, Robin; Trautner, Barbara et al. (2015) Optimizing Antibiotic Stewardship in Nursing Homes: A Narrative Review and Recommendations for Improvement. Drugs Aging 32:699-716
Cassone, Marco; Mody, Lona (2015) Colonization with Multi-Drug Resistant Organisms in Nursing Homes: Scope, Importance, and Management. Curr Geriatr Rep 4:87-95
Mody, Lona; Gibson, Kristen E; Horcher, Amanda et al. (2015) Prevalence of and risk factors for multidrug-resistant Acinetobacter baumannii colonization among high-risk nursing home residents. Infect Control Hosp Epidemiol 36:1155-62

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