This is the competitiverenewalapplicationfor the CDC """"""""Epi-Centersfor Preventionof Healthcare- AssociatedInfections""""""""grant fromWashingtonUniversitySchoolof Medicine(WUSM) & BJCHealthcare. We have been a CDC Epi-Centerfor the past 8 years.BJCis an integratedhealthcaredeliverysystemwith 12 hospitalsin Missouri& Illinoisincluding2 """"""""US News & World Report"""""""" top 10 hospitals(BarnesJewish Hospital& St. LouisChildrensHospital),3 large communityhospitals,3 smallsuburbanhospitals,4 small ruralhospitals, 6 longtermcare facilities,a dialysisnetwork& an ambulatorysurgery center.The infection controlprogramsof all BJCfacilitiesareintegratedwithcommonpolicies& procedures,surveillance, electronic data repositories&, expertpharmacy& microbiologyinformaticssystems.WUSM & BJC havea longhistorystudyingriskfactors,outcomes,& costsof healthcareassociatedinfections& theyhave developed& implementedmultiplesuccessfulinterventionstoreduceinfectionsindiversehealthcare settings.We proposeto continuetowork collaborativelywithCDC & otherEpi-Centersto performresearch todecreasethe riskof healthcareacquiredinfections,antibioticresistance,& otheradverseevents.
Our Specific Aims are to: 1) Evaluatethe effectivenessof 0.125% chlorhexidinebodywashestoreducemethicillin-resistant Staphylococcus aureus (MRSA) in 2 ICUsperforming activesurveillance for MRSA; 2) Determine the efficacy of academic detailing by a antimicrobial stewardship team to improve antimicrobial use & evaluate a computerized expert system to improve antibiotic use in4 ICUs; 3) Evaluate the accuracy & efficiency of 2 C. difficile-associated disease (CDAD)surveillance methods, ICD-9 codes & electronic microbiology reports, & compare CDAD rates by these methods with traditional infection control surveillance in 4 hospitals; 4) Use real time electronically collected data including type, dose, & timing of surgical prophylactic antibiotics, blood glucose, ICD-9 codes, microbiology & antibiotic data at 3 hospitals to determine compliance v,ith recommendationsfor surgical antibiotic prophylaxis & the effect of noncompliance on surgical site infection (SSI) rates, the incidence of hyperglycemia& its effect on SSI rates, &the accuracy of electronic surveillancecompared to traditional infection control surveillance; and Identify specific including timing failing hospital by performinga prospective case controlstudy of medication use in fallers & non fallers, to guide development 5o)f interventions to dmecerdeiacasetiothnes risk of falltihnegirindhoosesp, irtoaulitze,d&patientsa.ssociated with inthe PFERFO._J,',A,N_SEITE(S) (organ_.a'Jon,citys.tate) Washington University 680 South Euclid Avenue St. Louis, MO 63110 PHS 3.=$(Rev. (3C_'04) Page 2 FormPage 2 P_=""""""""_E'_I'_mat!esSgator,'ProgramDirector(Last, First, Middle): Fraser, Victoria J. I__'-'YPERSO,%.%ELSee L,'_tru_Jens.Use continuabbn pages as needed to provide the requiredinformation in the format shown below. S_ _%_ PrL"""""""",,_'--;Ia,,!west_g3torL.ist another key personnelin alphabeticalorder, last namefirst. N_e eRA CommonsUser Name Organization Roleon Project Fraser, V_ctoriaJ VICKYFRASER WashingtonUniversity PI Babcock, Hilary HILBABCOCK WashingtonUniversity Investigator Camins, Bernard BCAMINS WashingtonUniversity Investigator Coopersmith,Craig COOPERSMITHC WashingtonUniversity Investigator Dubberke, Eric R ERIKDUBBERKE WashingtonUniversity Investigator Elvrard,Alexis ALEXlSELWARD Washington University Investigator Kollef, Marin Washington University Investigator McDonald, Jay Washington University Investigator OIsen, Margaret OLSENM Washington University Investigator Warren, David K DAVIDWARREN Washington University Co-PI Woeltje, Keith KEITHWOELTJE Washington University Investigator OTHER SlG.%"""""""".rC'-Ai NT CO,NTRIBUTORS P_a.,"""""""":'_. Organization Roleon Project Hollenbeak, Christopher PennsylvaniaState University Collaborator Murphy,Denise BJC Healthcare Collaborator Human Embryonic Stem Cells [] No [] Yes If theprop<:_edprojectinvolveshumanembryonicstem cells,list below the registrationnumberofthespecificcellline{s)from the followinglist: h,,'_:llstemcetls nih aov/reoistry/index asp. Use continuationpages as needed. If,as'3e'_'._. c_-""""""""='_be re,'erencedat this;lb'nein. cludea statementhatonefromtheReqistr]/willbeused. CeTIUne Disclosure Permission Statement. Ap_lic._bTteo SBIPJSTrR Only, See instructions.[] Yes [] No PHS 3-=-3(Re,,,.0_3,""""""""_4) Page 3 Form Page 2-continued Numbetrhefoflowingpagesconsecutivetlhyroughout theapplicationD.onotusesuffixesuchas4a.4b. P._.._,._!Invest_jator/ProgramDirector (Last, First, Middle): Fraser, Victoria J Tr,e r.a.,""""""""=ecf t._.eprLn_palinvestigatorlprogram director must be provided at the top of each pnnted pageand each continuation page. RESEARCH GRANT TABLE OF CONTENTS Page Numbers Face Page ....:............................................................................................................................................. 1 Description,

Agency
National Institute of Health (NIH)
Institute
National Center for Infectious Diseases (CID)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01CI000333-03
Application #
7369880
Study Section
Special Emphasis Panel (ZCI1-TYM (10))
Program Officer
Llata, Eloisa
Project Start
2006-02-01
Project End
2011-01-31
Budget Start
2008-03-15
Budget End
2009-03-14
Support Year
3
Fiscal Year
2008
Total Cost
$382,496
Indirect Cost
Name
Washington University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Lin, Michael Y; Woeltje, Keith F; Khan, Yosef M et al. (2014) Multicenter evaluation of computer automated versus traditional surveillance of hospital-acquired bloodstream infections. Infect Control Hosp Epidemiol 35:1483-90
Honda, Hitoshi; Sakurai, Yasuo; Kang, Jong-Hon et al. (2013) Implantable arterial port-related bloodstream infection in patients with primary or metastatic hepatic malignancies. Am J Infect Control 41:930-2
Lankiewicz, Julie D; Yokoe, Deborah S; Olsen, Margaret A et al. (2012) Beyond 30 days: does limiting the duration of surgical site infection follow-up limit detection? Infect Control Hosp Epidemiol 33:202-4
Yokoe, Deborah S; Khan, Yosef; Olsen, Margaret A et al. (2012) Enhanced surgical site infection surveillance following hysterectomy, vascular, and colorectal surgery. Infect Control Hosp Epidemiol 33:768-73
Schwartz, David N; Evans, R Scott; Camins, Bernard C et al. (2011) Deriving measures of intensive care unit antimicrobial use from computerized pharmacy data: methods, validation, and overcoming barriers. Infect Control Hosp Epidemiol 32:472-80
Lanzas, C; Dubberke, E R; Lu, Z et al. (2011) Epidemiological model for Clostridium difficile transmission in healthcare settings. Infect Control Hosp Epidemiol 32:553-61
Honda, Hitoshi; Krauss, Melissa J; Coopersmith, Craig M et al. (2010) Staphylococcus aureus nasal colonization and subsequent infection in intensive care unit patients: does methicillin resistance matter? Infect Control Hosp Epidemiol 31:584-91
Camins, Bernard C; Richmond, Amy M; Dyer, Kathrin L et al. (2010) A crossover intervention trial evaluating the efficacy of a chlorhexidine-impregnated sponge in reducing catheter-related bloodstream infections among patients undergoing hemodialysis. Infect Control Hosp Epidemiol 31:1118-23
Lin, Michael Y; Hota, Bala; Khan, Yosef M et al. (2010) Quality of traditional surveillance for public reporting of nosocomial bloodstream infection rates. JAMA 304:2035-41
Butler, Anne M; Olsen, Margaret A; Merz, Liana R et al. (2010) Attributable costs of enterococcal bloodstream infections in a nonsurgical hospital cohort. Infect Control Hosp Epidemiol 31:28-35

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