The overall purpose of this award application is to support the patient-oriented research program and career development of a beginning clinical investigator in hospital-acquired infections in the elderly. Long-term objective: Elderly (> 65 years old) adults are particularly vulnerable to nosocomial infections. Despite significant morbidity associated with surgical site infection (SSI) and infections caused by multi-drug resistant bacteria (MDRB), investigators have paid relatively little attention to these infections in elderly hospitalized patients. The broad objectives for this application are to identify risk factors and interventions to improve outcomes of elderly hospitalized persons.
Specific aims : 1) Create risk models for the development of SSI and MDRB in the elderly and to test a prior hypotheses regarding particular risk factors; and 2) quantify the impact of SI and nosocomial MDRB on health outcomes in the elderly. Health outcomes (mortality, duration of hospitalization and hospital costs) will be assessed for the 90-day period following surgery (for SSI) and infection (for MDRB). In addition, the impact of SSI on ADL disability will also be assessed. Methods: The project will utilize 10 study hospitals and an infection control infrastructure that includes 3 physician epidemiologists and over 20 infection control practitioners. Patients with SSI and nosocomial infection and colonization due to MDRB are currently identified through prospective surveillance and have been and will continued to be prospectively entered into electronic databases at study hospitals. Additional study data will be obtained from patient charts and hospital databases. For the study of SSI, elderly patients with SSI will be studied as cases and will be compared to elderly operative patients without SSI. ADL disability will be assessed preoperatively through chart review and postoperatively by phone interview 90 days after surgery. For the study of MDRB, elderly patients with an initial episode of nosocomial MDRB will be studied as cases and will be compared to elderly patients without infection or colonization due to MDRB. For the risk model analysis, patients colonized or infected with MDRB will be included as cases; and for the health outcomes analysis, only patients with infections due to MDRB will be studied as cases. The risk factor identified for SSI and MDRB and the impact of SSI and MDRB on health outcomes will be used to design and implement future preventive interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
7K23AG023621-06
Application #
7815868
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Nayfield, Susan G
Project Start
2004-09-30
Project End
2010-07-31
Budget Start
2009-05-15
Budget End
2010-07-31
Support Year
6
Fiscal Year
2008
Total Cost
$115,272
Indirect Cost
Name
Wayne State University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
001962224
City
Detroit
State
MI
Country
United States
Zip Code
48202
Chopra, Teena; Zhao, Jing J; Alangaden, George et al. (2010) Preventing surgical site infections after bariatric surgery: value of perioperative antibiotic regimens. Expert Rev Pharmacoecon Outcomes Res 10:317-28
Cummings, Keith L; Anderson, Deverick J; Kaye, Keith S (2010) Hand hygiene noncompliance and the cost of hospital-acquired methicillin-resistant Staphylococcus aureus infection. Infect Control Hosp Epidemiol 31:357-64
Kaye, Keith S; Anderson, Deverick J; Sloane, Richard et al. (2009) The effect of surgical site infection on older operative patients. J Am Geriatr Soc 57:46-54
Anderson, Deverick J; Kaye, Keith S; Chen, Luke F et al. (2009) Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: a multi-center matched outcomes study. PLoS One 4:e8305
Anderson, Deverick J; Chen, Luke F; Sexton, Daniel J et al. (2008) Complex surgical site infections and the devilish details of risk adjustment: important implications for public reporting. Infect Control Hosp Epidemiol 29:941-6
Kaye, Keith S; Anderson, Deverick J; Choi, Yong et al. (2008) The deadly toll of invasive methicillin-resistant Staphylococcus aureus infection in community hospitals. Clin Infect Dis 46:1568-77
Kaye, Keith S; Harris, Anthony D; McDonald, Jay R et al. (2008) Measuring acceptable treatment failure rates for community-acquired pneumonia: potential for reducing duration of treatment and antimicrobial resistance. Infect Control Hosp Epidemiol 29:137-42
Friedman, N Deborah; Sexton, Daniel J; Connelly, Sarah M et al. (2007) Risk factors for surgical site infection complicating laminectomy. Infect Control Hosp Epidemiol 28:1060-5
McDonald, Jay R; Carriker, Charlene M; Pien, Brian C et al. (2007) Methicillin-resistant Staphylococcus aureus outbreak in an intensive care nursery: potential for interinstitutional spread. Pediatr Infect Dis J 26:678-83
Anderson, Deverick J; Sexton, Daniel J; Kanafani, Zeina A et al. (2007) Severe surgical site infection in community hospitals: epidemiology, key procedures, and the changing prevalence of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol 28:1047-53

Showing the most recent 10 out of 16 publications