C-PIE II ABSTRACTMultidrug-resistant organisms (MDROs) are increasingly common causes of healthcare-associatedinfections (HAIs), complicating treatment and leading to increased morbidity, mortality and cost. TheChicago Prevention and Epicenter II (C-PIE II) has developed a portfolio of research projects to study theepidemiology and prevention of key HAI problems, i.e. those caused by MDROs, from the level of individualintensive care units to entire healthcare facilities (long-term acute care hospitals) to the region (Chicago, thethird largest city in the nation) and to the state (Illinois, population 13 million). Our proposals range frominvestigations to improve basic infection control interventions that we have pioneered, such aschlorhexidine gluconate (CHG) bathing, to research that employs the most advanced molecular diagnostictechniques, e.g. bacterial whole genome sequencing and microbiome analysis, and cutting-edgeinformatics and analytic methods, such as automated alerts and social network analysis. We will conductour work within a sophisticated existing infrastructure of strong collaborative public health and academicpartnerships. These proposed activities comprise our Core Project and Multicenter Collaborative Projectproposals.Core Project: We will continue to evaluate novel methods to study the epidemiology and control ofcarbapenem-resistant Enterobacteriaceae, to optimize antimicrobial stewardship interventions throughethnographic evaluation, and to assess the effect of alternative nasal decolonization strategies on thesusceptibility of methicillin-resistant Staphylococcus aureus to antibiotics and antiseptics. The likelihood ofsuccess of our investigations is increased by our plan to use a coordinated, collaborative approach acrossmany healthcare facility types, public health agencies, and academic institutions.Multicenter Projects: We propose a Large-sized Collaborative Project (MAriMbA) that will test thehypothesis that specific host factors, clinical care exposures, and gut microbiota alterations are associatedwith an increased risk of colonization by enteric MDROs. We propose a Medium-sized CollaborativeProject (DataMAP-AU) to promote an infrastructure that can be expanded nationally to facilitate andstandardize antimicrobial use metrics that are most informative for antimicrobial stewardship interventions.We propose a Small Collaborative Project (CHECkuP) to better understand the optimal use of CHG skinantisepsis to reduce patient colonization by MDROs. In total, we expect our work to fill critical gaps inknowledge related to the epidemiology and prevention of HAIs caused by MDROs, and to advance thescience of infection prevention.
Healthcare-associated infections (HAIs) caused by antibiotic-resistant organisms are a major source ofpatient suffering and societal cost. Contributors to the spread of antibiotic resistant organisms includesuboptimal infection control practices and antibiotic overuse. We propose to better define the epidemiology;evaluate interventions; and strengthen the infrastructure for public health action to combat antibiotic-resistance and HAIs.
