This K23 proposal combines focused coursework, a substantial research plan, and close personal mentoring to train Susan Huang, M.D., M.P.H. for independence as a clinical investigator. Dr. Huang is currently an Instructor in Infectious Diseases who has a long-standing interest in bacterial antibiotic resistance and hospital epidemiology. This project will develop and test methods to guide more effective control of nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) in the intensive care unit (ICU) setting. Specifically, it will introduce an alternative monitoring method and assess its ability to identify periods of high MRSA and VRE transmission when compared to current methods, b) evaluate the use of carriage pressure to predict transmission and control for the non-independent (contagious) nature of infectious agents, c) re-evaluate the association of potential predictors of transmission after controlling for carriage pressure, and d) develop and implement an improved monitoring system which warns of high risk potential and activates an intervention to prevent transmission of MRSA and VRE. Methods will include state-change transmission models, observational cohort, case cohort, and prospective cohort designs. Mentors will include experts from the fields of infectious diseases and epidemiology (Richard Platt, M.D., M.S., Brigham & Women's Hospital, Harvard Medical School), and mathematics and infectious diseases transmission modeling (Marc Lipsitch, Ph.D., Harvard School of Public Health). This project will provide foundational knowledge about the validity of regression techniques for non-independent infectious outcomes, and evaluate the impact of an intervention to stem health care associated transmission of MRSA and VRE.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AI064161-05
Application #
7409070
Study Section
Microbiology and Infectious Diseases B Subcommittee (MID)
Program Officer
Perdue, Samuel S
Project Start
2005-05-01
Project End
2010-04-30
Budget Start
2008-05-01
Budget End
2009-04-30
Support Year
5
Fiscal Year
2008
Total Cost
$133,920
Indirect Cost
Name
University of California Irvine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
046705849
City
Irvine
State
CA
Country
United States
Zip Code
92697
Lee, Bruce Y; Wong, Kim F; Bartsch, Sarah M et al. (2013) The Regional Healthcare Ecosystem Analyst (RHEA): a simulation modeling tool to assist infectious disease control in a health system. J Am Med Inform Assoc 20:e139-46
Lee, Bruce Y; Yilmaz, S Levent; Wong, Kim F et al. (2013) Modeling the regional spread and control of vancomycin-resistant enterococci. Am J Infect Control 41:668-73
Elkins, Kristen R; Nguyen, Christopher M; Kim, Diane S et al. (2011) Successful strategies for high participation in three regional healthcare surveys: an observational study. BMC Med Res Methodol 11:176
Lee, Bruce Y; McGlone, Sarah M; Song, Yeohan et al. (2011) Social network analysis of patient sharing among hospitals in Orange County, California. Am J Public Health 101:707-13
Huang, Susan S; Datta, Rupak; Rifas-Shiman, Sheryl et al. (2011) Colonization with antibiotic-susceptible strains protects against methicillin-resistant Staphylococcus aureus but not vancomycin-resistant enterococci acquisition: a nested case-control study. Crit Care 15:R210
Datta, Rupak; Platt, Richard; Yokoe, Deborah S et al. (2011) Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants. Arch Intern Med 171:491-4
Kypraios, Theodore; O'Neill, Philip D; Huang, Susan S et al. (2010) Assessing the role of undetected colonization and isolation precautions in reducing methicillin-resistant Staphylococcus aureus transmission in intensive care units. BMC Infect Dis 10:29
Datta, Rupak; Huang, Susan S (2010) Risk of postdischarge infection with vancomycin-resistant enterococcus after initial infection or colonization. Infect Control Hosp Epidemiol 31:1290-3
Huang, Susan S; Diekema, Daniel J; Warren, David K et al. (2008) Strain-relatedness of methicillin-resistant Staphylococcus aureus isolates recovered from patients with repeated infection. Clin Infect Dis 46:1241-7
Datta, Rupak; Huang, Susan S (2008) Risk of infection and death due to methicillin-resistant Staphylococcus aureus in long-term carriers. Clin Infect Dis 47:176-81

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