Iowa continues CDC infection prevention research

Three years ago, the Centers for Disease Control and Prevention (CDC) first funded researchers at the University of Iowa to study infection prevention activities and expand the surveillance of healthcare associated infections. The UI was one of six Prevention Epicenters tasked with “conducting innovative infection control and prevention research.”

That work continues as a multidisciplinary team of researchers at UI will now partner with Epicenters at University of Maryland School of Medicine, Emory University, Johns Hopkins University, University of Utah School of Medicine, and the University of Illinois. Under the grant’s renewal, significant portions of a variety of infection prevention projects will proceed in Iowa City.

“This new CDC grant will provide us additional armamentarium to identify better methods to improve hospital performance measures and quality of care delivered to patients,” said Dr. Rajeshwari Nair, Epidemiologist and Assistant Research Scientist in UI’s College of Public Health.

Using the funding from the grant, principal investigators Drs. Nair and Eli Perencevich, Professor in General Internal Medicine, will conduct several studies focused on hospital-onset bacteremia (HOB) and Clostridioides difficile infections. One step in this will involve the development of a preventability assessment tool. After identifying the source of the hospital-onset bacteremia in past cases, the researchers will use this tool to estimate the preventability of these cases. In another study, they will observe the effects of risk adjustments in identifying and preventing C. difficile infections.

“Results from this study will directly impact patient care as we will be able to identify ‘preventable’ infections and factors that can be modified to aid this prevention,” Dr. Nair said, “So next time a patient is admitted to UI Health Care, they can rest assured that all care will be taken to prevent a HOB with evidence gathered from the HOB surveillance study.”

Drs. Nair and Perencevich also plan to set metrics for ranking hospitals. “We want to rank hospitals by facts that fairly differentiate hospitals using risk adjustment and identify an infection that has a large proportion that are preventable by currently available methods,” Dr. Perencevich said.

Principal Investigator Dr. Loreen Herwaldt, Professor in Infectious Diseases, will be working with Dr. Marin Schweizer, Associate Professor in General Internal Medicine, on another project in which they will evaluate the use of negative pressure wound therapy devices in obese and diabetic patients during abdominal and colon surgeries. The results of these studies will reveal which patients will benefit from these devices.

“Our team, which includes surgical site infection experts and surgeons, are some of the most qualified people in the country to get this study done,” Dr. Schweizer said. Dr. John Cromwell, Clinical Professor of Surgery, and Dr. Abbey Hardy-Fairbanks, Clinical Assistant Professor of Obstetrics and Gynecology, will assist Drs. Herwaldt and Schweizer in their research.

Drs. Daniel Diekema, Director of the Division of Infectious Diseases, Oluchi Abosi, Infection Prevention Control Professional and Quality and Safety Member, and Jorge Salinas, Hospital Epidemiologist and Clinical Assistant Professor in Infectious Diseases, will work to improve the diagnosis of C. difficile. Researchers plan to reform the process of diagnosis using education and an electronic medical record alert to guarantee that only patients who most likely contracted the disease are tested.

“By improving test ordering, we may directly benefit patients by reducing their exposure to unneeded antibiotics and improve our hospital’s rate of ‘C diff’ infections by excluding false positive cases,” Dr. Diekema said.

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