Infectious disease experts at the School of Medicine and Barnes-Jewish Hospital will participate in a new multicenter research network dedicated to assessing, treating and preventing hospital-acquired infections.
“As improved health care has led to extended life spans, the population of older patients who are more susceptible to hospital-acquired infections has increased,” said Victoria J. Fraser, M.D., the J. William Campbell Professor of Medicine and co-director of the Division of Infectious Diseases. “We have additional growing patient populations that are vulnerable, including patients with suppressed immune systems and surgical patients.”
At the same time, Fraser noted, new pathogens that are particularly virulent or resistant to antibiotics have emerged in patients. Two of the most worrisome are methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile.
MRSA most often causes mild skin infections, but it can also result in more serious skin infections, or infect surgical sites, the bloodstream or the urinary tract. Epidemiologists estimate that Clostridium difficile causes nearly 3 million cases of diarrhea and colon inflammation per year.
The Centers for Disease Control and Prevention (CDC) estimates that each year, about 2 million infections are acquired in health-care settings, resulting in about 90,000 deaths and more than $4.5 billion in excess costs.
To support innovative research dedicated to stopping these infections, the CDC is providing $10 million in funding over five years through its Prevention Epicenter Program. WUSTL and BJH researchers will receive $300,000 annually for five years.
In addition to faculty from the Division of Infectious Diseases, researchers from the departments of Medicine and Surgery and St. Louis Children’s Hospital will contribute to the research.
The other medical schools and hospitals in the network are the University of Utah, Ohio State University, Rush University/Stroger Hospital of Cook County and Harvard University/Eastern Massachusetts Hospitals.
A primary goal of the program will be to standardize reporting of hospital-acquired infections and the development of antibiotic-resistant strains of pathogens.
“Right now, everyone does surveillance for hospital-acquired infections differently — there’s no uniform system,” Fraser said. “Once we have that system and can get accurate data about the rates of infections and the different types of infections, we can develop improved interventions and measure the cost-effectiveness of those interventions.”
Fraser also is interested in what she calls “risk stratifying,” which involves incorporating data about patient health and susceptibility in assessments of hospital-acquired infection rates.
For example, a young, healthy person coming in to have a wart removed should have a near-zero risk of hospital-acquired infection, while an older cancer patient coming in for surgery may have a much higher risk. Until researchers establish baseline data on what the risks are, they have no objective grounds to determine if efforts to reduce hospital-acquired infections are succeeding or failing.
“We need to carefully look within patient populations and know what infection rates are, and what kinds of infections are occurring in different settings in the hospital,” Fraser said.