CDC, Cook County and Rush Collaborate to Research and Prevent HAIs

The Centers for Disease Control and Prevention (CDC) is awarding researchers at the Cook County Health & Hospitals System and Rush University Medical Center a $2 million grant to continue a successful program aimed at preventing healthcare-associated infections, antibiotic resistance, and other adverse events associated with healthcare. The project, dubbed the Chicago Antimicrobial Resistance and Infection Prevention Epicenter (CARPE), is one of only five CDC Prevention Epicenters in the country.

Rush and Cook County were chosen to participate in the program because the two institutions have a long standing collaboration and legacy of research innovation in antimicrobial resistance and infection prevention by internationally known infectious disease experts.

The CDC estimates that one out of 20 hospitalized patients will acquire an infection while receiving health care treatment for other conditions. Healthcare-associated infections cause significant death and illness among patients treated in U.S. healthcare institutions and add billions of dollars to healthcare costs. With the emergence of drug-resistant infections and new pathogens in health care settings, new strategies to detect and reduce health care-associated infections become even more critical.

"Dr. Robert Weinstein and his colleagues at Cook County and Rush University have been pioneers in preventing infections caused by medical devices and by antimicrobial-resistant organisms. CDC looks forward to continuing our research partnership together and hope to build upon some of their prior groundbreaking work," says Dr. John Jernigan, director of CDCs Office of HAI Prevention Research and Evaluation.

The CARPE program was established in 2006 to facilitate partnership between Rush, Cook County, the CDC and other academic institutions to conduct research designed to fill knowledge gaps that are most important from a public health perspective. Because the investigators work together as a group, there is an emphasis on multicenter collaborative research projects, many of which would not be possible for a single academic center.

"Funding from the federal CDC will be instrumental as we begin a region-wide multi-facility approach --more coordinated surveillance, better communication between healthcare facilities, and improved hygiene and cleaning -- to control the spread of bacteria that are resistant to antibiotics. The health of our patients and the control of escalating healthcare costs make this far-reaching plan essential," says principal investigator Dr. Robert Weinstein, chairman of the Department of Medicine at John H. Stroger, Jr. Hospital of Cook County and professor of medicine at Rush Medical College.

CARPE researchers are involved in numerous studies, including evaluating the effectiveness of state-mandated screening of intensive care unit patients for methicillin-resistant Staphylococcus aureus (MRSA) and investigating patient cleansing methods to lower the risk of antimicrobial resistant pathogens, including MRSA and carbapenem-resistant Enterobacteriaceae (CRE or KPC).

"Rush University Medical Center and the Cook County Health & Hospitals System have a longstanding, collaborative infection prevention research partnership. This grant will allow us to broaden the scope of our investigations into the most effective ways to prevent healthcare-associated infections," says investigator Dr. Mary Hayden, associate professor of medicine, infectious diseases and pathology at Rush University Medical Center.

The CARPE program has developed a clinical data warehouse using data from the electronic health records from affiliated hospitals, laboratories, and ambulatory clinics to track healthcare-associated bloodstream infections, monitor the prevalence of antimicrobial-resistant bacteria, such as MRSA, and assess antibiotic use.

Using these data, researchers are benchmarking bacterial resistance and antibiotic use in order to develop practice guidelines and policies to control the use of antibiotics that may be contributing to resistant pathogens. Researchers are also collaborating with Ohio State University and Washington University in St. Louis to use electronic surveillance to study central vascular catheter blood stream infections.

Innovations developed for the CARPE data warehouse are being used as the basis for a Chicago citywide effort to implement electronic laboratory reporting of communicable diseases. The warehouse is helping to provide mechanisms for automated surveillance in CDCs National Healthcare Safety Network and will facilitate rapid detection and automated surveillance of infectious diseases as part of the Epicenters quality improvement initiatives.

"Discoveries through the CDC Prevention Epicenter program have had great impact on decreasing healthcare-associated infections, " said CDC director Thomas R. Frieden, MPH. "With prevention epicenters, we can expand our current knowledge and save even more lives as we work toward our goal of eliminating healthcare-associated infections."

The CDC names new Prevention Epicenters every five years based on peer-reviewed grant applications. The other institutions selected this year include the Duke University Prevention Epicenter, the Eastern Massachusetts Prevention Epicenter (Harvard Pilgrim Health Care), Southeastern Pennsylvania Adult and Pediatric Prevention Epicenter Network (University of Pennsylvania) and Washington University and BJC Epi-Center for Prevention of Healthcare Associated Infections.

The knowledge created through the Prevention Epicenter program has been extremely valuable and has resulted in over 150 publications in peer-reviewed journals on a wide variety of topics to prevent hospital acquired infections.

County and Rush have been jointly and continuously funded by the CDC for infection control research over the past three decades. The institutions first federally-sponsored infection prevention project, dating back to 1998, was the Chicago Antimicrobial Resistance Project (CARP). That project successfully developed novel interventions to track and to combat multi-drug resistant bacteria.