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Research to Stem Hospital Infections Bring Together Three Major Utah Health-Care Systems

May 8, 2006 — A team of Utah-based investigators has been selected to join the Prevention Epicenter grant program sponsored by the U.S. Centers for Disease Control and Prevention (CDC). The purpose of this program is to develop and test innovative approaches to reduce infections in health-care settings. The new “Utah Epicenter,” called the Intermountain Center of Excellence for Infection Prevention Strategies (INTERCEPT), represents a collaboration between the University of Utah and three integrated health-care delivery systems: University Health Care, Intermountain Healthcare, and the VA Salt Lake City Health Care System. INTERCEPT is one of only five national sites funded through this program.

Over the next five years, INTERCEPT will receive $2 million to improve methods to detect health care-associated infections and to implement strategies to prevent health care-associated infections. INTERCEPT researchers will use the computerized medical records and alerting systems that are in place at the three health-care systems. They will evaluate how to reduce the transmission of antibiotic-resistant bacteria, find ways to decrease the prolonged use of urinary catheters-which can lead to urinary tract infections-and devise computer-based surveillance to track problems associated with electronic medical devices.

“This grant is an exemplary integration of academia and practice,” said Matthew H. Samore, M.D., the Utah principal investigator, professor of internal medicine, and chief of clinical epidemiology at the U of U School of Medicine and Salt Lake City VA. “But we’re not just measuring the problem, we”re doing something about it.”

Intermountain Healthcare will initially implement and test the program at LDS Hospital and Primary Children’s Medical Center before rolling out the study at other Intermountain hospitals.

R. Scott Evans, Ph.D., a senior medical informaticist at Intermountain Healthcare’s LDS Hospital and professor of biomedical informatics at the University medical school, is the Utah co-principal investigator. Evans notes, “We have been using computerized methods to improve infection surveillance and infection control practice for more than 20 years. This grant will allow us to extend our previous work in highly innovative ways.”

Health care-associated infections cause an estimated 2 million infections and 90,000 deaths annually in the United States. In recent years, health care consumer groups have mobilized increased political attention to this problem. The spread of drug-resistant bacteria because of overuse of antibiotics and patient-to-patient transmission is a major public health threat, according to Samore.

To identify people at high risk for drug-resistant bacteria, the researchers will establish a computer-flagging system to alert hospitals when those patients are admitted; this will include identifying patients who carry these types of bacteria when they enter the hospital. The researchers will electronically track the use of urinary catheters as a way to let physicians and nurses know when patients no longer need them. Urinary tract infections acquired from catheters are a major source of drug-resistant bacteria, and reducing the prolonged use of the devices can help contain the spread of these bacteria.

“The CDC was looking for health-care systems that are leaders in using electronic medical records to drive safety and improve quality,” Samore said. “We can do a formal study in one location and then transfer knowledge to other institutions in Utah and even nationwide.”

Utah is the Epicenter Program’s only western site and joins Washington University in St Louis, Harvard Pilgrim Healthcare in Boston, the Hektoen Institute for Medical Research in Chicago, and Ohio State University in the project. The University already has close relationships with these institutions in this area of research, Samore said.

INTERCEPT will receive $400,000 annually during the five years of the study, with potential for renewal after that period.