Harvard Prevention Epicenter
- Centers for Disease Control and Prevention
Project Summary
The CDC Prevention Epicenters Program unites academic healthcare experts across the United States with the goal of enhancing public health knowledge and improving healthcare quality through innovative research focusing on prevention of healthcare-associated infections (HAIs), antibiotic resistance, and other healthcare-associated adverse events.
Harvard Pilgrim Health Care Institute (HPHCI) has served as a CDC Prevention Epicenter site since the program began in 1997.
Current Projects
During this current funding cycle, the Harvard Epicenter is leading projects investigating:
- Associations between time-to-antibiotics and outcomes in patients with bloodstream infections
- Trends in empiric antibiotic choices for suspected sepsis
- Antibiotic de-escalation practices for patients with suspected sepsis and their associations with patient outcomes
- Reducing non-ventilator hospital-acquired pneumonia (NV-HAP) by improving the frequency and reliability of oral care and patient mobility in the HCA Healthcare hospital system
- Causes and preventability of deaths in patients with NV-HAP
- Decreasing unnecessary antibiotic usage for patients with possible pneumonia
Preventing Clostridioides difficile (C. difficile) infections in high-risk patients using an antibiotic stewardship and prophylaxis bundle
Selected Past Projects
Selected past projects of the Harvard Epicenter (and related projects funded by other federal agencies) are highlighted below and include pragmatic cluster randomized trials related to prevention of Staphylococcus aureus infections, implementation of an outbreak detection system and standardized response protocol, and projects related to sepsis, non-ventilator hospital-acquired pneumonia (NV-HAP) and COVID-19 surveillance and prevention.
Principal Investigators: Susan Huang, MD, MPH; Richard Platt, MD, MSc
Intensive care units (ICUs) have one of the highest rates of healthcare-associated infections due to patients’ severity of illness and frequent use of medical devices. The previously conducted REDUCE MRSA Trial showed that ICUs using chlorhexidine (CHG) antiseptic for routine daily bathing and mupirocin for nasal decolonization of all admissions experienced a significant reduction in (MRSA) clinical cultures and all-cause bloodstream infections. This trial is the basis for current guidelines that recommend decolonizing all ICU patients with CHG baths. An enhanced protocol was developed that provides instructions for implementing universal decolonization in adult intensive care units.
Principal Investigator: Meghan Baker, MD,ScD
Healthcare-associated infections are a leading cause of preventable morbidity and mortality, and numerous hospital outbreaks are reported each year. However, there are no standardized, validated outbreak detection methods or response strategies. The CLUSTER study assessed the feasibility of implementing the WHONET-SaTScan outbreak detection system and establishing a standardized outbreak response protocol within the HCA Healthcare network of hospitals.
Principal Investigators: Michael Klompas, MD, MPH; Chanu Rhee, MD, MPH
Sepsis is a leading cause of death, disability, and cost worldwide. Our team developed a novel strategy to track sepsis incidence, characteristics, and outcomes using detailed clinical data extracted from electronic health record (EHR) systems. The strategy developed by DPM lay the foundation for CDC’s Adult Sepsis Event definition and serves as the basis for the CDC’s current best estimate of sepsis case counts and outcomes in the US.
Principal Investigator: Michael Klompas, MD MPH
Non-ventilator hospital-acquired pneumonia (NV-HAP) is the most common and deadly healthcare-associated infection, affecting approximately 1% of patients with a crude mortality rate of 15-30%. Despite a pressing need for surveillance, detailed yet subjective diagnostic criteria for NV-HAP make monitoring onerous and difficult to replicate. DPM investigators developed a pilot EHR-based surveillance definition for NV-HAP and validated it by applying it to hundreds of hospitals affiliated with Veteran’s Affairs Administration and HCA healthcare.
Principal Investigators: Richard Platt, MD MSc; Susan Huang, MD MPH; Michael Klompas, MD MPH; Chanu Rhee, MD MPH
COVID-19 led to profound changes in hospital operations, particularly infection prevention and control activities. Our team has published dozens of studies investigating Covid transmission in hospitals, the impact of the COVID-19 epidemic on healthcare-associated infection (HAI) rates, and strategies to prevent nosocomial transmission of SARS-CoV-2 and other respiratory viruses.