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A UC Irvine infectious disease specialist has received a three-year, $10 million grant to explore the effectiveness of new methods to prevent staph infections in people who harbor MRSA bacteria when theyre discharged from the hospital.
The federal Agency for Healthcare Research & Quality awarded the grant as part of its CHOICE program, which is funded by American Recovery & Reinvestment Act of 2009. CHOICE grants will support large projects in comparative effectiveness research to aid decision making in priority areas of clinical care. Selected studies are deemed likely to result in major healthcare advances.
The UCI study, led by Susan Huang, MD, medical director of epidemiology and infection prevention at UC Irvine Medical Center and a UCI Health Policy Research Institute affiliate, may provide the first post-discharge preventative treatments for the 1.8 million Americans each year who carry methicillin-resistant Staphylococcus aureus (MRSA) bacteria.
MRSA is highly contagious and resistant to the antibiotics used in ordinary staph infections. Most MRSA cases occur in people whove recently been in the hospital or another healthcare setting, such as a nursing home or dialysis center. About 25 percent of patients with MRSA will develop an infection within a year of discharge. These infections require costly medical attention, including frequent hospital readmission.
"While prior studies have focused on preventing transmission, our effort will fill the large and important gap of how to prevent infection in the growing number of people who already harbor MRSA," Huang said. "Identification of an effective strategy to reduce MRSA infection and hospitalization would be a major advancement in clinical care."
Project CLEAR Changing Lives by Eradicating Antibiotic Resistance involves a randomized trial at hospitals in Orange County and southeast Los Angeles County comparing the efficacy of antibacterial nasal ointments, mouth rinses and body washes among patients carrying MRSA upon hospital discharge.
Additionally, the project will assess the medical and nonmedical costs of MRSA infections and quantify the potential savings attributable to different preventative treatments.
"MRSA containment and eradication is a national priority because of its virulence and rapid expansion in healthcare settings," Huang said. "This trial will provide a critically needed comprehensive evaluation of strategies to decrease MRSA infection risk across the continuum of inpatient and outpatient care."
Through its Health Policy Research Institute, UCI has become a nationwide leader in comparative effectiveness research, which explores the best possible treatment options for patients, based on criteria like age, gender, race and health history.
In 2009, the centers co-executive director, Dr. Sheldon Greenfield, helped chair an influential Institute of Medicine panel charged with advising the government on how to spend money allocated by Congress for comparative effectiveness research. It crafted a list of 100 healthcare priorities such as heart disease, Alzheimers and cancer that became the foundation of the CHOICE program and related initiatives.
Greenfield also is co-investigator on two CHOICE-funded projects: A Vanderbilt University-led effort will identify the best use of radiation or surgery for various forms of prostate cancer. And one headed by UCLA will examine different approaches to congestive heart failure that limit the need for hospitalization.
"The commitment by the federal government to CHOICE and other comparative effectiveness programs will usher in new forms of research, leading to more effective personal care," said Greenfield, the Donald Bren Professor of Medicine at UCI. "It ultimately will produce more tools for the physician and more options for the patient."