Washington University and BJC Epicenter
First Funded: 1997
Overview:The Washington University School of Medicine in St. Louis (WU), Barnes-Jewish Hospital (BJH), and BJC Healthcare, a 13-hospital integrated healthcare delivery system in the Midwest partnered together to form the WU/ BJC Epicenter for Prevention of Healthcare-associated Infections (HAI). The WU/BJC Epicenter has been funded since the inception of the CDC Epicenter Program in 1997.
The overarching goal of this multicenter research team is to develop improved systems to detect and prevent HAIs. Standardized reporting systems to accurately record risk-stratified HAI rates and types of infections in diverse healthcare settings are limited. The Epicenter team developed standardized reporting procedures to more efficiently and effectively collect and report risk-stratified HAI surveillance data using active surveillance, electronic medical record data, and administrative data. This data led to improved interventions to prevent HAIs in the most vulnerable patients including the elderly, immuno-suppressed, intensive care unit (ICU) patients, patients with invasive devices such as central venous catheters and mechanical ventilation, and surgical patients. The Epicenter developed and implemented multidisciplinary interventions which have dramatically reduced the rates of catheter-related bloodstream infections and ventilator-associated pneumonia in ICU patients over the past 10 years. The Epicenter currently uses large administrative databases (i.e., Medicare, Medicaid, National Inpatient Sample) to study risk factors, outcome, and prevention of HAIs in diverse settings.
Research Study Areas: MRSA, antimicrobial use, Clostridium difficile-associated disease (CDAD), surgical site infections (SSIs), electronic surveillance, infections in dialysis, and the epidemiology of falls and other adverse events.
Research Project Examples:The WU/BJC Epicenter is evaluating the effectiveness of chlorhexidine body washes to reduce MRSA acquisition in ICUs, assessing the efficacy of a multidisciplinary antimicrobial stewardship program, evaluating adherence to surgical antibiotic prophylaxis recommendations using real-time electronically collected data, and using Medicare claims data to identify hospitals with high SSI rates following cardiac surgery. The Epicenter is also studying the benefits of active surveillance to prevent and control MRSA, the role of colonization pressure in MRSA and CDAD acquisition, risk factors and outcomes of SSI after breast cancer surgery, spine surgery, cardiac surgery, and total joint replacement surgery, and risk factors for falls and fall-related injuries. Attributable costs of HAIs and noninfectious adverse events are studied using economic models.
Victoria Fraser, MD
J. William Campbell Professor of Medicine
Co-Director Infectious Diseases Division
Washington University School of Medicine