Healthcare Epidemiology

This work aims to evaluate the carriage and transmission of multidrug-resistant bacteria in healthcare settings in order to inform optimal policies to prevent acquisition and infection with these high-consequence pathogens.

We have studied Methicillin-resistant Staphylococcus aureus (MRSA) epidemiology in highly vulnerable patient populations, including the neonatal intensive care unit. One of our primary goals has been to assess the impact of a leading MRSA control strategy, decolonization, in this setting. To do so we have used mathematical models that explicitly characterize the infectious process in healthcare settings, account for the dependent nature of hospital-based infectious outcomes, address interval-censored observation of colonization status, and facilitate simulation of hypothetical prevention strategies.

We are also investigating asymptomatic gastrointestinal carriage of carbapenem-resistant Enterobacteriaceae (CRE) in intensive care unit patients in order to establish whether carriage risk factors, and propensity for intra-facility spread, differ by CRE resistance mechanism. The broad, long-term goals of this research are to advance our understanding of the epidemiology of CRE colonization and the implications of CRE resistance mechanisms to routes of nosocomial acquisition in order to guide CRE control policies and resource prioritization in U.S. healthcare facilities.

An additional interest of our work is the utilization of machine learning methodologies to address diagnostic and hospital epidemiology policy questions. For example, we have developed a classification and regression tree (CART)-derived decision tree to identify highly drug-resistant bacteremias in order to guide empiric antibiotic treatment while awaiting microbiological confirmation.

Updates #HAI

2 months 2 days ago

RT @JustinLessler: Congratulations to @rpierc13. The newest PhD out of @JHIDDynamics and @JohnsHopkinsEPI! #HAI #WonderWoman https://t.co/kxJzC2iJrz
8 months 3 weeks ago

Congrats to @rpierc13 on her paper on risk of MRSA in the NICU with @JustinLessler and @AaronMilstone. https://t.co/mrLCkYBeaa #HAI
1 year 1 month ago

Congratulations to Katie Goodman on her paper in Clinical Infectious Diseases https://t.co/1tC9ZqskIv #HAI