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Pediatric research priorities in healthcare-associated infections and antimicrobial stewardship

Published online by Cambridge University Press:  26 November 2020

Susan E. Coffin ,
Francisca Abanyie ,
Kristina Bryant ,
Joseph Cantey ,
Anthony Fiore ,
Stephanie Fritz ,
Judith Guzman-Cottrill ,
Adam L. Hersh ,
W. Charles Huskins  and
Larry K. Kociolek
...Show all authors
Susan E. Coffin*
Affiliation:
Division of Infectious Diseases and Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
Francisca Abanyie
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Kristina Bryant
Affiliation:
Kosair Children’s Hospital, University of Louisville School of Medicine, Louisville, Kentucky
Joseph Cantey
Affiliation:
University of Texas Health, San Antonio, Texas
Anthony Fiore
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Stephanie Fritz
Affiliation:
Washington University School of Medicine in St Louis, St Louis, Missouri
Judith Guzman-Cottrill
Affiliation:
Doernbecher Children’s Hospital; Oregon Health & Science University, Portland, Oregon
Adam L. Hersh
Affiliation:
Department of Pediatrics, Division of Infectious Diseases, University of Utah, Salt Lake City, Utah
W. Charles Huskins
Affiliation:
Mayo Clinic College of Medicine, Rochester, Minnesota
Larry K. Kociolek
Affiliation:
Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
Matthew Kronman
Affiliation:
Seattle Children’s Hospital; University of Washington, Seattle, Washington
Ebbing Lautenbach
Affiliation:
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
Grace Lee
Affiliation:
Stanford Children’s Hospital; Stanford University School of Medicine, Palo Alto, California
Matthew Linam
Affiliation:
Children’s Healthcare of Atlanta; Emory University School of Medicine, Atlanta, Georgia
Latania K. Logan
Affiliation:
Rush University Medical Center; Rush Medical College, Chicago, Illinois
Aaron Milstone
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Jason Newland
Affiliation:
Washington University School of Medicine in St Louis, St Louis, Missouri St Louis Children’s Hospital, St. Louis, Missouri
A. Christine Nyquist
Affiliation:
Children’s Hospital Colorado; University of Colorado School of Medicine, Aurora, Colorado
Debra L. Palazzi
Affiliation:
Texas Children’s Hospital: Baylor College of Medicine, Houston, Texas
Sameer Patel
Affiliation:
Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
Karen Puopolo
Affiliation:
Division of Infectious Diseases and Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
Sujan C. Reddy
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Lisa Saiman
Affiliation:
New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York
Thomas Sandora
Affiliation:
Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
Andi L. Shane
Affiliation:
Children’s Healthcare of Atlanta; Emory University School of Medicine, Atlanta, Georgia
Michael Smith
Affiliation:
Duke Children’s Health Center; Duke University Medical Center, Durham, North Carolina
Pranita D. Tamma
Affiliation:
Johns Hopkins University School of Medicine, Baltimore, Maryland
Theoklis Zaoutis
Affiliation:
Division of Infectious Diseases and Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
Danielle Zerr
Affiliation:
Seattle Children’s Hospital; University of Washington, Seattle, Washington
Jeffrey S. Gerber
Affiliation:
Division of Infectious Diseases and Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
*
Author for correspondence: Susan E. Coffin, E-mail: [email protected]
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Abstract

Objective:

To develop a pediatric research agenda focused on pediatric healthcare-associated infections and antimicrobial stewardship topics that will yield the highest impact on child health.

Participants:

The study included 26 geographically diverse adult and pediatric infectious diseases clinicians with expertise in healthcare-associated infection prevention and/or antimicrobial stewardship (topic identification and ranking of priorities), as well as members of the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention (topic identification).

Methods:

Using a modified Delphi approach, expert recommendations were generated through an iterative process for identifying pediatric research priorities in healthcare associated infection prevention and antimicrobial stewardship. The multistep, 7-month process included a literature review, interactive teleconferences, web-based surveys, and 2 in-person meetings.

Results:

A final list of 12 high-priority research topics were generated in the 2 domains. High-priority healthcare-associated infection topics included judicious testing for Clostridioides difficile infection, chlorhexidine (CHG) bathing, measuring and preventing hospital-onset bloodstream infection rates, surgical site infection prevention, surveillance and prevention of multidrug resistant gram-negative rod infections. Antimicrobial stewardship topics included β-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous to oral conversion of antimicrobial therapy, developing a patient-level “harm index” for antibiotic exposure, and benchmarking and or peer comparison of antibiotic use for common inpatient conditions.

Conclusions:

We identified 6 healthcare-associated infection topics and 6 antimicrobial stewardship topics as potentially high-impact targets for pediatric research.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 5 , May 2021 , pp. 519 - 522
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

Magill, SS, O’Leary, E, Janelle, SJ, et al. Changes in prevalence of health care–associated infections in US hospitals. N Engl J Med 2018;379:1732–1744.CrossRefGoogle Scholar
Lake, JG, Weiner, LM, Milstone, AM, Saiman, L, Magill, SS. Pathogen distribution and antimicrobial resistance among pediatric healthcare—associated infections reported to the National Healthcare Safety Network, 2011–2014. Infect Control Hosp Epidemiol 2018:39:1–11.CrossRefGoogle Scholar
Gerber, JS, Newland, JG, Coffin, SE, et al. Variability in antibiotic use at children’s hospitals. Pediatrics 2010;126:1067–1073.CrossRefGoogle ScholarPubMed
Smith, MJ, Gerber, JS, Hersh, AL. Inpatient antimicrobial stewardship in pediatrics: a systematic review. J Pediatric Infect Dis Soc 2015;4:e127–e135.CrossRefGoogle Scholar
Fleming-Dutra, KE, Hersh, AL, Shapiro, DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA 2016;315:1864–1873.CrossRefGoogle ScholarPubMed
Coffin, SE, Huskins, WC. Editorial commentary: healthcare-associated infections: one size does not fit all. J Pediatric Infect Dis Soc 2012;1:44–46.CrossRefGoogle Scholar
Quach, C, Shah, R, Rubin, LG. Burden of healthcare-associated viral respiratory infections in children’s hospitals. J Pediatric Infect Dis Soc 2018;7:18–24.CrossRefGoogle ScholarPubMed
Gerber, JS, Kronman, MP, Ross, RK, et al. Identifying targets for antimicrobial stewardship in children’s hospitals. Infect Control Hosp Epidemiol 2013;34:1252–1258.CrossRefGoogle ScholarPubMed
Payoff matrix in economics: theory and examples. Study website. …https://study.com/academy/lesson/payoff-matrix-in-economics-theory-examples.html…. Accessed June 2018.Google Scholar
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