UCI Health team receives $13.7 million federal grant to address antibiotic resistance in nursing homes

Novel project brings together diverse investigators to examine six organisms at once

July 25, 2023
uci health infectious diseases expert dr susan huang wearing red blazer in hallway, smiling with arms crossed, huang has been awarded a 13.7 million federal grant to study six pathogens in nursing homes
UCI Health Dr. Susan Huang is one of the nation’s leading researchers
dedicated to finding strategies to reduce the risk of MDRO infection
and spread in the healthcare setting.

Orange, Calif. — A team led by UCI Health and the UCI School of Medicine has been awarded a $13.7 million, five-year grant from the National Institute of Allergy and Infectious Diseases to address the growing problem of multidrug resistant organisms (MDROs) in nursing homes throughout the United States.

Six antibiotic-resistant MDROs deemed as serious and urgent national health threats will be studied by a national team of investigators led by UCI Health infectious diseases expert Dr. Susan Huang.

The MDROs will be examined using one of the world’s largest compilations of specimens from healthcare facilities: 16,000 samples collected for previous and future studies from residents and environmental surfaces of 50 U.S. nursing homes.

It is the first time all six major MDROs will be investigated using multiple scientific methods at the same time.

“Despite having a large number of residents at risk for multidrug resistant organism spread and disease, nursing homes remain understudied and effective interventions are needed,” says Huang, the medical director of epidemiology and infection prevention at UCI Health and the study’s principal investigator.

MDROs: a serious problem

MDROs are a serious problem for the 1.4 million people living in the nation’s 15,000 nursing homes. Huang says the percent of them harboring MDROs – estimated to be around 65% – is four to six times that seen in hospitals. Collectively, these MDROs cause about 590,000 infections and 26,000 deaths in the U.S. every year.

Huang and her team are seeking the best MDRO detection methods, sources and drivers of their spread, major risk factors associated with colonization, infection and hospitalization, and the best interventions that inform infection prevention policies and reduce hospitalizations and deaths.

The national team of grant investigators includes notable experts in infectious diseases, epidemiology, microbiology, pathogen genomics, human microbiome, statistics, systems science, health economics and mathematical modeling. Huang is joined by colleagues from the Broad Institute of MIT and Harvard, City University of New York Graduate School of Public Health and Health Policy, UMass Amherst, and the National Institutes of Health.

The six MDROs under investigation include five bacteria and one fungus: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum beta-lactamase producers (ESBL), carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Acinetobacter baumanii (CRAB) and Candida auris.

Combating MDRO infection and spread

Huang is one of the nation’s leading researchers dedicated to finding strategies to reduce the risk of MDRO infection and spread in the healthcare setting — both hospitals and nursing homes.

During the pandemic, she and her colleagues developed the Orange County Nursing Home Infection Prevention Toolkit to mitigate the spread of COVID-19. She created SHIELD OC, a quality improvement project for hospitals, nursing homes and long-term acute care hospitals to prevent MDRO spread.

Her past research has found that decolonization can be an effective tool to prevent infections for at-risk populations in the healthcare system. The REDUCE MRSA Trial found that decolonizing all intensive care unit patients with chlorhexidine and nasal mupirocin decreased all-cause bloodstream infections by nearly half.

The Agency for Healthcare Research and Quality (AHRQ) published a toolkit that expands the decolonization protocol to non-ICU hospital patients who have had medical devices based on the ABATE Infection Trial, also led by Huang. The CLEAR post-discharge trial showed that chlorhexidine and nasal mupirocin used after hospital discharge could reduce infection and hospitalization in those colonized with MRSA.

The study’s investigators are:

UCI School of Medicine

Susan Huang, MD, MPH (Principal Investigator)
Chancellor’s Professor
Division of Infectious Diseases
Medical Director, Epidemiology & Infection Prevention

Cassiana Bittencourt, MD
Assistant Professor
Pathology & Laboratory Medicine

Broad Institute of MIT and Harvard

Ashlee Earl, PhD
Institute Scientist and Director of the Bacterial Genomics Group
Infectious Disease & Microbiome Program

Colin Worby, PhD
Senior Computational Biologist
Infectious Disease & Microbiome Program

City University of New York Graduate School of Public Health and Health Policy (CUNY SPH)

Bruce Y. Lee, MD, MBA
Professor of Health Policy and Management
Executive Director of the Center for Advanced Technology and Communication in Health (CATCH)

UMass Amherst

Ken Kleinman, ScD
Biostatistics & Epidemiology

National Institutes of Health

Julia Segre, PhD
Chief and Senior Investigator
Translational and Functional Genomics Branch

National Human Genome Research Institute

Sean Conlan, PhD
Associate Investigator
Translational and Functional Genomics Branch
National Human Genome Research Institute

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About UCI Health

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed, acute care hospital, listed among America’s Best Hospitals by U.S. News & World Report for 22 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook, Instagram, LinkedIn and Twitter.