Hospital Epidemiology and Antimicrobial Stewardship

Completion of the Society for Healthcare Epidemiology of America Primer on Hospital Epidemiology, Infection Control and Antimicrobial Stewardship; this primer is a required component for all ID trainees by the end of the ACGME-accredited training.

For trainees on this track, the primer will be completed in year 1 of fellowship during the four scheduled weeks for research. In addition, the trainee will have hands-on participation in HE-AS activities at BMC and/or VABHS that will allow the trainee to put the learning into real-life context and practice. The trainee will have the option of spending one of those weeks as an observer at the Boston Public Health Commission.

During this time, the trainee will work with BMC and VABHS faculty to either choose from a list of available scholarly projects or develop their own original proposal to complete during the second year of fellowship training and to address any required Institutional review board submissions or certifications. The trainee will also identify a quality improvement project to complete during fellowship training.

During this year, the fellow will have the opportunity to function within the infection control and antimicrobial stewardship teams at either BMC or the VABHS. The trainee will have the option to complete this training at either or both sites but will preferentially be assigned to BMC or VABHS based on chosen scholarly and QI projects and the home institution of the trainee’s primary mentor.

• Didactic and hands-on in-depth curriculum in infection control, hospital epidemiology and antimicrobial stewardship, guided by the principles outlined by the Society for Healthcare Epidemiology of America and their published compendia on hospital-associated infections.
• Participation in disease surveillance, outbreak investigation, federal and state reporting, participation in AS rounds with the MD-ID pharmacist team, clinical guidelines development, drug use evaluations, and implementation of new AS strategies.
• Active participation in HE-AS committees and Quality Improvement
• BMC-based training curriculum on research methods, implementation and improvement science, and qualitative research.
• Participation in a scholarly project relevant to HE-AS (this can be an academic extension of the quality improvement project or a separate endeavor) with the goal of preparing an abstract for presentation at a national meeting, which the trainee will be supported to attend.

Tamar Barlam, MD, MSc – Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine; Chief, Section of Infectious Diseases; Director, Antimicrobial Stewardship Program and Hospital Epidemiology, BMC

Kalpana Gupta, MD – Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine; Chief, Infectious Diseases VABHS

Mari-Lynn Drainoni, PhD – Research Professor of Health Policy and Management, Boston University School of Public Health; Research Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine; Research Health Scientist, Center for Health Quality, Outcomes, and Economic Research at the Edith Norse Rogers Memorial Veterans Hospital

Cassandra Pierre, MD, MSc – Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine; Associate Hospital Epidemiologist; Medical Director of Public Health Programs

Alison Nelson, DO –Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine; Assistant Hospital Epidemiologist, BMC; Assistant Director, Antimicrobial Stewardship Program, BMC

Judith Strymish, MD – Boston VA Hospital, Antibiotic Stewardship Champion, Assistant Professor of Medicine, Harvard Medical School

Katherine Linsenmeyer, MD – Associate Hospital Epidemiologist, Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine

Fellows have rich opportunities to participate in scholarly projects at both BMC and the VABHS. Both institutions have grant-funded ongoing investigations that fellows can join, rich datasets that can be used to ask original research questions, and resources available to provide epidemiology, biostatistics, implementation science and mixed methods expertise and support. The BU profiles of the faculty summarize individual research interests and publications. Examples of fellow- and trainee-led publications in peer-reviewed journals are listed below.

1. Acuna-Villaorduna C, Branch-Elliman W, Strymish J, Gupta K. Active identification of patients who are methicillin-resistant Staphylococcus aureus colonized is not associated with longer duration of vancomycin therapy. Am J Infect Control. 2017 Oct 01; 45(10):1081-1085.View Related Profiles. PMID: 28629753

2. Luo R, Barlam TF. Ten-year review of Clostridium difficile infection in acute care hospitals in the USA, 2005-2014. Journal of Hospital Infection 2018;98(1):40-43. PMID 29017933

3. Luo R, Weinberg JM, Barlam TF. The impact of Clostridium difficile infection on future outcomes of solid organ transplant recipients. Infection Control and Hospital Epidemiology 2018;39(5):565-570., https://doi.org/10.1093/ofid/ofy102 PMID 30280120

4. Asundi A, Stanislawski M, Mehta P, Barón AE, Gold H, Mull H, Ho PM, Gupta K, Branch-Elliman W. Prolonged antimicrobial prophylaxis following cardiac device procedures increases preventable harm: insights from the VA CART program. Infect Control Hosp Epidemiol. 2018 Sep;39(9):1030-1036. doi: 10.1017/ice.2018.170. PMID: 30226128

5. Gallegos Salazar J, O’Brien W, Strymish JM, Itani K, Branch-Elliman W, Gupta K. Association of Screening and Treatment for Preoperative Asymptomatic Bacteriuria With Postoperative Outcomes Among US Veterans. JAMA Surg. 2019 03 01; 154(3):241-248.View Related Profiles. PMID: 30540346; PMCID: PMC6439639; DOI: 10.1001/jamasurg.2018.4759

6. Asundi A, Stanislawski M, Mehta P, Baron AE, Mull HJ, Ho PM, Zimetbaum PJ, Gupta K, Branch-Elliman W. Real-world effectiveness of infection prevention interventions for reducing procedure-related cardiac device infections: Insights from the veterans affairs clinical assessment reporting and tracking program. Infect Control Hosp Epidemiol. 2019 08; 40(8):855-862.View Related Profiles. PMID: 31159895; PMCID: PMC7239318; DOI: 10.1017/ice.2019.127

7. Gupta K, O’Brien W, Gallegos-Salazar J, Strymish J, Branch-Elliman W. How Testing Drives Treatment in Asymptomatic Patients: Level of Pyuria Directly Predicts Probability of Antimicrobial Prescribing. Clin Infect Dis. 2019 Aug 30. PMID: 31504317

8. Burrowes SAB, Rader A, Ni P, Drainoni ML, Barlam TF. Low Uptake of Rapid Diagnostic Tests for Respiratory Tract Infections in an Urban Safety Net Hospital. Open Forum Infect Dis. 2020 Mar; 7(3). doi: 10.1093/ofid/ofaa057. PMID: 32166096

9. Burrowes SAB, Barlam TF, Skinner A, Berger R, Ni P, & Drainoni M-L. Provider views on rapid diagnostic tests and antibiotic prescribing for respiratory tract infections: A mixed methods study. PloS One 2021; 16(11): e0260598. https://doi.org/10.1371/JOURNAL.PONE.0260598. PMID: 34843599

10. Burns RH, Pierre CM, Marathe JG, Ruiz-Mercado G, Taylor JL, Kimmel SD, Johnson SL, Fukuda HD, Assoumou SA. Partnering With State Health Departments to Address Injection-Related Infections During the Opioid Epidemic: Experience at a Safety Net Hospital. Open Forum Infect Dis. 2021 Apr 27;8(8):ofab208. doi: 10.1093/ofid/ofab208. PMID: 34409120; PMCID: PMC8364760

11. Dhanani M, Goodrich C, Weinberg J, Acuna-Villaorduna C, Barlam TF. Antibiotic therapy completion for injection drug use-associated infective endocarditis at a center with routine addiction medicine consultation: a retrospective cohort study. BMC Infectious Diseases 2022; 22(1):128. Doi:10.1186/s12879-022-07122-x. PMID: 35123439

12. Dhanani M, Krishnamoorthy A, Ciolino JD, Gupta K, Strymish JM. Prophylaxis against spontaneous bacterial peritonitis: Too much or too little? Antimicrob Steward Healthc Epidemiol. 2022; 2(1):e95. PMID: 36483431

13. Khan GK, Harvey L, Johnson S, Long P, Kimmel S, Pierre C, Drainoni ML. Integration of a community-based harm reduction program into a safety net hospital: a qualitative study. Harm Reduct J. 2022 Apr 12;19(1):35. doi: 10.1186/s12954-022-00622-8. PMID: 35414072; PMCID: PMC9002225

14. Nelson A, Gupta K, Strymish J, Nee M, Linsenmeyer K. 10-Year Trends in Urine Testing and Treatment in Patients with Spinal Cord Injury: An Opportunity for Targeted Stewardship. Infection Control & Hospital Epidemiology. 2020;41(S1):s90-s90. doi:10.1017/ice.2020.586