# Epicenter V: Harvard Pilgrim Health Care Institute Center for Excellence in HAI Surveillance and Prevention

> **NIH ALLCDC U54** · HARVARD PILGRIM HEALTH CARE, INC. · 2022 · $1,511,694

## Abstract

Abstract
Epicenter V: Harvard Pilgrim Health Care Institute Center for
Excellence in HAI Surveillance and Prevention: Core Projects
 This Epicenter will pursue six aims to develop essential information to guide improved management of
sepsis, non-ventilator hospital acquired pneumonia, and prevention of C. difficile infection among hospital
inpatients.
 The sepsis work will be grounded in analyses of electronic health record data from 300 hospitals drawn
from HCA Healthcare and Cerner’s HealthFacts database, together covering the years 2013 through 2019, and
involving 1 million sepsis admissions. These studies will use advanced causal inference methods to address
three major questions with direct relevance both to management of sepsis and to national mandates and
reimbursement policies. These questions are: 1) How does severity of illness at presentation affect the
relationship between time-to-antibiotic and survival among patients with bloodstream infections? 2) How
common and serious are adverse effects of short course empiric antibiotic therapy among patients with
suspected sepsis who prove to have non-infectious conditions? 3) What are the consequences of failure to de-
escalate empiric antibiotics prescribed for suspected sepsis after infection is ruled out?
 The first non-ventilator hospital acquired pneumonia (NV-HAP) aim will address a critical unknown
about this common and frequently fatal condition – to what extent are NV-HAP associated deaths preventable?
This assessment will use previously validated methods by which expert clinicians review full text medical
records from both teaching and community hospitals to determine the cause of death and to determine its
relationship to NV-HAP. These findings will inform the urgency of implementing national surveillance and
reporting of NV-HAP occurrence, and of designing and testing mitigation strategies.
 The second NV-HAP aim will design and test a pharmacist led opt-out protocol for discontinuing
antibiotics for the 20% of inpatients diagnosed with NV-HAP who have normal clinical signs. This randomized
trial will be powered to assess the impact on antibiotic utilization and lay the groundwork for a later definitive
trial of the impact on patient outcomes.
 The final aim will address methods for preventing hospital-onset C. difficile infection amongst high risk
patients. We will identify patients colonized with C. difficile via PCR testing of VRE surveillance swabs
obtained on admission. Colonized patients in the intervention period will receive a prevention bundle including
antibiotic and antacid stewardship as well as consideration of prophylactic probiotics and oral vancomycin.

## Key facts

- **NIH application ID:** 10402234
- **Project number:** 5U54CK000611-02
- **Recipient organization:** HARVARD PILGRIM HEALTH CARE, INC.
- **Principal Investigator:** Michael Klompas
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $1,511,694
- **Award type:** 5
- **Project period:** 2021-06-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10402234

## Citation

> US National Institutes of Health, RePORTER application 10402234, Epicenter V: Harvard Pilgrim Health Care Institute Center for Excellence in HAI Surveillance and Prevention (5U54CK000611-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10402234. Licensed CC0.

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