# RFA-CK20-004: Infection Prevention and Antimicrobial Stewardship: Minding the Gaps: The Iowa Prevention Epicenter

> **NIH ALLCDC U54** · UNIVERSITY OF IOWA · 2024 · $578,198

## Abstract

ABSTRACT
We designed this proposal to address multiple CDC Epicenters' research priorities: preventing healthcare
personnel (HCP) contamination, understanding and decreasing transmission of epidemiologically important
pathogens including emerging respiratory viruses such as COVID-19, extending antimicrobial stewardship
(AS), decreasing antimicrobial resistant infections, exploring sepsis epidemiology and prevention, quantifying
and decreasing environmental contamination, implementing a decolonization program to obtain source control
and decrease surgical site infections (SSI), applying innovative research methodology, and training the next
generation of healthcare epidemiologists. Our proposed projects range from translational stage T0 to T2 and
involve academic medical centers, a VA Medical Center, acute care hospitals, quick/urgent care centers
(UCC), surgical patients, patients discharged from hospitals, and healthcare personnel (HCP) exposed to viral
respiratory pathogens. Our long-term objectives are to: 1) improve the integration of infection prevention
measures into HCP's patient care processes, 2) improve personal protective equipment (PPE) design and use
to decrease HCP contamination and transmission, 3) improve surveillance for healthcare-associated infections
(HAI), 4) identify practical ways to decrease spread of viral pathogens, 4) improve antibiotic use and decrease
antimicrobial resistance, and 5) prevent hospital-onset sepsis (HOS) and HAI, including SSI. Core Project
(CP) I uses methods from human factors engineering, ethnography, industrial hygiene, environmental
microbiology, and computer visioning to improve PPE design, decrease HCP self-contamination, improve
integration of PPE use and hand hygiene during patient care, and decrease bacterial and viral environmental
contamination. CP II employs novel software via cellphones to expand surveillance for SSI and C. difficile
infections after discharge and to monitor HCP exposed to respiratory viruses for signs or symptoms of
infection. CP III and the Medium Optional Collaborative Project (OCP) address neglected opportunities for
AS--UCC and patients at hospital discharge--by creating and testing novel AS metrics to decrease antibiotic
prescriptions for acute respiratory tract infections in UCC (CP III) and by conducting a cluster-randomized trial
of post-prescription audit-and-review to reduce unnecessary antibiotic use after discharge (Medium OCP). CP
IV mines large administrative data sets and analyzes data from individual medical records to define the
epidemiology of HOS, validate CDC's acute sepsis event algorithm for HOS, and identify remediable HOS risk
factors that could be targets for preventive measures. The Large OCP will conduct a stepped wedge trial of a
simple, inexpensive intervention—2 doses of intranasal povidone iodine—to prevent SSI in patients with high-
energy lower extremity fractures, who are a high-risk population with few available preventive measures. The
...

## Key facts

- **NIH application ID:** 10829212
- **Project number:** 5U54CK000613-04
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Loreen A Herwaldt
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $578,198
- **Award type:** 5
- **Project period:** 2021-06-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10829212

## Citation

> US National Institutes of Health, RePORTER application 10829212, RFA-CK20-004: Infection Prevention and Antimicrobial Stewardship: Minding the Gaps: The Iowa Prevention Epicenter (5U54CK000613-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10829212. Licensed CC0.

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