# Simulating the Spread and Control of Multiple MDROs Across a Network of Different Nursing Homes

> **NIH NIH U19** · UNIVERSITY OF CALIFORNIA-IRVINE · 2024 · $526,205

## Abstract

Abstract
Project 3: Simulating the Spread and Control of Multiple MDROs
Across a Network of Nursing Homes in a Region
 Multidrug-resistant organisms (MDROs) cause nearly 3 million healthcare-associated infections (HAIs),
which are a major cause of death in US nursing homes (NHs), annually. While MDROs are commonly studied
in isolation, these pathogens circulate simultaneously, and their spread and prevention may affect and
compound each other. Therefore, determining the value of such strategies in NHs requires an understanding of
how they would affect colonization and infection risks of various MDROs simultaneously. Moreover, the impact
of MDROs and their prevention and control strategies extend beyond individual NHs and involve the dynamic
ecosystem of NHs in a region. Computational modeling that integrates epidemiologic, operational, and
economic components can help delineate the circulation and impact of multiple MDROs, test various
prevention and control strategies, and determine the subsequent ecosystem-wide effects related to
transmission and disease burden in ways that can save time, effort, and resources. The overall goal of this
proposed project is to elucidate (1) the combined effects of multiple MDROs spreading simultaneously
and (2) how policies and interventions (e.g., contact precautions, decolonization) may have an impact
across a variety of MDROs at the same time, using agent-based models (ABMs) of NHs in Orange
County (OC), California (CA). These detailed representations of NHs will include and help differentiate
among various multi-level factors affecting MDRO spread. This modeling Project will proceed in a synergistic,
iterative manner with the other two Projects. Model results will guide data collection and analyses for Projects 1
and 2, and data insights from Projects 1 and 2 will guide further refinement of the models. Shifting the focus
from one MDRO at a time to various MDROs collectively will help decision makers choose the best
overall infection control strategy. Specific Aim 1 will develop ABMs for each of the 70 nursing NHs in OC,
CA simulating how multiple MDROs (methicillin-resistant Staphylococcus aureus, vancomycin-resistant
enterococci, extended-spectrum beta-lactamase-producing Enterobacterales, carbapenem-resistant
Enterobacterales, and Candida auris) interact among carriers and co-carriers to promote spread. Specific Aim
2 will evaluate how different pathogens, host factors (e.g., comorbidities, wounds, bedbound status), and room
characteristics (e.g., roommates, common areas, shared equipment) simultaneously affect MDRO
transmission in NHs across a region using the various NH ABMs. Specific Aim 3 will estimate how various
pathogen-specific and non-specific multi-modal strategies may affect the transmission and spread of different
MDROs individually and simultaneously in NHs across a region using the NH ABMs.

## Key facts

- **NIH application ID:** 10885905
- **Project number:** 5U19AI172725-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA-IRVINE
- **Principal Investigator:** Bruce Y Lee
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $526,205
- **Award type:** 5
- **Project period:** 2023-07-11 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10885905

## Citation

> US National Institutes of Health, RePORTER application 10885905, Simulating the Spread and Control of Multiple MDROs Across a Network of Different Nursing Homes (5U19AI172725-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10885905. Licensed CC0.

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