Susan E Coffin1,2, Francisca Abanyie3, Kristina Bryant4, Joseph Cantey5, Anthony Fiore3, Stephanie Fritz6, Judith Guzman-Cottrill7, Adam L Hersh8, W Charles Huskins9, Larry K Kociolek10, Matthew Kronman11, Ebbing Lautenbach2, Grace Lee12, Matthew Linam13, Latania K Logan14, Aaron Milstone15, Jason Newland6,16, A Christine Nyquist17, Debra L Palazzi18, Sameer Patel10, Karen Puopolo1,2, Sujan C Reddy3, Lisa Saiman19, Thomas Sandora20, Andi L Shane13, Michael Smith21, Pranita D Tamma15, Theoklis Zaoutis1,2, Danielle Zerr11, Jeffrey S Gerber1,2. 1. Division of Infectious Diseases and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. 3. Centers for Disease Control and Prevention, Atlanta, Georgia. 4. Kosair Children's Hospital, University of Louisville School of Medicine, Louisville, Kentucky. 5. University of Texas Health, San Antonio, Texas. 6. Washington University School of Medicine in St Louis, St Louis, Missouri. 7. Doernbecher Children's Hospital; Oregon Health & Science University, Portland, Oregon. 8. Department of Pediatrics, Division of Infectious Diseases, University of Utah, Salt Lake City, Utah. 9. Mayo Clinic College of Medicine, Rochester, Minnesota. 10. Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. 11. Seattle Children's Hospital; University of Washington, Seattle, Washington. 12. Stanford Children's Hospital; Stanford University School of Medicine, Palo Alto, California. 13. Children's Healthcare of Atlanta; Emory University School of Medicine, Atlanta, Georgia. 14. Rush University Medical Center; Rush Medical College, Chicago, Illinois. 15. Johns Hopkins University School of Medicine, Baltimore, Maryland. 16. St Louis Children's Hospital, St. Louis, Missouri. 17. Children's Hospital Colorado; University of Colorado School of Medicine, Aurora, Colorado. 18. Texas Children's Hospital: Baylor College of Medicine, Houston, Texas. 19. New York-Presbyterian Hospital, Columbia University Irving Medical Center, New York, New York. 20. Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. 21. Duke Children's Health Center; Duke University Medical Center, Durham, North Carolina.
Abstract
OBJECTIVE: To develop a pediatric research agenda focused on pediatric healthcare-associated infections and antimicrobial stewardship topics that will yield the highest impact on child health. PARTICIPANTS: The study included 26 geographically diverse adult and pediatric infectious diseases clinicians with expertise in healthcare-associated infection prevention and/or antimicrobial stewardship (topic identification and ranking of priorities), as well as members of the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention (topic identification). METHODS: Using a modified Delphi approach, expert recommendations were generated through an iterative process for identifying pediatric research priorities in healthcare associated infection prevention and antimicrobial stewardship. The multistep, 7-month process included a literature review, interactive teleconferences, web-based surveys, and 2 in-person meetings. RESULTS: A final list of 12 high-priority research topics were generated in the 2 domains. High-priority healthcare-associated infection topics included judicious testing for Clostridioides difficile infection, chlorhexidine (CHG) bathing, measuring and preventing hospital-onset bloodstream infection rates, surgical site infection prevention, surveillance and prevention of multidrug resistant gram-negative rod infections. Antimicrobial stewardship topics included β-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous to oral conversion of antimicrobial therapy, developing a patient-level "harm index" for antibiotic exposure, and benchmarking and or peer comparison of antibiotic use for common inpatient conditions. CONCLUSIONS: We identified 6 healthcare-associated infection topics and 6 antimicrobial stewardship topics as potentially high-impact targets for pediatric research.
OBJECTIVE: To develop a pediatric research agenda focused on pediatric healthcare-associated infections and antimicrobial stewardship topics that will yield the highest impact on child health. PARTICIPANTS: The study included 26 geographically diverse adult and pediatric infectious diseases clinicians with expertise in healthcare-associated infection prevention and/or antimicrobial stewardship (topic identification and ranking of priorities), as well as members of the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention (topic identification). METHODS: Using a modified Delphi approach, expert recommendations were generated through an iterative process for identifying pediatric research priorities in healthcare associated infection prevention and antimicrobial stewardship. The multistep, 7-month process included a literature review, interactive teleconferences, web-based surveys, and 2 in-person meetings. RESULTS: A final list of 12 high-priority research topics were generated in the 2 domains. High-priority healthcare-associated infection topics included judicious testing for Clostridioides difficile infection, chlorhexidine (CHG) bathing, measuring and preventing hospital-onset bloodstream infection rates, surgical site infection prevention, surveillance and prevention of multidrug resistant gram-negative rod infections. Antimicrobial stewardship topics included β-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous to oral conversion of antimicrobial therapy, developing a patient-level "harm index" for antibiotic exposure, and benchmarking and or peer comparison of antibiotic use for common inpatient conditions. CONCLUSIONS: We identified 6 healthcare-associated infection topics and 6 antimicrobial stewardship topics as potentially high-impact targets for pediatric research.
Authors: James W Antoon; Carlos G Grijalva; Alison G Grisso; Cosby A Stone; Jakobi Johnson; Justine Stassun; Allison E Norton; Sunil Kripalani; Derek J Williams Journal: Hosp Pediatr Date: 2022-07-01