A group of seniors sit in chairs around a medical professional in a nursing home. Credit: Getty Images

Diverse Team including UMass Amherst Biostatistician Receives $13.7 Million Grant to Address Antibiotic Resistance in Nursing Homes

Novel project examines six superbugs at once

Six antibiotic-resistant pathogens that are serious and urgent national health threats will be studied by a national team of investigators who received a $13.7 million, five-year grant from the National Institute of Allergy and Infectious Diseases.

Led by UCI Health infectious diseases expert Dr. Susan Huang and the University of California, Irvine (UCI) School of Medicine, researchers from the University of Massachusetts Amherst, Broad Institute of MIT and Harvard, City University of New York Graduate School of Public Health and Health Policy, and the National Institutes of Health (NIH) will collaborate to address the growing problem of multidrug-resistant organisms (MDROs) in nursing homes throughout the United States.

The MDROs will be examined using one of the world’s largest compilations of specimens from healthcare facilities: 16,000 samples collected from residents and environmental surfaces of 50 U.S. nursing homes.

The grant investigators include notable experts in infectious diseases, epidemiology, biostatistics, microbiology, pathogen genomics, human microbiome, systems science, health economics and mathematical modeling. The project marks the first time all six major MDROs will be investigated using multiple scientific methods at the same time.

Ken Kleinman

We’ll be able to say that one resident got it [an infection] from the handrail outside their room, whereas the residents of the other side of the nursing home got it from the lunch tray that was served to them.

Ken Kleinman, professor of biostatistics in the School of Public Health and Health Sciences

“Despite having a large number of residents at risk for multidrug resistant organism spread and disease, nursing homes remain understudied, and effective interventions are needed,” says Huang, medical director of epidemiology and infection prevention at UCI Health.

UMass Amherst biostatistician Ken Kleinman is leading a part of the research that will help investigators understand how best to use the data collected. He also will design the data collection strategy.

“We’re going to figure out the most efficient way to collect the data and the best ways to use it in the study,” says Kleinman, professor of biostatistics in the School of Public Health and Health Sciences.

Huang is one of the nation’s leading researchers focused on finding strategies to reduce the risk of MDRO infection and spread in the healthcare setting. Kleinman has worked previously with Huang on such groundbreaking research as the REDUCE MRSA Trial, which found that decolonizing all hospital intensive care unit patients with chlorhexidine and nasal mupirocin decreased all-cause bloodstream infections by nearly half.

MDROs are a serious problem for the 1.4 million people living in the nation’s 15,000 nursing homes. The estimated 65% of nursing home residents harboring MDROs is four to six times that seen in hospitals. Collectively, these MDROs cause about 590,000 infections and 26,000 deaths in the U.S. every year.

The researchers are seeking the best MDRO detection methods, sources and drivers of their spread, major risk factors associated with colonization, infection and hospitalization, and the interventions to inform infection prevention policies and reduce hospitalizations and deaths. Genome analysis of the superbug samples will show where and how the pathogens are spread in the nursing homes.

“We’ll be able to say that one resident got it from the handrail outside their room, whereas the residents of the other side of the nursing home got it from the lunch tray that was served to them,” Kleinman says. “It’s super cool science.”

The six MDROs under investigation include five bacteria and one fungus: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum beta-lactamase producers (ESBL), carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Acinetobacter baumanii (CRAB) and Candida auris.

Scanning electron microscope images showing spiny oxalate crystals with which microbes tune their ECM. Credit: Dr. Nina E. Nagy, Norwegian Institute of Bioeconomy Research (NIBIO)

Earlier this year, professor of microbiology Barry Goodell and his colleagues found that the slime layer, which can be a barrier to antibiotics, can be unlocked with common oxalic acid.