The damage response framework and infection prevention: From concept to bedside.

Journal: Infection control and hospital epidemiology
Published Date:

Abstract

Hospital-acquired infections remain a common cause of morbidity and mortality despite advances in infection prevention through use of bundles, environmental cleaning, antimicrobial stewardship, and other best practices. Current prevention strategies and further hospital-acquired infection reduction are limited by lack of recognition of the role that host-microbe interactions play in susceptibility and by the inability to analyze multiple risk factors in real time to accurately predict the likelihood of a hospital-acquired infection before it occurs and to inform medical decision making. Herein, we examine the value of incorporating the damage-response framework and host attributes that determine susceptibility to infectious diseases known by the acronym MISTEACHING (ie, microbiome, immunity, sex, temperature, environment, age, chance, history, inoculum, nutrition, genetics) into infection prevention strategies using machine learning to drive decision support and patient-specific interventions.

Authors

  • Emily J Godbout
    Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.
  • Theresa Madaline
    Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, New York City, New York.
  • Arturo Casadevall
    Department of Microbiology and Immunology, Johns Hopkins University School of Public Health, Baltimore, Maryland.
  • Gonzalo Bearman
    Division of Infectious Diseases, Virginia Commonwealth University Health, Virginia Commonwealth University, Richmond, VA, USA.
  • Liise-Anne Pirofski
    Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, New York City, New York.