Literature Review & Research Synthesis
Antibiotic Stewardship: A Universal Framework Through the Lenses of Three Model Organisms
My undergraduate thesis' proposed a universal framework for antibiotic resistance prevention. This three-pronged approach interconnected under the spectacles of antibiotic stewardship emphasized antibiotic stewardship (conversation), the reduction of the burden of infectious disease (prevention), and the refinement of current medical practices and treatment options (innovation). This thesis highlights my capacity to conduct a thoughtful literature review and synthesize research into an actionable framework for antibiotic stewardship programming. I am in the process of reformatting the thesis for online dissemination. Request access to my thesis via email |
Microbial Transmission
Contamination of Common Area and Rehabilitation Gym Environment with Multidrug-Resistant Organisms
In this project, I conducted secondary data analysis from a prospective longitudinal cohort study that evaluated patient colonization and room environment contamination of newly admitted nursing home patients. This study evaluated the contamination of common area and rehabilitation gym with multidrug-resistant organisms in six nursing homes. We also designed and implemented pilot study to evaluate the transfer of bacteria to patient hands during rehabilitation sessions. My Role: Study design, data analysis, and manuscript writing. Link: https://pubmed.ncbi.nlm.nih.gov/31851386/ |
Improving Surveillance Strategies in Nursing Homes
Assessment of Race and Sex as Risk Factors for Colonization with Multidrug-resistant Organisms in Six Nursing Homes
In this project, we conducted secondary data analysis from a prospective longitudinal cohort study that evaluated the colonization and room environment contamination of newly admitted nursing home patients. This study assessed whether race or sex serves as risk factors for MDRO colonization in six nursing homes. We find that male sex is a significant risk factor for MDRO prevalence during the nursing home stay. Specifically, we show that sex differences are depending on organism of interest and body site. My Role: Study design, data analysis, and manuscript writing. Link: https://pubmed.ncbi.nlm.nih.gov/32493534/ |
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Can alternative anatomical sites and environmental surveillance replace perianal screening for multidrug-resistant organisms in nursing homes?
Many studies performing surveillance of antibiotic-resistant organisms rely upon rectal or perianal specimen collection. Collecting these specimens in nursing homes can be challenging due to patient frailty or disinterest in research. We identified that the use of multianatomical, non-perianal screening and room environment surveillance may replace perianal screening and reduce healthy participant bias in nursing homes. My Role: Study design, data analysis, and manuscript writing. Link: https://doi.org/10.1017/ice.2021.134 |
Resistance in Long-Term Acute Care Hospitals
Characterization of resistance to newer antibiotics among carbapenem-resistant Klebsiella pneumoniae in the post-acute care setting
We assessed susceptibility patterns to newer antimicrobial agents among clinical carbapenem-resistant Klebsiella pneumoniae isolates from patients in long-term acute-care hospitals from 2014 to 2015. Meropenem-vaborbactam and imipenem-relebactam nonsusceptibility were observed among 9.9% and 9.1% of isolates, respectively. Nonsusceptibility to ceftazidime-avibactam (1.1%) and plazomicin (0.8%) were uncommon. My Role: Phylogenetic tree visualizations, data analysis, and review of manuscript Link: https://doi.org/10.1017/ice.2022.185 |
Antibiotic Stewardship
Association of Exposure to High-risk Antibiotics in Acute Care Hospitals With Multidrug-Resistant Organism Burden in Nursing Homes
In this project, we were interested in whether patient exposure to antibiotics therapy within a hospital stay influenced multidrug-resistant organism burden in nursing homes. We found that hospital antibiotic exposure increased the odds of colonization and room environment contamination on patient enrollment in the nursing home. Of note, exposure to high-risk antibiotics significantly increased the effect size. Our work suggest that high-risk hospital antibiotic prescribing is a potentially high-value antibiotic stewardship target to reduce the burden of MDROs in nursing homes. My role: Alongside mentorship from Dr. Payal Patel, I design the study, curated the dataset, performed the analyses, and wrote the mansucript. Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788560 |
Public Health
Health education after COVID-19: A time to revisit, revamp, and revitalize?
The COVID-19 pandemic placed considerable stress on the K-12 student and the K-12 educational system. Alongside educational disruptions via non-pharmaceutical interventions, students’ physical, emotional, and social health were deeply impacted by the pandemic. This crisis unearthed the urgency to move society’s framework of health away from predominantly reactive, clinical models toward those that honor health as a multi-component state of well-being. In response, we utilize this piece to argue that addressing public health topics in K-12 health curriculum would promote coping strategies with the current pandemic, prepare the populace for future public health crises, further encourage healthy behavior, and inspire future generations to join the public health workforce. My role: Project lead, conceptualization, and manuscript writing. Link: https://www.ajicjournal.org/article/S0196-6553(22)00817-3/fulltext |
Science Communication
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Preventing Resistance and Infection by Integrating Systems in Michigan (PRIISM)
This project aims to develop an integrated infection prevention program leveraging the close relationship between hospitals and their preferred nursing homes. This intervention highlights the importance of UTI/CAUTI prevention, antimicrobial stewardship, implementing evidence based policies to reduce drug-resistant bacteria, and enhance patient safety. My Role: During this project, I have assisted with the designing and implementation of educational interventions. One of my favorite games was a "Wheel of Infection" where we quizzed the audience on infection prevention related questions (see picture). I also wrote a blog article on "What are Urinary Tract Infections." This work is an ongoing AHRQ-funded project spearheaded by Dr. Lona Mody and her team. Check out the PRIISM website & follow the PRIISM Team on Twitter for more information! |
Integration of Work & Faith
From a culture of blame to a culture of grace: A letter in reply to Papadakis
Throughout the COVID-19 pandemic, I enjoyed appraising the current state of affairs through my professional, cultural, and religious lens. This practice was pushed to the forefront amidst the large waves of negativity and blame found found levied onto healthcare providers and the public. In this article, we argued for the fostering of a culture of blame, one marked by forgiveness and inclusive healthcare. My Role: Drafted initial outline and manuscript under the direction and mentorship of Dr. Kristin Collier, the director of the Health, Spirituality and Religion Program at the University of Michigan. Link: https://pubmed.ncbi.nlm.nih.gov/34446119/ |