Medical Student Research Fellowship for Summer 2012

Mentor: James P. Luby                   
Department: Internal Medicine. Infectious Diseases                   
Room number: Y7.218        
Mail Code: 9113                  
Phone number: 214 648 0234       
E-mail: james.luby@utsouthwestern.edu              
Project title: Surgical Site Infections in Cardiovascular Surgery             

Human subjects IRB approved project number (where applicable):      

Animal subjects IRB approved project number (where applicable):      

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient-based research

Brief Description of Project:

Surgical Site Infections in Cardiovascular Surgery

Cardiovascular surgery is performed in a wide variety of patients; those undergoing elective or semi-elective procedures, those in which infection is already present as in valve repair in patients with infective endocarditis or in those undergoing heart transplant who will be immunosuppressed after surgery and who might be predisposed to infection.  With this variety of patients, it was considered that they might represent a group who could be intensively studied to determine whether patterns were present in the surgical site infections that might occur.  Accordingly, it is proposed that all patients undergoing cardiovascular surgical procedures at SPUH over the last two years will be studied retrospectively in a case-control study. Each patient with an infection involving the (deep incisional) sternum and/or the mediastinum will be matched chronologically with four patients without infection. The electronic medical records (EMRs) of these patients will be reviewed and the following parameters in both groups ascertained: age, race, sex, BMI, procedure type, length of procedure, peri-operative antibiotics, originating hospital, type of infection, time of occurrence of the infection, organism(s) causing the infection, prior colonization with MRSA or VRE, skin preparation,  glucose and temperature control adequacy during and after the procedure, preoperative anemia/RBC transfusion, transplant recipient status, left ventricular assist device status, presence of other infections,  and personnel involved in performing the procedure. Separate from the case-control study, we propose to look in-depth at the patients who are referred from other institutions, at their infection risk stratification and whether they have been prepared pre-operatively to minimize infection.  The student will be involved in the design of the study, preparing the protocol for IRB approval, analyzing the EMRs, entering the data into an infection prevention computer program (Theradoc)  and project database and meeting and following the patients who will come from other institutions through surgery. The project will be instituted by Infection Control at the hospital with the participation of the Cardiovascular Surgical and the Cardiovascular Anesthesiology Services. 

Previous Research Activities or Publications with Medical Students:

Encephalitis virus antibody determinations  in residents of a community near the Trinity River in Dallas TX

Cytomegalovirus and abnormal liver function tests in renal transplant recipients

Aspergillus in lung transplant recipients

Bloodstream infections in patients on emergent hemodialysis