Pre-rerouting strategy to ensure business continuity for low-Earth-orbit satellite network

Beijing Institute of Technology Press Co., Ltd

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Fig. 1. The structure of the extended Route-LSA (the red font represents the extension parts). LSA, link state advertisement.

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Credit: Space: Science & Technology

With the rapid development of 6G space–air–ground integrated communication networks, low Earth orbit (LEO) satellite constellations, leveraging their advantages of wide-area coverage and freedom from geographic constraints, have become key infrastructure for achieving global seamless connectivity. However, due to the relative motion among satellites in different orbits, inter-satellite links (ISLs) exhibit periodic dynamic on–off characteristics, among which a portion of the interruptions are predictable topological changes. Conventional Open Shortest Path First (OSPF) protocols compute shortest paths solely based on link distance, without considering link effective duration or bandwidth constraints, rendering them inadequate for adapting to the dynamic topological characteristics of satellite networks. Although fast reroute strategies can address sudden link failures, they consume substantial bandwidth resources and cannot provide protection for all nodes across the entire network. Therefore, how to proactively switch service paths before predictable link interruptions occur, so as to minimize service disruption and resource overhead, has become a core issue in ensuring service continuity in LEO satellite networks.

In a recent study published in Space: Science & Technology, the research team led by Huang Shanguo from the School of Electronic Engineering, Beijing University of Posts and Telecommunications, proposed a pre-rerouting strategy based on an extended OSPF protocol. The study first extends the routing information advertisement by adding two new fields—namely, "termination time of validity" and "available bandwidth"—and achieves synchronization of the link state database across the entire network through the Link Management Protocol. Furthermore, the routing metric is redefined as a weighted combination of the conventional metric and the link effective duration, enabling the Constrained Shortest Path First (CSPF) algorithm to simultaneously account for both path length and effective duration. On this basis, a pre-rerouting mechanism is established: the source node continuously monitors the remaining effective time of the label switched path (LSP); when the remaining effective time falls below the remaining service transmission duration and is less than a preset threshold, the node automatically computes the optimal backup path based on the current network state, establishes a new LSP, performs service switching, and finally releases the resources of the old path. Functional verification based on the VxWorks embedded system and FPGA hardware platform demonstrates that the pre-rerouting mechanism achieves seamless service switching before the old link interruption, with zero packet loss during the switching process. Performance verification on the EXata hardware-in-the-loop simulation platform shows that the pre-rerouting strategy attains a packet loss rate of 1%, representing a reduction of approximately 6 percentage points compared to the 7% rate of conventional rerouting schemes. This research provides an efficient, low-loss service continuity assurance solution for LEO satellite networks in dealing with predictable link interruptions, offering significant engineering application value for the stable and reliable operation of space–air–ground integrated networks.

First, this study focuses on the service interruption problem caused by dynamic changes in inter-satellite links (ISLs) within LEO satellite networks, and proposes a pre-rerouting strategy based on an extended Open Shortest Path First (OSPF) protocol. Owing to the relative motion among satellites in different orbits, ISLs exhibit periodic on–off characteristics, a portion of which can be predicted in advance based on orbital motion laws. Conventional OSPF protocols compute the shortest path solely on the basis of link distance, without accounting for constraints such as link effective duration or bandwidth availability; meanwhile, fast reroute strategies, although capable of handling sudden failures, consume substantial bandwidth resources. To address this, the study extends the routing information advertisement by adding two new fields—namely, "termination time of validity" and "available bandwidth"—to the original link state information, as shown in Fig. 1, enabling routers to acquire information on the remaining available duration and bandwidth of each link. On this basis, the routing metric computation is redefined by incorporating link effective duration as a significant weighting factor in path selection, allowing users to adjust the weighting factor according to service requirements to strike a balance between the shortest path and the longest effective duration. As illustrated in the example in Fig. 2, a path with fewer hops but an interruption after 200 seconds cannot satisfy a service duration requirement of 800 seconds; in contrast, the Constrained Shortest Path First (CSPF) algorithm can select a path with slightly more hops but an effective duration of up to 1,000 seconds, thereby validating the effectiveness of the proposed scheme in ensuring service continuity under dynamic topologies.

Second, the study elaborates on the detailed design of the trigger and execution process of the pre-rerouting strategy, and verifies its functionality through hardware experiments. As shown in Fig. 3, the source node continuously monitors the remaining effective time of the established Label Switched Path (LSP). When this remaining time falls below the remaining service transmission duration and is less than a preset time threshold, the pre-rerouting mechanism is automatically triggered: the source node recomputes the optimal path satisfying both bandwidth and duration constraints based on the current network state, reserves resources and establishes a new LSP through the constraint-based routed label distribution protocol, and releases the resources of the old path after service switching is completed. To verify this functionality, the research team built an experimental environment based on the VxWorks embedded system and an FPGA hardware platform, with the topology shown in Fig. 4, where dynamic link on–off is simulated by plugging and unplugging ports between control nodes. The functional verification results demonstrate that when the old LSP is established using a port with a shorter effective time, upon triggering of the pre-rerouting, the source node automatically constructs a new path using a port with a longer effective time, during which ping packets are transmitted normally; after the old path is released, service transmission continues without packet loss. This proves that the pre-rerouting strategy can autonomously complete path switching before link interruption and ensure service continuity.

Finally, the study quantitatively validates the performance of the pre-rerouting strategy on the EXata hardware-in-the-loop simulation platform. In the simulation topology, two alternative paths are available between the source node and the destination node, with the primary path configured with an effective duration of 100 seconds and a service duration of 500 seconds. Fig. 5 shows that the source node transmits a total of 1,000 UDP packets. In the conventional OSPF rerouting scenario, as depicted in Fig. 6, the link fails at 100 seconds, and service transmission resumes only after an interruption of approximately 20 seconds; ultimately, the destination node receives 930 packets, corresponding to a packet loss rate of 7%. In contrast, in the scenario employing the pre-rerouting strategy, as shown in Fig. 13, the service is switched to the backup path before the interruption occurs, resulting in uninterrupted transmission throughout the entire duration; the destination node receives 990 packets, with a packet loss rate of merely 1%, representing a reduction of approximately 6 percentage points compared to the conventional scheme. The experimental results demonstrate that the pre-rerouting strategy can effectively avoid service loss caused by predictable link interruptions. The study also notes that the new path established by pre-rerouting may be inferior to the original path in terms of hop count and transmission delay, and future work could further optimize transmission performance by recomputing the globally optimal path after the interruption. This strategy provides an efficient, low-loss service continuity assurance solution for LEO satellite networks in coping with dynamic topological changes.

 

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Journal

Space: Science & Technology

DOI

10.34133/space.0420

Article Title

Pre-rerouting Strategy to Ensure Business Continuity for Low-Earth-Orbit Satellite Network

Fig. 2. An example of the comparison between CSPF routes and Open Shortest Path First (OSPF) routes.

Fig. 3. The flowchart of pre-rerouting strategy. LSP, label switching path; CR-LDP, Constraint-based Routing Label Distribution Protocol.

Fig. 4. Test topology of the experiment.

Fig. 5. The number of packets sent by source nodes. CBR, constant bit rate.

Fig. 6. Traditional OSPF scenario. (A) The number of packets received by destination nodes. (B) Packet receiving curve. CBR, constant bit rate.

Fig. 13. Pre-rerouting scenario. (A) The number of packets received by destination nodes. (B) Packet receiving curve. CBR, constant bit rate.

 

Credit

Space: Science & Technology

 

New low-waste method breaks down tough-to-recycle plastics

The method could help create plastic products with the best of both worlds by combining durability with an eco-friendly life cycle

University of Texas at Austin

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A 3D-printed pufferfish made of pDCPD undergoes deconstruction in a solution containing an eco-friendly solvent and ruthenium-based catalyst.

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Credit: University of Texas at Austin.

A new recycling technique could help tackle a major challenge: breaking down some of the toughest plastics without generating large amounts of waste.

A team led by researchers from The University of Texas at Austin and Sandia National Laboratories has developed a simple method for breaking down durable plastics that currently have no practical recycling method. This approach uses less energy and produces less waste than incineration, while allowing for the full recovery of valuable fibers. The team published its results in the journal Science Advances.

When manufacturers need a plastic that is both durable and lightweight, they often turn to poly(dicyclopentadiene), or pDCPD. The material is used in products ranging from vehicle bumpers and construction equipment to chemical storage tanks. But products made with pDCPD are extremely difficult to recycle and are instead often incinerated, which requires much energy, produces harmful byproducts, and degrades fibers blended in for reinforcement.

“Before now, people might have avoided using these materials, despite their strength, durability and lightness, because they didn’t have a good way to recycle them,” said Zak Page, a UT associate professor of chemistry and corresponding author on the paper. “Switching to pDCPD might mean the same product can perform better, while also having a longer lifespan before it needs to be recycled. I hope this will encourage more people to consider using pDCPDs.”

The research was primarily funded by the U.S. Department of Energy, with additional support from the Robert A. Welch Foundation, the Alfred P. Sloan Foundation, and the Arnold and Mabel Beckman Foundation.

To dissolve an object made of pDCPD with this new method, the researchers placed it in a solution that included an eco-friendly solvent and a catalyst containing ruthenium. The object was then stirred for periods ranging from hours to days, depending on its size. In a process that looks like a sugar lump dissolving in water, the plastic deconstructs and dissolves in the solution, leaving behind a powder that can be reused in new plastics. Any fibers, such as carbon or glass, that were added to pDCPD can also be isolated in pristine form and reused in new materials.

One of the biggest remaining questions is whether the ruthenium catalyst can be recovered and reused, making the overall process more sustainable and affordable.

The breakthrough originated from an unexpected result. While working on a new method to produce pDCPD plastics, UT Austin graduate student Keldy Mason exposed the material to a solution containing a solvent and catalyst that was meant to make it more durable. Rather than strengthening the plastic, the process broke it down, dissolving the material.

“This type of material has been around a long time, and the wisdom was that it was just too thermodynamically stable for this reaction to go the other way,” Page said. “So, this was quite a surprise.”

There are many types of plastics used in everyday life. This new method could eventually enable a circular lifecycle for pDCPDs, similar to advances made in recent years by UT researchers that could help address even more widely used types of plastics, such as those in water bottles and disposable bags and wrappers.

UT, Sandia National Laboratories and four study authors have applied for a U.S. patent related to the technology.

Co-first authors were Keldy Mason, Meghan Kiker and Zhenchuang Xu. Researchers from the University of Illinois Urbana-Champaign and the Massachusetts Institute of Technology also contributed.

Decontructing a plastic pufferfish made of pDCPD [VIDEO] 

A 3D-printed pufferfish made of pDCPD undergoes deconstruction in a solution containing an eco-friendly solvent and ruthenium-based catalyst.

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Journal

Science Advances

DOI

10.1126/sciadv.aef4204

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Direct Metathesis Deconstruction to Recycle Poly(dicyclopentadiene) Composites

Article Publication Date

11-Sep-2026

COI Statement

The University of Texas at Austin, Sandia National Laboratories and four study authors have applied for a U.S. patent related to the technology.

 

NIH awards multi-university team over $4 million to improve women’s health

Michigan State University

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EAST LANSING, Mich. – Backed by a new $4.6 million award from the National Institutes of Health, or NIH, Michigan State University researchers are launching a novel project to transform how medications are developed and prescribed for women. This is the first installment of an award worth up to $12.8 million over three years. Researchers from Rutgers, Emory, Tulane, University of Colorado Anschutz, University of Michigan and University of Utah are collaborating with the MSU team to accomplish this goal, which the lead scientist describes as a moon shot.

Clinical trials often fail to account for the unique ways female hormones change throughout life — such as during menstrual cycles, pregnancy, birth control use, menopause and hormone replacement therapy. This oversight can lead to treatments that are less effective or cause more severe side effects in women than in men.

To bridge this gap, 13 researchers are collaborating to build advanced computer models that will predict how a woman’s natural hormonal changes affect how medicines move through and act within the body. Their findings are expected to result in stronger research studies, advances in precision medicine and better real-world outcomes for women.

“Developing computational models that provide insights into women’s health — including the consequences of disease, efficacy and side effects of medicines — and integrate age and reproductive cycle stage is a moon shot,” said Teresa K. Woodruff, the lead investigator on this project, president emerita of MSU and an MSU Research Foundation Distinguished Professor in the Department of Obstetrics, Gynecology and Reproductive Biology at the MSU College of Human Medicine and in the Department of Biomedical Engineering at MSU’s College of Engineering. “Our world-class team is taking on this project to enable a generation of healthier women.” 

This award is part of a national program, the Computational Modeling of Hormone Homeostasis Initiative, which is a joint effort by the NIH Office of Research on Women’s Health and the Division of Program Coordination, Planning and Strategic Initiatives to leverage advancements in computer modeling to deepen the understanding of sex-specific hormonal biology. A total of $21 million is being awarded to expand national research and high-impact science. The award number is 1OT2OD042764.

Research teams across the country will be developing the next generation of human-based data-driven tools that advance understanding of hormone-related health and improve care for people and communities.  

“Empowered by AI, novel assays and legacy human data, we will develop mechanistically based computational models of female physiology that can make translational, quantitative predictions for women’s responses to metabolic therapies,” said Qiang Zhang, associate professor in the Rollins School of Public Health at Emory University

Closing the gap in women’s metabolic health

Metabolic conditions such as obesity, type 2 diabetes, cholesterol imbalances and thyroid disorders are widespread in women. They also frequently co-occur with reproductive conditions like polyendocrine metabolic ovarian syndrome, or PMOS.

Because energy metabolism and female reproductive hormones directly influence each other, widely prescribed drugs — including insulin and GLP-1 weight-loss and diabetes medications — can produce different results in women depending on their individual hormone levels.

“Because female hormone levels are constantly shifting, precision medicine allows us to map out these complex interactions,” Woodruff said. “This NIH-backed initiative will create the first computationally driven clinical tool designed to guide medical care across every stage of a woman’s life.”

The team will use advanced computational and modeling frameworks to accomplish five main goals:

1. Artificial intelligence will digitize and organize over 40 years of hormone research data, creating a free, publicly accessible database.
2. A standard computer model will map out a normal 28-day menstrual cycle alongside how key organs (like the liver, muscle and fat tissues) are regulated by hormones to process nutrients.
3. Real-world patient data will expand the standard digital model to account for various groups — such as women going through menopause or taking birth control — and specific health conditions like diabetes and obesity.
4. Lab-grown organ testing will be achieved by using human-relevant three-dimensional tissue models and mini lab-grown organoids (such as liver, muscle and ovarian tissue) to inform, test and verify the computer predictions.
5. Personalized treatment tools for specific medications (including metformin, insulin and GLP-1 drugs) predicted by the computer models will help doctors better prescribe ideal doses and avoid dangerous side effects.

Public health impact

The final open-access computer platform will give healthcare providers practical tools to anticipate drug efficacies, prevent harmful side effects and tailor prescriptions for female patients.

“Women experience large shifts in reproductive hormones at several points in their lifespan: puberty, pregnancy and menopause,” said Nanette Santoro, E. Stewart Taylor Professor, Department of Obstetrics and Gynecology at the University of Colorado Anschutz and president of the Endocrine Society. “During reproductive years, women also undergo profound day-to-day changes in reproductive hormone levels, giving them a markedly different endocrine backdrop than men. Using state-of-the-art computational technology to examine how these changes interact with commonly used medications is a critical pathway toward supporting life-course women’s health.”

Additionally, the findings will directly inform NIH guidelines, national safety standards and clinical protocols for testing new treatments.  

“By systematically and automatically extracting and curating decades of fragmented public research and clinical data, we are finally dismantling a historic data gap in this research project,” said Hao Zhu, professor of biomedical informatics and genomics at the Tulane University School of Medicine. “Transforming these raw, disparate datasets into structured, actionable insights enables modelers and informaticians to accelerate precision health and disease models tailored specifically to women’s biology. This critical data-driven computational infrastructure elevates women’s health from an understudied niche to a central scientific priority, paving the way for more equitable, life-saving outcomes worldwide.”

All computer models and data produced through this NIH initiative will be freely available to researchers and healthcare professionals worldwide upon completion. 

Additional researchers include Sudin Bhattacharya, Brian Johnson, Rance Nault and Timothy Zacharewski from MSU, Shuo Xiao and Jiyang Zhang from Rutgers University, Ariella Shikanov from the University of Michigan, Corrine Welt from the University of Utah, and Mary Sammel from the University of Colorado Anschutz.

Additional researcher remarks:

“Sharing open and reproducible computational models extends the impact of this team’s work, providing resources that the broader research community can reuse to further advance women’s health research.”

—Rance Nault, assistant professor, Department of Pharmacology and Toxicology, Institute for Integrative Toxicology and College of Veterinary Medicine at MSU

“Some of the most important challenges in women’s health are also among the most complex. This project unites researchers with expertise spanning hormone biology, engineering and computational modeling to tackle questions that no single field could solve alone. Together, we can make these complex biological systems more approachable and generate new insights that ultimately benefit women’s health.”

—Brian P. Johnson, assistant professor in the MSU Department of Pharmacology and Toxicology and Department of Biomedical Engineering

“We’ll supplement the project’s computer models with lab-grown biological models, known as new approach methodologies, or NAMs, that mimic hormone levels in multiple organs during key moments in women, like ovulation, menstruation, pregnancy, menopause or the onset of a hormone-altering disease. We’ll expose each of these wet-lab NAM models to common metabolic drugs and measure responses to inform the development of computer models that can help improve women’s medication use.”

—Shuo Xiao, associate professor, and Jiyang Zhang, research assistant professor, in the Department of Pharmacology and Toxicology at the Ernest Mario School of Pharmacy at Rutgers University

“This award allows us to bring new approach methodologies directly into the modeling loop. We will incorporate engineered human ovarian follicles and tissues that generate dynamic hormone and secretome data through measurements taken over time, under conditions that mimic a woman’s changing endocrine state. This data will validate, enrich, and optimize hormone models built from clinical data.”

—Ariella Shikanov, professor in the Department of Biomedical Engineering at University of Michigan

Read on MSUToday.

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Michigan State University has been advancing the common good with uncommon will for more than 170 years. Among the world’s top 100 universities and a leading U.S. public research institution, MSU pushes the limits of discovery and innovation to advance the state of Michigan and the nation, and make a better, safer, healthier world for all. The university provides life-changing educational opportunities through an inclusive academic community with more than 400 programs of study and is the largest producer of talent for Michigan, educating more undergraduates than any other university in the state.

For generations, Spartans have changed lives through research and innovation. Support from federal, state and local funding helps power discoveries that improve health, strengthen communities and keep America at the forefront of innovation and competitiveness. From lifesaving cancer treatments to advances in agriculture, energy and technology, see how Michigan State University researchers are shaping a better future for Michigan and the world. 

For MSU news on the web, go to MSUToday or x.com/MSUnews.

 

Fierce fish: How hormone pollution turned male fish into fiercer rivals and poorer parents

McMaster University

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A rare whole-lake experiment has revealed unexpected effects of hormone pollution on wild fish.

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Credit: Karen Kidd/McMaster University

Sept. 14, 2026, Hamilton, ON – A team of researchers has found that a common wastewater pollutant turned male fathead minnows into worse fathers and fiercer rivals, revealing ecological impacts that laboratory studies missed.

The pollutant, called ethinylestradiol (EE2), is a synthetic estrogen used in oral contraceptives and other hormone therapies. While municipal wastewater treatment removes much of the compound, small but potent amounts still enter rivers and lakes. Scientists have long known it can affect fish reproduction. What remained unclear was whether it could also alter fish behaviours that are critical for population survival.

While laboratory studies suggested that exposure to EE2 would reduce aggression in male fish, researchers studying an entire lake ecosystem found the opposite. Researchers observed more fish around active nests, increasing competition and causing nesting males to spend more time defending territories and eggs.

“This is a great example of how animals can respond differently in the real world than they do in laboratory experiments,” explains Karen Kidd, a professor in the Department of Biology. “When fish are living in a natural environment, their behaviour is influenced by competition and social interactions that are difficult or impossible to recreate in the lab.”

To better understand the hormone’s effects in a natural setting, researchers conducted a whole-lake experiment, monitoring male fathead minnows before, during and after a three-year period where trace amounts of EE2 were added to an experimental lake. They compared the fish with populations living in nearby lakes that were not exposed.

The researchers found that EE2 changed the social dynamics of the fish population.

Male fathead minnows normally establish territories, court females and guard the eggs laid in their nests. During the exposure period, competition around active nests increased. The added rivalry, combined with reduced parental care and fewer eggs in nests, likely contributed to the population collapse observed during the experiment.

These results were published in the journal Current Biology.

“The hormone didn’t just affect individual fish. It changed the social conditions in the lake. Those changes had ripple effects on reproduction across the population,” says Erin McCallum, an associate professor at the Swedish University of Agricultural Sciences who co-led the research with Kidd and Paul Blanchfield from Fisheries and Oceans Canada.

The findings suggest scientists may be underestimating the ecological risks posed by hormone pollution and other contaminants.

Many environmental studies are done under controlled laboratory conditions, where researchers can isolate the direct effects of a pollutant. Whole-lake studies like this provide a unique opportunity to understand how pollution influences wildlife populations over time.

“In the lab, the environment and animal interactions are controlled and simplified; in these whole-ecosystem experiments we capture the complex and often unpredictable responses happening in response to chemical pollution. That’s why large-scale experiments like this are so valuable,” says Kidd. “They allow us to see consequences that would otherwise remain hidden.”

The researchers hope the findings will help improve environmental risk assessments and strengthen efforts to protect freshwater ecosystems from hormone pollution.

A new study led by researchers from McMaster University found that a synthetic hormone commonly found in wastewater altered the behaviour of wild fathead minnows.

Credit

Karen Kidd/McMaster University

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Journal

Current Biology

DOI

10.1016/j.cub.2026.07.034

Article Title

Whole-lake exposure to a widespread estrogenic pollutant leads to unanticipated reproductive behaviors in wild fish

Article Publication Date

7-Sep-2026

 

Nationwide Safety Program associated with 65% reduction in hospital-onset MRSA bloodstream infections

Johns Hopkins Armstrong Institute researchers, federal partners and collaborators help hospitals translate evidence-based infection prevention strategies into everyday practice 

Johns Hopkins Medicine

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A large-scale, federally funded quality improvement program developed in collaboration with infection prevention experts at the Johns Hopkins Armstrong Institute for Patient Safety and Quality was associated with a 65% reduction in hospital-onset bloodstream infections caused by methicillin-resistant Staphylococcus aureus (MRSA) among participating hospital units.

The findings, published Aug. 27 in JAMA Network Open, suggest that a comprehensive approach to putting existing infection prevention evidence into everyday practice can substantially reduce infections among hospitalized patients. The Agency for Healthcare Research and Quality (AHRQ) Safety Program for MRSA Prevention was implemented in 106 intensive care units (ICUs) and 87 non-ICUs at 94 hospitals across the United States. The results highlight both the preventability of MRSA infections and the importance of a deliberate strategy for turning evidence into everyday practice.

“Some people think risks from multidrug-resistant organisms like MRSA are inevitable, that they’re not preventable, but we in infection prevention know that they are,” says Lisa Maragakis, M.D., M.P.H., senior author of the study, professor of medicine and epidemiology at the Johns Hopkins University School of Medicine, and Armstrong Institute for Patient Safety and Quality faculty. “Infection prevention works, but it is complex. It takes a very deliberate implementation strategy to translate the existing evidence into practice so we can protect patients.”

MRSA is a type of staph bacteria that is resistant to antibiotics, making infections more difficult to treat. Staph bacteria commonly live on human skin without causing illness, but hospitalized patients can be particularly vulnerable to infection because of underlying illnesses and invasive medical procedures. Devices such as central venous catheters provide lifesaving medications and fluids, but also cross the body’s natural skin barrier, creating a potential route for bacteria to enter the bloodstream.

To help prevent these infections, Johns Hopkins Armstrong Institute researchers and collaborators from NORC at the University of Chicago and AHRQ conducted an 18-month program centered on helping healthcare teams consistently implement a comprehensive set of infection prevention strategies targeting MRSA transmission and infection.

Participating hospital units received education and implementation resources on hand hygiene, environmental cleaning, device-associated infection prevention, chlorhexidine bathing and nasal decolonization. The program also engaged front-line workers across disciplines, including environmental services personnel.

“Taking the available evidence and implementing it is quite complex because you have to make sure that every front-line personnel member of the healthcare team is aware of the evidence and has the knowledge, skills and tools they need to implement it,” Maragakis says. “The system and workflow also have to support making sure those things happen every single time for every patient.”

Researchers compared infection rates during the 18-month implementation period with rates during the 12 months before the program began. Across participating ICUs and non-ICUs, the rate of hospital-onset MRSA bloodstream infections was 65% lower during the implementation period. Researchers also observed a 39% reduction in MRSA-positive clinical cultures collected later during hospitalization, a 37% reduction in bloodstream infections from all causes and a 31% reduction in central line-associated bloodstream infections.

The researchers also found changes in how participating units approached infection prevention. The proportion of ICUs reporting nasal MRSA decolonization for all patients increased from 35% to 61%, while the proportion of non-ICUs reporting the practice increased from 13% to 35%. Monitoring of environmental cleaning also increased from 50% to 75% among ICUs and from 52% to 76% among non-ICUs.

Collaboration among institutions helped make it possible to implement the program across hospitals nationwide, with researchers at NORC and AHRQ contributing to the coordination and infrastructure needed to support participating sites.

“It really was a large collaborative project,” Maragakis says. “Each researcher brought something different to the table, and that was important to making a project of this scale possible.”

The resulting AHRQ MRSA Prevention Toolkit is publicly available and includes educational and implementation materials that healthcare teams can use to build or strengthen infection prevention programs. Hospitals can select components based on the needs of an individual unit.

Researchers say many of the toolkit’s strategies address fundamental infection prevention practices that can help reduce the spread of other organisms and healthcare-associated infections as well.

“This toolkit is about MRSA prevention, but once you get into it, you’ll see it’s really about preventing healthcare-associated infections and organism transmission,” Maragakis says. “There will be collateral benefits to doing these basics of infection prevention well beyond MRSA prevention.”

Other Johns Hopkins researchers who contributed to the study are Clare Rock, Valeria Fabre, Sara Cosgrove, Kathleen Speck, Samuel Kim, Kerri Huber, Cheryl Conners and Sandra Swoboda.

This work was funded and guided by the AHRQ (HHSP233201500020I/75P00120F37009).

COI: Maragakis reported receiving grants from the Agency for Healthcare Research and Quality (AHRQ) during the conduct of the study and serving as the president of the Society for Healthcare Epidemiology of America. Miller reported being an employee of AHRQ during the conduct of the study. Cosgrove reported receiving grants from AHRQ during the conduct of the study and personal fees from Danaher, Philips, and Duke Clinical Research Institute outside the submitted work. Kim reported that his salary from the Johns Hopkins University School of Medicine was supported in part by a contract between the school of medicine and AHRQ during the conduct of the study. Huber, Connors, Swoboda and Koepp reported receiving grants from AHRQ during the conduct of the study. No other disclosures were reported. 

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Journal

JAMA Network Open