Translating Science into Action: Finding the Right Antibiotic for a Deadly Infection

During the past few decades, new, hypervirulent pathogens have emerged, capturing the attention of the public, as well as Vanessa Stevens, PhD, a research assistant professor in the department of internal medicine at the University of Utah Health Sciences and an investigator at the IDEAS 2.0 Center at the Veterans Affairs (VA) Salt Lake City Health Care System.

While a student, Stevens was intrigued by books about epidemic intelligence officers with the Centers for Disease Control and Prevention (CDC), who investigated infectious diseases around the world. She enrolled in a doctoral program in epidemiology and focused on one emerging pathogen, Clostridium difficile. “I really wanted to study this pathogen, not only because it was interesting, but I wanted to help people, like my grandmother, who have suffered from C. diff infections,” Stevens said.

C. diff does not cause illness outright. The bacterium produces two chemicals that are toxic to the human body. These toxins work in concert to irritate the cells of the intestinal lining producing severe bouts of diarrhea. Patients often fear having a recurrence of the infection, especially when symptoms continue long after they are discharged from the hospital.

The CDC reports that C. diff is now the most common hospital-acquired infection in the United States.  In 2011, it infected almost half a million Americans, mostly 65 or older.

Stevens quickly realized that she did not want to spend her future doing repetitive lab work, but she welcomed the challenge of analyzing complex datasets. As part of her early career training in clinical research, she received mentorship through Vice President’s Clinical and Translational Scholars Program (VPCAT), as well as assistance with study design through the Population Health Research for Discovery program. “These consultations were invaluable as I set up the study design for one of my earliest projects,” she said. 

The VPCAT program offers intensive mentorship to junior faculty committed to careers in clinical or translational research. The Population Heath Research Foundation for Discovery provides methodological and data analytic support to investigators seeking to perform research to improve the health of patient populations. Both programs are part of the Center for Clinical and Translational Science (CCTS), which improves the transfer of scientific research from the laboratory into practices to improve human health.

Through her research, Stevens showed how the choice of antibiotics is critical when treating severe C. diff infections. Using her knowledge of study design, she analyzed the data from more than 10,000 patients treated for this infection through the VA healthcare system from 2005 to 2012. Stevens found that patients with a severe C. diff infection were less likely to die when treated with the antibiotic vancomycin compared to the standard treatment of metronidazole.

This work is important, but it is still in its early stages. “The optimal way to move forward is to do decision analysis that allows us to weigh the pros and cons of the various treatment strategies,” said Stevens.  She will continue researching this pathogen to find the best ways to treat and prevent the infection. “I will probably continue in this work until there are no more questions for me to ask,” she said.