COIN Investigators & Staff
COIN Investigators
-
Margaret A. Fitzpatrick, MD, MS
- Title: Core Investigator; Career Development Awardee
Associate Professor, University of Colorado School of Medicine - Contact: margaret.fitzpatrick@va.gov
- Location: Denver
- University of Colorado webpage
- See Dr. Fitzpatrick's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
- My research interests include multi-drug resistant and healthcare-associated infections and antimicrobial stewardship in high-risk special patient populations, particularly those with chronic neurologic injury. My research interests also encompass patient-reported outcomes related to infectious diseases and antimicrobial use.
Morbidity and mortality related to multi-drug resistant and healthcare-associated infections remains high, and has increased during the COVID-19 pandemic. Veterans with chronic neurologic injuries and other rehabilitation needs are high risk for these infections. Effective prevention of such infections through judicious use of antibiotics and other strategies is critical.
My current work focuses on improving management of urinary tract infections (UTIs) in patients with bladder dysfunction due to chronic neurologic diseases. We hope to design and intervention to optimize UTI management via improved patient-provider communication and patient recognition and understanding of UTI signs and symptoms. Improved UTI management leads to more appropriate diagnosis and antibiotic use which, in turn, improves rehabilitative health, reduces illness and disability from infections and antibiotic side effects, and optimizes quality of life for high priority Veteran populations.
Grants & Funding
Optimizing Management of Urinary Tract Infections in Patients with Neurogenic Bladder through Improved Knowledge of Provider Practice and Patient-reported Outcomes
Role: PI
The research in this CDA2 proposal will address fundamental gaps in knowledge about [how to optimize the] management of urinary tract infections (UTIs), which are one of the most common complications experienced by Veterans with chronic neurologic disorders that affect bladder functioning (`neurogenic bladder'). Inappropriate UTI management causes diminished patient functioning and quality of life through adverse effects of improper antibiotic use.
My project will support the development of a novel multifaceted patient-centered intervention to improve UTI management in patients with neurogenic bladder.
Such an intervention could optimize UTI management via improved patient-provider communication and patient recognition and understanding of UTI signs and symptoms. Improved UTI management leads to more appropriate diagnosis and antibiotic use which, in turn, improves rehabilitative health, reduces illness and disability from infections and antibiotic side effects, and optimizes the quality of life for these high-priority Veteran populations.
Funder: Veterans Affairs
NIH website
Publications of Note:
— Clostridioides difficile infection following dental antibiotic prescriptions in a cohort of US veterans
— Treatment of Extensively-drug Resistant (XDR) Acinetobacter and Impact on Clinical Outcomes in U.S. Veterans Affairs (VA) Medical Centers
— Antibiotic prophylaxis prescriptions prior to dental visits in the Veterans’ Health Administration (VHA), 2015–2019
Combating Antimicrobial Resistance through Rapid Implementation of Available Guidelines and Evidence 2.0 (CARRIAGE 2.0)
Role: C0-I
Funder: Veterans Affairs, HSR Quality Enhancement Research Initiative (QUERI)
Improving Veteran health by increasing dental stewardship of antibiotics and opioids
Role: C0-I
Funder: Veterans Affairs, HSR
Effectiveness of treatment and outcomes for Veterans infected with resistant Gram-negative organisms
Role: C0-I
Funder: Veterans Affairs, HSR
Antimicrobial Stewardship Program Implementation in a Specialized Population
Role: C0-I
Funder: Midwest Roybal Center for Health Promotion and Translation UIC
Data MIME: Data Model for Initiatives to Monitor Exposure to Antimicrobials in PCORNet and Sentinel
Role: Site PI
Funder: PCORI
Recent Publications
2024
Wirth M, Solanki P, Weaver FM, Suda KJ, Burns SP, Safdar N, Collins E, Evans CT, Fitzpatrick MA. A mixed-methods analysis of provider-documented and patient-reported urinary tract infection symptoms among veterans with neurogenic bladder. Am J Phys Med Rehabil. 2024 Jul 8. doi: 10.1097/PHM.0000000000002542. Epub ahead of print.
PMID: 38984527
Fitzpatrick MA, Nwafo N. Urinary Tract Infection Diagnostic and Management Considerations in People with Spinal Cord Injury and Neurogenic Bladder. Infect Dis Clin North Am. 2024 Apr 4:S0891-5520(24)00014-X. doi: 10.1016/j.idc.2024.03.012. Epub ahead of print.
PMID: 38580574
Fitzpatrick MA, Solanki P, Wirth M, Weaver FM, Suda KJ, Burns SP, Safdar N, Collins E, Evans CT. Knowledge, perceptions, and beliefs about urinary tract infections in persons with neurogenic bladder and impacts on interventions to promote person-centered care. Spinal Cord. 2024 Mar 7. doi: 10.1038/s41393-024-00972-z. Epub ahead of print.
PMID: 38454065
Livorsi DJ, Branch-Elliman W, Drekonja D, Echevarria KL, Fitzpatrick MA, Goetz MB, Graber CJ, Jones MM, Kelly AA, Madaras-Kelly K, Morgan DJ, Stevens VW, Suda K, Trautner BW, Ward MJ, Jump RLP. Research agenda for antibiotic stewardship within the Veterans' Health Administration, 2024-2028. Infect Control Hosp Epidemiol. 2024 Feb 2:1-7. doi: 10.1017/ice.2024.6. Epub ahead of print.
PMID: 38305034
2023
Vivo A, Fitzpatrick MA, Suda KJ, Wilson GM, Jones MM, Evans ME, Evans CT. Treatment effectiveness of antibiotic therapy in Veterans with multidrug-resistant Acinetobacter spp. bacteremia. Antimicrob Steward Healthc Epidemiol. 2023 Dec 12;3(1):e230. doi: 10.1017/ash.2023.500. PMCID: PMC10753468.
PMID: 38156232
Hughes AM, Evans CT, Ray C, Kaur H, Fitzpatrick MA, Vivo A, Olagoke AA, Wilson GM, Suda KJ. Antimicrobial stewardship strategy implementation and impact in acute care spinal cord injury and disorder units. J Spinal Cord Med. 2023 Nov 20:1-17. doi: 10.1080/10790268.2023.2277963. Epub ahead of print.
PMID: 37982811
Fitzpatrick MA, Solanki P, Wirth M, Weaver FM, Suda KJ, Burns SP, Safdar N, Collins E, Evans CT. Perceptions, experiences, and beliefs regarding urinary tract infections in patients with neurogenic bladder: A qualitative study. PLoS One. 2023 Nov 1;18(11):e0293743. doi: 10.1371/journal.pone.0293743. PMCID: PMC10619779.
PMID: 37910578
Fitzpatrick MA, Wirth M, Burns SP, Suda KJ, Weaver FM, Collins E, Safdar N, Evans CT. Management of Asymptomatic Bacteriuria and Urinary Tract Infections in Patients with Neurogenic Bladder and Factors Associated with Inappropriate Diagnosis and Treatment. Arch Phys Med Rehabil. 2023 Oct 10:S0003-9993(23)00585-3. doi: 10.1016/j.apmr.2023.09.023. Epub ahead of print.
PMID: 37827486
Wirth M, Suda KJ, Burns SP, Weaver FM, Collins E, Safdar N, Kartje R, Evans CT, Fitzpatrick MA. A retrospective cohort study of patient-reported urinary tract infection signs and symptoms among individuals with neurogenic bladder. Am J Phys Med Rehabil. 2023 Mar 15. doi: 10.1097/PHM.0000000000002204. Epub ahead of print.
PMID: 36927768
2022
Fitzpatrick MA, Wirth M, Nguyen J, Suda KJ, Weaver FM, Burns S, Collins E, Safdar N, Patel U, Evans CT. Clinical outcomes associated with guideline-discordant management of asymptomatic bacteriuria and urinary tract infection in hospitalized patients with neurogenic bladder. Antimicrob Steward Healthc Epidemiol. 2022 Dec 9;2(1):e195. doi: 10.1017/ash.2022.348. PMCID: PMC9879921.
PMID: 36712473
Learn more about this publication on Dimensions
Wilson GM, Fitzpatrick MA, Suda KJ, Smith BM, Gonzalez B, Jones M, Schweizer ML, Evans M, Evans CT. Comparative effectiveness of antibiotic therapy for carbapenem-resistant Enterobacterales (CRE) bloodstream infections in hospitalized US veterans. JAC Antimicrob Resist. 2022 Oct 26;4(5):dlac106. doi: 10.1093/jacamr/dlac106. PMCID: PMC9596539.
PMID: 36320448
Learn more about this publication on Dimensions
Ramanathan S, Albarillo FS, Fitzpatrick MA, Suda KJ, Poggensee L, Vivo A, Evans ME, Jones M, Safdar N, Pfeiffer C, Smith B, Wilson G, Evans CT. Infectious Disease Consults of Pseudomonas aeruginosa Bloodstream Infection and Impact on Health Outcomes. Open Forum Infect Dis. 2022 Sep 9;9(9):ofac456. doi: 10.1093/ofid/ofac456. PMCID: PMC9511117.
PMID: 36168551
Learn more about this publication on Dimensions
Evans CT, Fitzpatrick MA, Poggensee L, Gonzalez B, Gibson G, Jurasic MM, Echevarria K, McGregor JC, Gellad WF, Suda KJ. High Prescribing of Antibiotics is Associated with High Prescribing of Opioids in Medical and Dental Providers. Pharmacotherapy. 2022 Jul 22. doi: 10.1002/phar.2720. Epub ahead of print.
PMID: 35869691
Learn more about this publication on Dimensions
Fitzpatrick MA, Suda KJ, Ramanathan S, Wilson G, Poggensee L, Evans M, Jones MM, Pfeiffer CD, Klutts JS, Perencevich E, Rubin M, Evans CT; QUERI CARRIAGE Program. Increased carbapenemase testing following implementation of national VA guidelines for carbapenem-resistant Enterobacterales (CRE). Antimicrob Steward Healthc Epidemiol. 2022 Jun 2;2(1):e88. doi: 10.1017/ash.2021.220. PMCID: PMC9726513.
PMID: 36483386
Learn more about this publication on Dimensions
Hughes AM, Evans CT, Fitzpatrick MA, Kale IO, Vivo A, Boyer TL, Solanki PA, Gibson G, Jurasic MM, Sharp LK, Echevarria KL, Suda KJ. A qualitative approach to examining antimicrobial prescribing in the outpatient dental setting. Antimicrob Steward Healthc Epidemiol. 2022 Jun 24;2(1):e102. doi: 10.1017/ash.2022.242. PMCID: PMC9726505.
PMID: 36483419
Learn more about this publication on Dimensions
Vivo A, Durkin MJ, Kale I, Boyer T, Fitzpatrick MA, Evans CT, Jurasic MM, Gibson G, Suda KJ. Opportunities for penicillin allergy evaluation in dental clinics. Antimicrob Steward Healthc Epidemiol. 2022 Apr 11;2(1):e58. doi: 10.1017/ash.2022.18. PMCID: PMC9726497.
PMID: 36483385
Learn more about this publication on Dimensions
Vivo A, Fitzpatrick MA, Suda KJ, Jones MM, Perencevich EN, Rubin MA, Ramanathan S, Wilson GM, Evans ME, Evans CT. Epidemiology and outcomes associated with carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa: a retrospective cohort study. BMC Infect Dis. 2022 May 24;22(1):491. doi: 10.1186/s12879-022-07436-w. PMCID: PMC9128216.
PMID: 35610601
Learn more about this publication on Dimensions
Suda KJ, Fitzpatrick MA, Gibson G, Jurasic MM, Poggensee L, Echevarria K, Hubbard CC, McGregor JC, Evans CT. Antibiotic prophylaxis prescriptions prior to dental visits in the Veterans' Health Administration (VHA), 2015-2019. Infect Control Hosp Epidemiol. 2022 Feb 22:1-10. doi: 10.1017/ice.2021.521. Epub ahead of print.
PMID: 35189986
Learn more about this publication on Dimensions
Wilson GM, Evans CT, Fitzpatrick MA, Poggensee L, Gibson G, Jurasic MM, Echevarria K, Suda KJ. Clostridioides difficile infection following dental antibiotic prescriptions in a cohort of US veterans. Infect Control Hosp Epidemiol. 2022 Feb 21:1-3. doi: 10.1017/ice.2021.516. Epub ahead of print.
PMID: 35188097
Learn more about this publication on Dimensions
Fitzpatrick MA, Suda KJ, Poggensee L, Vivo A, Wilson G, Jones MM, Evans M, Safdar N, Evans CT. Treatment of extensively-drug resistant (XDR) Acinetobacter and impact on clinical outcomes in U.S. veterans affairs (VA) medical centers. Am J Infect Control. 2022 Jan 30:S0196-6553(22)00052-9. doi: 10.1016/j.ajic.2022.01.011. Epub ahead of print.
PMID: 35108579
Learn more about this publication on Dimensions
