Clin-STAR Awardee Spotlight
L. Leigh Smith, MD, MAS
Assistant Professor, Epidemiology and Public Health
University of Maryland School of Medicine
Clin-STAR Aging Research Development and Training Grant – 2024
Skilled Nursing Facility Characteristics Associated with C. auris Transmission in the State of Maryland
Importantly, nursing home residents are at increased risk for infectious diseases due to well-defined risk factors such as comorbidities, age, and congregate settings. Candida auris is an emerging multidrug resistant fungal pathogen that is increasingly impacting residents in skilled nursing facilities (SNFs). There is a notable lack of data on the role that structural characteristics, such as staffing and quality of care, play in the transmission of C. auris in skilled nursing facilities. Transmission of C. auris is stopped through well implemented infection control practices. Our goal is to better understand and identify SNFs with C. auris transmission and define any health inequities to focus strategic interventions. In addition, this research will serve to help policymakers and SNF advocates determine policy changes that might help mitigate inequities associated with C. auris transmission.
Mentor
Mary-Claire Roghmann, PhD, MPH, MA
University of Maryland School of Medicine, Department of Epidemiology and Public Health
Research Interests: Epidemiology and public health
Age-related condition studied in research project:
- Long-term care
Impact of research project:
- Clinical
- Caregiving
Clin-STAR Grantee Interview
How did you first find out about Clin-STAR’s research development grant program?
My mentors Mary-Claire Roghmann and Jason Falvey recommended that I attend the Clin-STAR annual meeting to get a better idea of the work being completed in aging research. I ended up getting a travel award and was able to meet and connect with experts and other researchers who work advancing transdisciplinary research in aging. At this event, I was able to learn more about grant opportunities and how to further my education and training in aging.
What inspired you to pursue aging research and how does your perspective as a non-geriatrician specialist contribute to your research activity?
I am an infectious disease clinician by training, and I completed my fellowship during the start of the COVID-19 pandemic. During this training, I was part of a team who frequently went to nursing facilities to help with testing patients and help develop protocols to keep residents safe. This further piqued my interest in learning more about how infectious diseases can have a profound impact in aging populations, especially those who are living in congregate settings. I started working alongside the health department and responding to non-COVID outbreaks including multidrug resistant organisms. There is still a lot we must learn about the best practices to keep residents safe in nursing homes and prevent infections from spreading and adversely impacting the quality of life of individuals in these facilities. My perspective and experience as an infectious disease clinician complements the work being done by geriatricians in these long-term care settings.
In your view, what does Clin-STAR mean to the field and what does it mean for you to receive a Clin-STAR grant now?
As an early-stage career investigator, getting a Clin-STAR grant has been an excellent way to allow me to receive the training and collaboration to contribute to research in aging. I have been able to work with mentors who are experts in the field of aging and who have offered pivotal support in moving my research forward. Moreover, as someone who is not trained in geriatrics, this grant has given me the space, support and time to build collaborations and start towards a career becoming a leader in aging research.
What’s exciting about your research’s potential impact to your career, field, and patients?
My research looks at how older populations experience infectious diseases, particularly in congregate settings such as nursing facilities. The COVID-19 pandemic brought into sharp focus how vulnerable nursing facilities can be when there are not proper measures to stop disease from spreading. My research is meant to understand how to identify nursing facilities that are vulnerable to infectious disease outbreaks, especially multidrug resistant infections which can have a large impact on the quality of life of residents. In addition, this research is mean to better understand the lived experiences of older adults who are diagnosed with these hard-to-treat infections and are oftentimes put into isolation. Learning more about these topics will help us to develop better ways to prevent infections from happening in the first place and to identify how to properly stop transmission when it is occurring.
How have you collaborated with your mentor or co-investigators?
I have been privileged to have a great team of mentors who have encouraged me and helped me further develop my research on infectious disease in nursing facilities. Jason Falvey has been pivotal in better understanding health inequities among older populations and how that can contribute to poor outcomes in nursing facilities. This collaboration led to research that showed that nursing facilities that were in geographic regions with low socioeconomic status were more likely to have transmission of C. auris, a drug-resistant fungal organism. Mary-Claire Roghmann has helped me to better understand research protocols, infection prevention practices and the impact of infectious diseases in nursing facilities. This collaboration has led to qualitative research that showed how deficiencies in good infection control practices contribute to spread of C. auris in nursing facilities. These connections with my mentors are a large part of this Clin-STAR grant and I am excited to learn more about aging research