Project Grant R21AI202888

The National Institute of Allergy and Infectious Diseases awarded The Regents of the University of California, San Francisco $246,000 on August 17, 2026, under the Allergy and Infectious Diseases Research program (CFDA 93.855) to develop a hidden Markov modeling framework that characterizes the full clinical progression of Clostridioides difficile infection using patient-level electronic health data.

The project addresses gaps in current analytic approaches that treat CDI as a single symptomatic event, overlooking asymptomatic colonization, heterogeneity in severity, persistent carriage after treatment, and relapse. The research integrates latent and observable CDI states to model individual clinical trajectories and response to control interventions. The three aims quantify patient-level drivers of CDI progression by determining how clinical characteristics such as antibiotic exposures influence transitions across disease stages; evaluate how interventions including antibiotic stewardship, prophylaxis, and contact precautions affect individual incidence, severity, relapse, and persistent colonization; and project population-level impact of interventions by incorporating stages of CDI progression into a stochastic, covariate-dependent compartmental model to compare individual and population-level effects under different prevention strategies.

The award funds research performed in San Francisco, California, with a period of performance through July 31, 2028. This is a Project Grant, an assistance type supporting hypothesis-driven biomedical research.