My research continues along a translation and clinical track, focusing on preventing C. difficile infections in long-term care facility (LTCF) residents. An unintended consequence of antimicrobial administration is disruption of the human gut microbiota that protects the host from enteric pathogens, including C. difficile, through colonization resistance. Residents of LTCF are particularly vulnerable due to their inherent frailty, communal living conditions and frequent exposure to antimicrobials, the principle risk factor for C. difficile infection. Through their Grants for Early Medical/Surgical Subspecialists Transition to Aging Research (GEMSSTAR) program, the National Institute of Aging recently awarded me an R03 to study recovery of colonization resistance to C. difficile in LTCF residents who receive systemic antimicrobials. The work proposed in this grant also led to the 2011 Young Investigator Award in Geriatrics from the Infectious Disease Society/National Foundation for Infectious Diseases Association of Specialty Professors. The Steris Foundation has also awarded me a one-year grant to study restoration of colonization resistance to other nosocomial pathogens including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus and multi-drug resistant Gram-negative bacteria.