Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26553
Title: Pilot study of a combined genomic and epidemiologic surveillance program for hospital-acquired multidrug-resistant pathogens across multiple hospital networks in Australia.
Austin Authors: Sherry, Norelle L ;Lee, Robyn S;Gorrie, Claire L;Kwong, Jason C ;Stuart, Rhonda L;Korman, Tony M;Marshall, Caroline;Higgs, Charlie;Chan, Hiu Tat;Graham, Maryza;Johnson, Paul D R ;Leroi, Marcel J ;Reed, Caroline;Richards, Michael J;Slavin, Monica A;Worth, Leon J;Howden, Benjamin P ;Grayson, M Lindsay 
Affiliation: Microbiology
Department of Microbiology, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
Department of Infectious Diseases, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
Microbiological Diagnostic Unit (MDU) Public Health Laboratory, Department of Microbiology & Immunology at the Peter Doherty Institute for Infection & Immunity, University of Melbourne, Melbourne, Victoria, Australia
Department of Microbiology & Immunology at the Peter Doherty Institute for Infection & Immunity, University of Melbourne, Melbourne, Victoria, Australia
Infectious Diseases
Department of Infectious Diseases, Monash Health, Clayton, Victoria, Australia
Department of Medicine, Monash University, Clayton, Victoria, Australia
Department of Microbiology, Monash Health, Clayton, Victoria, Australia
Infection Prevention & Surveillance Service, Victorian Infectious Diseases Service, Melbourne Health, Parkville, Victoria, Australia
Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia
Medicine (University of Melbourne)
Department of Microbiology, Melbourne Health, Parkville, Victoria, Australia
Issue Date: May-2021
Date: 2020-11-26
Publication information: Infection Control and Hospital Epidemiology 2021; 42(5): 573-581
Abstract: To conduct a pilot study implementing combined genomic and epidemiologic surveillance for hospital-acquired multidrug-resistant organisms (MDROs) to predict transmission between patients and to estimate the local burden of MDRO transmission. Pilot prospective multicenter surveillance study. The study was conducted in 8 university hospitals (2,800 beds total) in Melbourne, Australia (population 4.8 million), including 4 acute-care, 1 specialist cancer care, and 3 subacute-care hospitals. All clinical and screening isolates from hospital inpatients (April 24 to June 18, 2017) were collected for 6 MDROs: vanA VRE, MRSA, ESBL Escherichia coli (ESBL-Ec) and Klebsiella pneumoniae (ESBL-Kp), and carbapenem-resistant Pseudomonas aeruginosa (CRPa) and Acinetobacter baumannii (CRAb). Isolates were analyzed and reported as routine by hospital laboratories, underwent whole-genome sequencing at the central laboratory, and were analyzed using open-source bioinformatic tools. MDRO burden and transmission were assessed using combined genomic and epidemiologic data. In total, 408 isolates were collected from 358 patients; 47.5% were screening isolates. ESBL-Ec was most common (52.5%), then MRSA (21.6%), vanA VRE (15.7%), and ESBL-Kp (7.6%). Most MDROs (88.3%) were isolated from patients with recent healthcare exposure.Combining genomics and epidemiology identified that at least 27.1% of MDROs were likely acquired in a hospital; most of these transmission events would not have been detected without genomics. The highest proportion of transmission occurred with vanA VRE (88.4% of patients). Genomic and epidemiologic data from multiple institutions can feasibly be combined prospectively, providing substantial insights into the burden and distribution of MDROs, including in-hospital transmission. This analysis enables infection control teams to target interventions more effectively.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26553
DOI: 10.1017/ice.2020.1253
ORCID: 0000-0002-7789-8360
Journal: Infection Control and Hospital Epidemiology
PubMed URL: 34008484
Type: Journal Article
Appears in Collections:Journal articles

Show full item record

Page view(s)

50
checked on Mar 29, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.