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April 14, 2022
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Real-time genomic surveillance quickly detects hospital outbreaks

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Study findings presented at the Society for Healthcare Epidemiology of America Spring Conference continued to show the ability of real-time genomic surveillance to detect nosocomial outbreaks.

In a previous 2-year study, University of Pittsburgh epidemiologist Alexander J. Sundermann, DrPH, MPH, and colleagues demonstrated that a combination of whole-genome sequencing surveillance and machine learning of the electronic health records — which is used to identify transmission routes — outperformed traditional infection prevention methods in identifying hospital outbreaks, saving hundreds of thousands of dollars.

IDN0422Sundermann_Graphic_01_WEB

“However, the adoption of this practice is not yet widespread given the potential costs and the unknown of how effective interventions could be,” Sundermann told Healio. “We started performing real-time whole-genome sequencing this past November to detect these outbreaks and implement interventions to stop transmission.”

Sundermann and colleagues call the approach the Enhanced Detection System for Healthcare-Associated Transmission.

For their follow-up study, they began collecting cultures that tested positive for select bacterial pathogens from patients who had been hospitalized for at least 3 days or had a health care exposure in the past 30 days.

Among 413 isolates collected as of Jan. 11, the system detected 18 that were related to at least one other isolate. In total, it detected seven clusters of infection ranging in size from two to six patients, including a cluster of Pseudomonas aeruginosa infections possibly related to a shared bronchoscope, a pseudo-outbreak of Serratia marcescens related to autopsy blood cultures and a cluster of vancomycin-resistant Enterococcus faecium on a shared transplant unit, Sundermann and colleagues reported.

Sundermann said the study demonstrated the feasibility of a real-time sequencing surveillance program that can detect outbreaks early, allowing hospitals to intervene quickly.

“We believe that this will substantially improve patient safety,” he said “Health care institutions should examine their outbreak detection and investigation practices and consider the use of whole-genome sequencing surveillance to find these under-the-radar outbreaks. We believe that sequencing surveillance will eventually become routine in U.S. health care.”