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Real-time, whole-genome sequencing efficiently types P. aeruginosa outbreak
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Whole-genome sequencing of Pseudomonas aeruginosa in real-time helped health care providers rapidly detect outbreaks and prevent the spread of infection, according to data recently published in Infection Control and Hospital Epidemiology.
“For organisms such as Pseudomonas aeruginosa, which are ubiquitous in the environment, it can be difficult to detect the source of an outbreak using traditional methods,” Raymond Chan, MBBS, MPH, PhD, clinical senior lecturer at Sydney Medical School-University of Sydney, and colleagues wrote. “There is particular concern about transmission of P. aeruginosa on a neonatal unit because infants who develop invasive infection with this organism have high mortality rates.”
The study was initiated when the incidence of P. aeruginosa in the neonatal unit at Royal Prince Alfred Hospital, Sydney, Australia, spiked from a monthly rate of 2.3 cases per 1,000 patient-days from March 2013 through February 2014, to 11.4 cases per 1,000 patient-days in March 2014. All infants on the unit were tested via nasal swabs during the outbreak, and 18 infants tested positive for P. aeruginosa, according Chan and colleagues.
Using whole-genome sequencing (WGS), researchers typed isolates from 12 of the infants and from seven pieces of frequently used equipment such as sinks and soap dispensers. WGS indicated that all but one isolate was colonized with the same strain of P. aeruginosa (ST253). It also detected that one of the sinks in the neonatal unit was likely responsible for the outbreak; multiple sinks including this one were replaced. In the subsequent 6 months, two infants were infected with P. aeruginosa and only one appeared to be related to the outbreak, the researchers wrote.
“On the basis of WGS, we were able to show that most of the available clinical isolates were identical but, importantly we were also able to demonstrate that the strain carried by one infant was not part of the outbreak,” Chan and colleagues wrote. “This would not have been otherwise recognized because the isolates shared the same antibiotic susceptibility pattern. For infection control purposes, the ability to quickly exclude a patient from an outbreak is as important as the recognition of isolates that are related.” – by David Jwanier
Disclosure: The researchers report no relevant financial disclosures.
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