ArticleMicrobiology (Reading, England)2018
Changing the paradigm for hospital outbreak detection by leading with genomic surveillance of nosocomial pathogens.
Article in Microbiology (Reading, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.
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Who cites it
55 citing papers in PubMed.
- Sampling and Host-Strain Interactions Shape Detection of Staphylococcus aureus Transmission in Hospitals.The Journal of infectious diseases · 2026Article
- Characterizing the Profiles of Gram-Negative Bacterial Pathogens of Wound Infections and Their Drug-Resistance Disposition.Microorganisms · 2026Article
- CRISPR-Cas-associated SCCmec Variants in Methicillin-resistant Staphylococcus aureus Evade Rapid Diagnostic Detection.The Journal of infectious diseases · 2026Article
- Real-Time Genomic Surveillance for Enhanced Healthcare Outbreak Detection and Control: Clinical and Economic Impact.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Implementation and outcomes of a rapid response genomic hospital epidemiology programme at an academic medical centre over 7 years.The Lancet. Microbe · 2026Review
- Evaluation of Fourier transform infrared spectroscopy as a first-line surveillance typing tool forFrontiers in antibiotics · 2026Article
- Article
- Genomic pitfalls in hospital surveillance: unexpected Enterobacter cloacae clustering without epidemiological link highlights the need for cautious core genome MLST analysis interpretation.Antimicrobial resistance and infection control · 2025Article
- Genomic Surveillance and Resistance Profiling of Multidrug-ResistantMicroorganisms · 2025Article
- Comparison of core genome multi-locus sequencing typing pipelines for hospital outbreak detection of common bacterial pathogens.Journal of clinical microbiology · 2025Article
- Integrating Genomic Data into Public Health Surveillance for Multidrug-Resistant Organisms, Washington, USA.Emerging infectious diseases · 2025Article
- A framework towards implementation of sequencing for antimicrobial-resistant and other health-care-associated pathogens.The Lancet. Infectious diseases · 2025Review
- Prevalence and Antibiogram Pattern ofAntibiotics (Basel, Switzerland) · 2025Article
- Pathogen genomics in healthcare: overcoming barriers to proactive surveillance.Antimicrobial agents and chemotherapy · 2025Article
- Article
- Genomic Surveillance for Enhanced Healthcare Outbreak Detection and Control.medRxiv : the preprint server for health sciences · 2024Article
- Tracing the origin of NDM-1-producing and extensively drug-resistant Pseudomonas aeruginosa ST357 in the Netherlands.BMC infectious diseases · 2024Article
- Evaluating the impact of genomic epidemiology of methicillin-resistantMicrobial genomics · 2024Article
- Epidemiological and Clinical Insights intoInternational journal of general medicine · 2024Article
- Treatment and Management ofInfection and drug resistance · 2024Review
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3 authors.
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Abstract
The current paradigm for hospital outbreak detection and investigation is based on methodology first developed over 150 years ago. Daily surveillance to detect patients positive for pathogens of particular importance for nosocomial infection is supported by epidemiological investigation to determine their relationship in time and place, and to identify any other factor that could link them. The antibiotic resistance pattern is commonly used as a surrogate for bacterial relatedness, although this lacks sensitivity and specificity. Typing may be used to define bacterial relatedness, although routine methods lack sufficient discriminatory power to distinguish relatedness beyond the level of bacterial clones. Ultimately, the identification of an outbreak remains a predominately subjective process reliant on the intuition of experienced infection control professionals. Here, we propose a redesign of hospital outbreak detection and investigation in which bacterial species associated with nosocomial transmission and infection undergo routine prospective whole-genome sequencing. Further investigation is based on the probability that isolates are associated with an outbreak, which is based on the degree of genetic relatedness between isolates. Evidence is provided that supports this model based on studies of MRSA (methicillin-resistant Staphylococcus aureus), together with the benefits of a 'Sequence First' approach. The feasibility of implementation is discussed, together with residual barriers that need to be overcome prior to implementation.
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