Evidence map›Paper›PMID 32663248›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021

Search and Contain: Impact of an Integrated Genomic and Epidemiological Surveillance and Response Program for Control of Carbapenemase-producing Enterobacterales.

Courtney R Lane, Judith Brett, Mark Schultz, Claire L Gorrie, Kerrie Stevens, Donna R M Cameron, Siobhan St George, Annaliese van Diemen, Marion Easton, Rhonda L Stuart and 16 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  12. Genomic investigation of multispecies and multivariantInfection control and hospital epidemiology · 2024
    Article
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  16. Genomic Epidemiology of Carbapenemase-ProducingAntimicrobial agents and chemotherapy · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Courtney R LaneMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Judith BrettVICNISS Healthcare Associated Infection Surveillance Coordinating Centre, at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Mark SchultzMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Claire L GorrieMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Kerrie StevensMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Donna R M CameronMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Siobhan St GeorgeMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Annaliese van DiemenDepartment of Health and Human Services, Victorian Government, Melbourne, Victoria, Australia.
Marion EastonDepartment of Health and Human Services, Victorian Government, Melbourne, Victoria, Australia.
Rhonda L StuartMonash Infectious Diseases, Monash Health, Monash Medical Centre, Clayton, Victoria, Australia.
Michelle SaitMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Anton Y PelegDepartment of Infectious Diseases, Alfred Hospital, and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Andrew J StewardsonDepartment of Infectious Diseases, Alfred Hospital, and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Allen C ChengDepartment of Infectious Diseases, Alfred Hospital, and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Denis W SpelmanDepartment of Infectious Diseases, Alfred Hospital, and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Mary Jo WatersDepartment of Microbiology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Susan A BallardMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Norelle L SherryMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Deborah A WilliamsonMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Finn RomanesDepartment of Health and Human Services, Victorian Government, Melbourne, Victoria, Australia.
Brett SuttonDepartment of Health and Human Services, Victorian Government, Melbourne, Victoria, Australia.
Jason C KwongDepartment of Microbiology & Immunology, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Torsten SeemannDepartment of Microbiology & Immunology, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Anders Goncalves da SilvaMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Nicola StephensDepartment of Microbiology & Immunology, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.
Benjamin P HowdenMicrobiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at the Peter Doherty Institute for Infection & Immunity, Melbourne, Victoria, Australia.

Funding

Australian Government Research Training Program scholarshipsMicrobiological Diagnostic Unit Public Health LaboratoryNational Health and Medical Research Council GNT1149991Victorian Government
6 · The paper itself

Abstract

backgroundMultiresistant organisms (MROs) pose a critical threat to public health. Population-based programs for control of MROs such as carbapenemase-producing Enterobacterales (CPE) have emerged and evaluation is needed. We assessed the feasibility and impact of a statewide CPE surveillance and response program deployed across Victoria, Australia (population 6.5 million).

methodsA prospective multimodal intervention including active screening, carrier isolation, centralized case investigation, and comparative pathogen genomics was implemented. We analyzed trends in CPE incidence and clinical presentation, risk factors, and local transmission over the program's first 3 years (2016-2018).

resultsCPE case ascertainment increased over the study period to 1.42 cases/100 000 population, linked to increased screening without a concomitant rise in active clinical infections (0.45-0.60 infections/100 000 population, P = .640). KPC-2 infection decreased from 0.29 infections/100 000 population prior to intervention to 0.03 infections/100 000 population in 2018 (P = .003). Comprehensive case investigation identified instances of overseas community acquisition. Median time between isolate referral and genomic and epidemiological assessment for local transmission was 11 days (IQR, 9-14). Prospective surveillance identified numerous small transmission networks (median, 2; range, 1-19 cases), predominantly IMP and KPC, with median pairwise distance of 8 (IQR, 4-13) single nucleotide polymorphisms; low diversity between clusters of the same sequence type suggested genomic cluster definitions alone are insufficient for targeted response.

conclusionsWe demonstrate the value of centralized CPE control programs to increase case ascertainment, resolve risk factors, and identify local transmission through prospective genomic and epidemiological surveillance; methodologies are transferable to low-prevalence settings and MROs globally.

Indexed as

Enterobacteriaceae InfectionsBacterial Proteinsbeta-LactamasesGenomicsHumansProspective StudiesVictoriaBacterial Proteinsbeta-Lactamasescarbapenemaseantimicrobial resistancecarbapenemase-producing Enterobacteralesgenomicsinfection controlpublic health surveillance

Identifiers

PMID32663248
PMCPMC8662772

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.