Pseudomonas aeruginosa intensive care unit outbreak: winnowing of transmissions with molecular and genomic typing

Parcell, B.J., Oravcova, K. , Pinheiro, M., Holden, M.T.G., Phillips, G., Turton, J.F. and Gillespie, S.H. (2018) Pseudomonas aeruginosa intensive care unit outbreak: winnowing of transmissions with molecular and genomic typing. Journal of Hospital Infection, 98(3), pp. 282-288. (doi: 10.1016/j.jhin.2017.12.005) (PMID:29229490) (PMCID:PMC5840502)

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Abstract

Background: Pseudomonas aeruginosa healthcare outbreaks can be time consuming and difficult to investigate. Guidance does not specify which typing technique is most practical for decision-making. Aim: To explore the usefulness of whole-genome sequencing (WGS) in the investigation of a P. aeruginosa outbreak, describing how it compares with pulsed-field gel electrophoresis (PFGE) and variable number tandem repeat (VNTR) analysis. Methods: Six patient isolates and six environmental samples from an intensive care unit (ICU) positive for P. aeruginosa over two years underwent VNTR, PFGE and WGS. Findings: VNTR and PFGE were required to fully determine the potential source of infection and rule out others. WGS results unambiguously distinguished linked isolates, giving greater assurance of the transmission route between wash-hand basin water and two patients, supporting the control measures employed. Conclusion: WGS provided detailed information without the need for further typing. When allied to epidemiological information, WGS can be used to understand outbreak situations rapidly and with certainty. Implementation of WGS in real-time would be a major advance in day-to-day practice. It could become a standard of care as it becomes more widespread due to its reproducibility and lower costs.

Item Type:Articles
Additional Information:Bioinformatics and computational biology analyses were supported by the University of St Andrews Bioinformatics Unit which is funded by a Wellcome Trust ISSF award (Grant 097831/Z/11/Z). BJP, KO, MP, MTGH, GP and SHG are funded by the Chief Scientist Office through the Scottish Infection Research Network, a part of the SHAIPI consortium (Grant Reference Number SIRN/10).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Oravcova, Dr Katarina
Authors: Parcell, B.J., Oravcova, K., Pinheiro, M., Holden, M.T.G., Phillips, G., Turton, J.F., and Gillespie, S.H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:Journal of Hospital Infection
Publisher:Elsevier
ISSN:0195-6701
ISSN (Online):1532-2939
Published Online:08 December 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Journal of Hospital Infection 98(3): 282-288
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
455196Scottish infection research network (SIRN) administrationAlistair LeanordScottish Government (SCOTGOV)SIRN/10SCHOOL OF LIFE SCIENCES