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The utility of whole-genome sequencing to inform epidemiologic investigations of SARS-CoV-2 clusters in acute-care hospitals
- Source :
- Infection Control & Hospital Epidemiology; February 2024, Vol. 45 Issue: 2 p144-149, 6p
- Publication Year :
- 2024
-
Abstract
- AbstractObjective:To evaluate the utility of selective reactive whole-genome sequencing (WGS) in aiding healthcare-associated cluster investigations.Design:Mixed-methods quality-improvement study.Setting:Thes study was conducted across 8 acute-care facilities in an integrated health system.Methods:We analyzed healthcare-associated coronavirus disease 2019 (COVID-19) clusters between May 2020 and July 2022 for which facility infection prevention and control (IPC) teams selectively requested reactive WGS to aid the epidemiologic investigation. WGS was performed with real-time results provided to IPC teams, including genetic relatedness of sequenced isolates. We conducted structured interviews with IPC teams on the informativeness of WGS for transmission investigation and prevention.Results:In total, 8 IPC teams requested WGS to aid the investigation of 17 COVID-19 clusters comprising 226 cases and 116 (51%) sequenced isolates. Of these, 16 (94%) clusters had at least 1 WGS-defined transmission event. IPC teams hypothesized transmission pathways in 14 (82%) of 17 clusters and used data visualizations to characterize these pathways in 11 clusters (65%). The teams reported that in 15 clusters (88%), WGS identified a transmission pathway; the WGS-defined pathway was not one that was predicted by epidemiologic investigation in 7 clusters (41%). WGS changed the understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in 8 clusters (47%) and altered infection prevention interventions in 8 clusters (47%).Conclusions:Selectively utilizing reactive WGS helped identify cryptic SARS-CoV-2 transmission pathways and frequently changed the understanding and response to SARS-CoV-2 outbreaks. Until WGS is widely adopted, a selective reactive WGS approach may be highly impactful in response to healthcare-associated cluster investigations.
Details
- Language :
- English
- ISSN :
- 0899823X and 15596834
- Volume :
- 45
- Issue :
- 2
- Database :
- Supplemental Index
- Journal :
- Infection Control & Hospital Epidemiology
- Publication Type :
- Periodical
- Accession number :
- ejs65469070
- Full Text :
- https://doi.org/10.1017/ice.2023.274