Automated detection of hospital outbreaks of multi-drug resistant pathogens in one Italian region.

Antimicrobial resistance antibacterial agents automated surveillance drug-resistant bacteria outbreak detection

Journal

Expert review of anti-infective therapy
ISSN: 1744-8336
Titre abrégé: Expert Rev Anti Infect Ther
Pays: England
ID NLM: 101181284

Informations de publication

Date de publication:
09 2022
Historique:
pubmed: 6 7 2022
medline: 11 9 2022
entrez: 5 7 2022
Statut: ppublish

Résumé

Automated tools for antimicrobial resistance surveillance are critical for improving detection of drug-resistant organisms and informing prevention and control interventions. In this study, the WHONET-SaTScan software was used at a multihospital level in Tuscany, Italy, to identify case clusters consistent with hospital outbreaks caused by drug-resistant pathogens. Antimicrobial resistance surveillance data from all Tuscany hospitals between January 2018 and December 2020 were analyzed using WHONET. The SaTScan package was used to detect case clusters applying a simulated prospective approach and the space-time permutation algorithm. Clusters were identified using resistance profiles and two distinct spatial variables: single medical services ('service') or groups of related services ('metaservice'). Data from eight bacterial pathogens were provided from 49 hospitals for 312,779 isolates from 158,809 patients. Single service-based analysis detected 693 hospital clusters, while metaservice-based analysis identified 635. There was no evidence for a difference between the two methods in terms of cluster length, cluster size, recurrence intervals, number of alerts, distribution across years or hospitals. Among clusters involving multiple services identified by both analyses, metaservice-detected clusters were usually larger and more statistically significant. WHONET-SaTScan proved to be a valuable multi-facility cluster detection tool that can be implemented for real-time surveillance.

Sections du résumé

BACKGROUND
Automated tools for antimicrobial resistance surveillance are critical for improving detection of drug-resistant organisms and informing prevention and control interventions. In this study, the WHONET-SaTScan software was used at a multihospital level in Tuscany, Italy, to identify case clusters consistent with hospital outbreaks caused by drug-resistant pathogens.
METHODS
Antimicrobial resistance surveillance data from all Tuscany hospitals between January 2018 and December 2020 were analyzed using WHONET. The SaTScan package was used to detect case clusters applying a simulated prospective approach and the space-time permutation algorithm. Clusters were identified using resistance profiles and two distinct spatial variables: single medical services ('service') or groups of related services ('metaservice').
RESULTS
Data from eight bacterial pathogens were provided from 49 hospitals for 312,779 isolates from 158,809 patients. Single service-based analysis detected 693 hospital clusters, while metaservice-based analysis identified 635. There was no evidence for a difference between the two methods in terms of cluster length, cluster size, recurrence intervals, number of alerts, distribution across years or hospitals. Among clusters involving multiple services identified by both analyses, metaservice-detected clusters were usually larger and more statistically significant.
CONCLUSIONS
WHONET-SaTScan proved to be a valuable multi-facility cluster detection tool that can be implemented for real-time surveillance.

Identifiants

pubmed: 35786114
doi: 10.1080/14787210.2022.2098115
doi:

Substances chimiques

Anti-Infective Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1233-1241

Auteurs

Nicolò Binello (N)

London School of Hygiene and Tropical Medicine, London, UK.

Fortunato D'Ancona (F)

National Institute of Health, Rome, Italy.

Silvia Forni (S)

Regional Health Agency of Tuscany, Florence, Italy.

Sara D'Arienzo (S)

Regional Health Agency of Tuscany, Florence, Italy.

Fabrizio Gemmi (F)

Regional Health Agency of Tuscany, Florence, Italy.

Adam Clark (A)

WHO Collaborating Centre for Surveillance of Antimicrobial Resistance, Brigham and Women's Hospital, Harvard Medical School, MA, USA.

John Stelling (J)

WHO Collaborating Centre for Surveillance of Antimicrobial Resistance, Brigham and Women's Hospital, Harvard Medical School, MA, USA.

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