Factors affecting turnaround time of SARS-CoV-2 sequencing for inpatient infection prevention and control decision making: analysis of data from the COG-UK HOCI study.


Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
Jan 2023
Historique:
received: 21 06 2022
revised: 13 09 2022
accepted: 22 09 2022
pubmed: 14 10 2022
medline: 18 1 2023
entrez: 13 10 2022
Statut: ppublish

Résumé

Barriers to rapid return of sequencing results can affect the utility of sequence data for infection prevention and control decisions. To undertake a mixed-methods analysis to identify challenges that sites faced in achieving a rapid turnaround time (TAT) in the COVID-19 Genomics UK Hospital-Onset COVID-19 Infection (COG-UK HOCI) study. For the quantitative analysis, timepoints relating to different stages of the sequencing process were extracted from both the COG-UK HOCI study dataset and surveys of study sites. Qualitative data relating to the barriers and facilitators to achieving rapid TATs were included from thematic analysis. The overall TAT, from sample collection to receipt of sequence report by infection control teams, varied between sites (median 5.1 days, range 3.0-29.0 days). Most variation was seen between reporting of a positive COVID-19 polymerase chain reaction (PCR) result to sequence report generation (median 4.0 days, range 2.3-27.0 days). On deeper analysis, most of this variability was accounted for by differences in the delay between the COVID-19 PCR result and arrival of the sample at the sequencing laboratory (median 20.8 h, range 16.0-88.7 h). Qualitative analyses suggest that closer proximity of sequencing laboratories to diagnostic laboratories, increased staff flexibility and regular transport times facilitated a shorter TAT. Integration of pathogen sequencing into diagnostic laboratories may help to improve sequencing TAT to allow sequence data to be of tangible value to infection control practice. Adding a quality control step upstream to increase capacity further down the workflow may also optimize TAT if lower quality samples are removed at an earlier stage.

Sections du résumé

BACKGROUND BACKGROUND
Barriers to rapid return of sequencing results can affect the utility of sequence data for infection prevention and control decisions.
AIM OBJECTIVE
To undertake a mixed-methods analysis to identify challenges that sites faced in achieving a rapid turnaround time (TAT) in the COVID-19 Genomics UK Hospital-Onset COVID-19 Infection (COG-UK HOCI) study.
METHODS METHODS
For the quantitative analysis, timepoints relating to different stages of the sequencing process were extracted from both the COG-UK HOCI study dataset and surveys of study sites. Qualitative data relating to the barriers and facilitators to achieving rapid TATs were included from thematic analysis.
FINDINGS RESULTS
The overall TAT, from sample collection to receipt of sequence report by infection control teams, varied between sites (median 5.1 days, range 3.0-29.0 days). Most variation was seen between reporting of a positive COVID-19 polymerase chain reaction (PCR) result to sequence report generation (median 4.0 days, range 2.3-27.0 days). On deeper analysis, most of this variability was accounted for by differences in the delay between the COVID-19 PCR result and arrival of the sample at the sequencing laboratory (median 20.8 h, range 16.0-88.7 h). Qualitative analyses suggest that closer proximity of sequencing laboratories to diagnostic laboratories, increased staff flexibility and regular transport times facilitated a shorter TAT.
CONCLUSION CONCLUSIONS
Integration of pathogen sequencing into diagnostic laboratories may help to improve sequencing TAT to allow sequence data to be of tangible value to infection control practice. Adding a quality control step upstream to increase capacity further down the workflow may also optimize TAT if lower quality samples are removed at an earlier stage.

Identifiants

pubmed: 36228768
pii: S0195-6701(22)00318-8
doi: 10.1016/j.jhin.2022.09.022
pmc: PMC9550290
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

34-42

Subventions

Organisme : Medical Research Council
ID : MC_PC_19027
Pays : United Kingdom

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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Auteurs

H Colton (H)

Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Directorate of Laboratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Electronic address: h.colton@sheffield.ac.uk.

M D Parker (MD)

Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, UK; Sheffield Bioinformatics Core, University of Sheffield, Sheffield, UK.

O Stirrup (O)

Institute for Global Health, University College London, London, UK.

J Blackstone (J)

The Comprehensive Clinical Trials Unit, University College London, London, UK.

M Loose (M)

School of Life Sciences, University of Nottingham, Nottingham, UK.

C P McClure (CP)

School of Life Sciences, University of Nottingham, Nottingham, UK.

S Roy (S)

Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK.

C Williams (C)

Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK.

J McLeod (J)

School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.

D Smith (D)

Department of Applied Biology, Cellular and Molecular Sciences/Microbiology Group, Northumbria University, Newcastle, UK.

Y Taha (Y)

Department of Infection and Tropical Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle Upon Tyne, UK.

P Zhang (P)

Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.

S N Hsu (SN)

Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK; Sheffield Bioinformatics Core, University of Sheffield, Sheffield, UK.

B Kele (B)

Virology Department, East and South East London Pathology Partnership, Royal London Hospital, Barts Health NHS Trust, London, UK.

K Harris (K)

Virology Department, East and South East London Pathology Partnership, Royal London Hospital, Barts Health NHS Trust, London, UK.

F Mapp (F)

Institute for Global Health, University College London, London, UK.

R Williams (R)

Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK.

P Flowers (P)

School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.

J Breuer (J)

Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, UK.

D G Partridge (DG)

Directorate of Laboratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

T I de Silva (TI)

Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.

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