Epidemiological aspects of healthcare-associated infections and microbial genomics

Abstract

Hospital-acquired infections (HAIs) are a cause of continuously increasing morbidity and mortality. Most of these infections are caused by a limited set of bacterial species, which share the capability to efficiently spread from patient to patient and to easily acquire antibiotic resistance determinants. This renders correct and rapid species identification and antibiotic susceptibility testing (AST) important and underscores the relevance of bacterial epidemiological typing. The latter is needed for the sensitive detection and exact tracing of nosocomial spread of these potentially multidrug-resistant microorganisms (MDRO). Many microbial typing technologies have been developed and put to some level of executive practice, but it seems that the continued evolution in methodology has currently reached an apex: there is likely to be scientific and practical consensus on the ultimate typing potential of bacterial whole-genome sequencing (WGS). The possibility to perform pan-genomic nucleotide-to-nucleotide comparisons between strains belonging to a single species and to detect even minute changes in nucleotide order will identify closely related organisms, while upon accumulation of such mutations, independent descend can be assumed. Calibration of difference levels [i.e. number of single nucleotide polymorphisms (SNPs)] into categories of inter-strain relatedness needs to be performed in order to generate robust, portable typing schemes. Here, we will briefly discuss the state of affairs regarding bacterial epidemiology based upon WGS, its relatedness with the nomenclature of former typing approaches and the continuing need for a global typing language.

Whole Genome Sequencing for Surveillance of Diphtheria in Low Incidence Settings

“…Often specific diagnostic tests are only available in reference laboratories, thus further delaying efficient therapy, surveillance reporting, and outbreak management. Once the pathogen is cultured and identified, molecular typing technologies, such as whole genome sequencing (WGS), allow a detailed comparison on the genomic level with high resolution (43–45). In the case of C. diphtheriae , high-resolution typing is helpful to (i) provide the epidemiological broader context (35) and (ii) include or exclude transmission events between patients (30, 31).…”

Bioprospecting the Skin Microbiome: Advances in Therapeutics and Personal Care Products

“…In contrast to broad-spectrum antibiotics, bacteriocin-based treatments could be tailored to the clearance of specific pathogenic organisms with minimal disruption to natural flora [ 62 , 63 , 64 , 65 ]. Hence, they are relevant in the treatment of nosocomial infections which are linked to unstable patient microbiomes and increased colonisation by reservoirs of highly antimicrobial-resistant pathogenic bacteria in the healthcare environment [ 65 , 66 ].…”

Apa yang Harus Dipahami Perawat Tentang Pencegahan Nosokomial Terkait Multidrug-Resistant Organisms (MDROS)?

“…MDRO dikaitkan dengan peningkatan morbiditas, mortalitas, dan biaya perawatan kesehatan, dan menimbulkan tantangan yang signifikan terhadap tindakan pencegahan dan pengendalian infeksi. MDROs adalah kelompok mikroorganisme yang resisten terhadap berbagai kelas antibiotik, sehingga sulit untuk diobati dan dikendalikan ( Jia et al, 2019;Mirande et al, 2018). Blanco et al (2019) menjelaskan bahwa ada 5 jalur penularan yang potensial untuk MDROs: (1) pasien ke petugas kesehatan, (2) pasien ke lingkungan, (3) petugas kesehatan ke pasien, (4) lingkungan ke pasien, dan (5) lingkungan kepada petugas kesehatan.…”