Microbial Genotyping Systems for Infection Control
Microbial genotyping in hospital infection control is traditionally used to confirm outbreaks that have been identified using spatiotemporal surveillance data. However, for organisms of high endemicity, such as methicillin-resistant Staphylococcus aureus (MRSA), this approach may have limited usefulness due to the inability to even suspect outbreaks without first performing molecular typing. New PCR based typing methods have a much faster turn-around time and higher throughput than traditional methods, and open the door to the possibility of performing universal typing rather than the traditional targeted strategy. However, using a universal strategy requires a more robust approach to result interpretation to avoid falsely calling outbreaks of organisms that have similar molecular profiles by chance. This chapter discusses both the targeted and universal approaches to molecular typing in hospital infection control, and the interpretation of typing results using a probabilistic framework. Lastly, the continuous integration of clinical data from electronic medical records with spatiotemporal and molecular surveillance data to produce a complete microbial genotyping system will be explored.
KeywordsInfection Control Molecular Typing Exponentially Weight Move Average Infection Control Measure Nosocomial Pathogen
- Amaral MM, Coelho LR, Flores RP et al. (2005) The predominant variant of the Brazilian epidemic clonal complex of methicillin-resistant Staphylococcus aureus has an enhanced ability to produce biofilm and to adhere to and invade airway epithelial cells. J Infect Dis 192:801–810CrossRefPubMedGoogle Scholar
- Australian Institute of Health and Welfare (2007) Australian hospital statistics 2005–06. Health services series no. 30. Cat. no. HSE 50. AIHW, CanberraGoogle Scholar
- Edgeworth JD, Yadegarfar G, Pathak S et al. (2007) An outbreak in an intensive care unit of a strain of methicillin-resistant Staphylococcus aureus sequence type 239 associated with an increased rate of vascular access device-related bacteremia. Clin Infect Dis 44:493–501CrossRefPubMedGoogle Scholar
- Riley LW (2004) Principles and approaches. Molecular epidemiology of infectious diseases: principles and practices. ASM Press, Washington, DCGoogle Scholar