Root of the Outbreak

Today, a very limited subset of antibiotic-resistant bacteria is sequenced. This means that we only see the tip of the iceberg when it comes to bacterial outbreaks because hospitals cannot currently track transmissions of fully antibiotic-susceptible bacteria.   

The Inspiration Behind the Innovation

The European Centre for Disease Prevention and Control (ECDC) has warned of a bacteria that is hypervirulent and can only be tracked by whole-genome sequencing (WGS). Therefore, it’s imperative that we perform more sequencing and apply more sophisticated tools to track the epidemiology of hospital outbreaks as quickly as possible.

WGS is the most precise method for determining genetic relationships of bacteria, and thus, infection transmissions. Expanding the application of WGS to more clinical isolates than today – and combining these efforts with Epilinx could improve the efficiency with which infection transmissions can be tracked. Epilinx is a tool developed by Statens Serum Institut that can visualise patient movement to give an overview of the root of the outbreak.

Currently, when an outbreak is confirmed via WGS, infection-control nurses look up individual patient information and draw a manual timeline in order to track the spread. Streamlining the epidemiology investigation process by removing the manual element for identifying and isolating infected patients could speed up the process of preventing further spread.

Quicker action could:

• Decrease morbidity associated with colonization of resistant bacteria
• Decrease the need for treatment with toxic antibiotics (e.g., Colistin)
• Decrease prolonged hospital stays due to hospital-acquired infections
• Contain the spread of identified outbreaks

The Innovation 

Since 2015, the project team has been whole-genome sequencing antibiotic-resistant bacteria at Rigshospitalet in Copenhagen. This has yielded critical insights into how the sequenced pathogens spread in hospitals, serving as a proof-of-concept.

This project aims to perform sequencing on a larger range of bacteria than is done today and to improve the epidemiological studies of identified outbreaks by applying Epilinx to identify the root of the outbreak and the patients involved. This can help to facilitate early detection of patient-to-patient spread, leading to the implementation of effective hygiene measures and the launch of intervention studies.

The Team 

Frederik Boëtius Hertz: Senior Registrar at Department of Clinical Microbiology, MD, PhD; Rigshospitalet 

Karen Leth Nielsen: Senior Scientist, M.Sc. Eng. (BioTech), PhD;   
Department of Clinical Microbiology, Rigshospitalet