Next Gen Diagnostics and Vanderbilt Report the Use of Whole Genome Sequencing to Detect Transmission of Infection in a Neonatal Intensive Care Unit

Published May 21, 2024

WEST PALM BEACH, FL / ACCESSWIRE / May 21, 2024 / Next Gen Diagnostics (NGD) and a team at Vanderbilt University Medical Center (VUMC) today announced the results of a study reporting that comparison of the whole genome sequence (WGS) of bacterial pathogens obtained from surveillance of infants in a neonatal intensive care unit (NICU) revealed substantial transmission of infection not detected by conventional infection control procedures. The findings demonstrate that even in highly resourced medical centers and in wards like the NICU with high levels of constant vigilance, WGS enables the detection of transmission not achievable with methods in current practice. The abstract reporting the results of the study will be presented for publication at the American Society for Microbiology Conference in Atlanta on June 15.

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"We found that WGS of S. aureus isolates obtained from surveillance swabs and clinical samples revealed a significant amount of likely transmission, which provided guidance enabling our infection control team to take a series of actions with beneficial effect," said Dr. Romney Humphries, Professor of Pathology, Microbiology and Immunology and Director of Laboratory Medicine at VUMC and senior author on the study. "The findings were notable in the apparent transmission discovered when WGS was utilized," noted first author Dr. David Gaston, Assistant Professor and Medical Director of Molecular Infectious Disease Laboratory of VUMC. "Moreover, we were struck by the observation that transmission was more likely to occur with MRSA versus MSSA infection, and occurred in multiple networks rather than a single outbreak."

In the study, 171 S. aureus samples from 132 distinct patients, obtained from surveillance sampling conducted in April, June and July supplemented with clinical samples, were short-read sequenced and bioinformatically analyzed for relatedness of core genomes at the SNP level by the NGD automated system1, with a strict (6 SNP) cutoff used to identify putative transmission for assessment and action by the VUMC infection prevention team. 42/132 (31.8%) of patients with S. aureus infections were found to be putatively connected by transmission, with the percentage of patients with MRSA infections connected by transmission (46.8%) over twice the frequency in patients with MSSA infection (21.2%). 13 distinct strains were involved in transmission, suggesting localized undetected causes of spread rather than a ward-level outbreak.

"NGD was privileged to have the opportunity to work with the very distinguished team at VUMC to employ NGD's automated bioinformatic systems to facilitate the use of WGS to detection of transmission in a setting such as a NICU," noted Dr. Paul A. Rhodes, founder and CEO of NGD. "The demonstration that comparison of WGS so readily enabled detection of transmission that was not otherwise observed even in a state-of-the-art medical setting and in a vigilantly monitored ward was striking."

"This result, along with those emerging from other medical centers2, of the use of WGS to detect rather than simply verify transmission may signal a sea-change in best practice," noted Tom Talbot, Professor of Medicine and Medical Director of Infection Prevention at VUMC. "With a sufficiently low cost for sequencing and bioinformatic analysis, use of WGS to detect transmission, at least in those wards where patients are at the greatest risk, may become a more routine infection prevention practice."

1Brown et al 2019, J Clinical Microbiology
2Sundermann et al 2022, Antibiotic Stewardship and Healthcare Epidemiology

About Next Gen Diagnostics
NGD offers integrated high-volume turn-key sequencing and bioinformatic services to enable detection of transmission in hospitals, and is working with leading collaborators in the U.S., Europe and Israel to be among the first to bring WGS-based regulated diagnostics to patient care. NGD is based in the U.S., with subsidiaries in Cambridge, UK and in Israel.

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SOURCE: Next Gen Diagnostics


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