Whole-genome sequencing of multidrug-resistant organisms in ICU

  • Research type

    Research Study

  • Full title

    Whole-genome sequencing to investigate colonisation and transmission of multidrug-resistant organisms on the adult intensive care unit at Addenbrooke’s Hospital

  • IRAS ID

    180415

  • Contact name

    Estee Torok

  • Contact email

    et317@cam.ac.uk

  • Sponsor organisation

    Cambridge University Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Background
    Healthcare associated infections (HCAI) are estimated to affect up to 10% of hospital inpatients and are associated with increased morbidity and mortality. Multidrug-resistant organisms (MDRO) are found more commonly in healthcare settings where they contribute to the burden of HCAI. Patients in intensive care units (ICU) are particularly vulnerable to HCAI, and several outbreaks of infection with MDRO have been reported. Current practices for screening for MDRO vary between countries, hospitals and units, reflecting a lack of data and the uncertainty around best practice. One strategy to reduce HCAI in the ICU setting would be to perform prospective surveillance for MDRO in patients admitted to intensive care units in order to identify them more quickly and to enable the earlier implementation of appropriate infection control measures and tailored antimicrobial therapy. Rapid whole genome sequencing (WGS) is a new technology that is faster and more discriminatory than current epidemiological typing methods.

    Study design, setting and participants
    This is a prospective surveillance study of MDRO in the adult ICU at Addenbrooke's Hospital Cambridge. All patients who are admitted to the adult ICU during the 6 month study period will be eligible for inclusion in he study.

    Objectives
    1. To determine the rates of carriage, infection and transmission of multidrug-resistant organisms in the John Farman Intensive Care unit at Addenbrooke’s Hospital using bacterial WGS.
    2. To compare standard epidemiological investigation / typing with WGS in the investigation of suspected outbreaks.
    3. To conduct a health economic evaluation of standard epidemiological investigation / typing with WGS in the investigation of suspected outbreaks.

    Study methods
    All patients admitted to the adult ICU at Addenbrooke's hospital will be screened for MDRO on admission, on discharge and weekly during their inpatient stay. Clinical and laboratory data will be collected on admission/discharge and weekly. Specimens will be tested for MDRO using standard methods and WGS.

  • REC name

    East of England - Cambridge Central Research Ethics Committee

  • REC reference

    15/EE/0318

  • Date of REC Opinion

    21 Apr 2016

  • REC opinion

    Further Information Favourable Opinion