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Determining infectious cross-transmission events in healthcare settings involves manual surveillance of case clusters by infection control personnel, followed by strain typing of clinical/environmental isolates suspected in said clusters. Recent advances in genomic sequencing and cloud computing now allow for the rapid molecular typing of infecting isolates.
To facilitate rapid recognition of transmission clusters, we aimed to assess infection control surveillance using whole-genome sequencing (WGS) of microbial pathogens to identify cross-transmission events for epidemiologic review.
Clinical isolates of Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, and Klebsiella pneumoniae were obtained prospectively at an academic medical center, from September 1, 2016, to September 30, 2017. Isolate genomes were sequenced, followed by single-nucleotide variant analysis; a cloud-computing platform was used for whole-genome sequence analysis and cluster identification.
Most strains of the 4 studied pathogens were unrelated, and 34 potential transmission clusters were present. The characteristics of the potential clusters were complex and likely not identifiable by traditional surveillance alone. Notably, only 1 cluster had been suspected by routine manual surveillance.
Our work supports the assertion that integration of genomic and clinical epidemiologic data can augment infection control surveillance for both the identification of cross-transmission events and the inclusion of missed and exclusion of misidentified outbreaks (ie, false alarms). The integration of clinical data is essential to prioritize suspect clusters for investigation, and for existing infections, a timely review of both the clinical and WGS results can hold promise to reduce HAIs. A richer understanding of cross-transmission events within healthcare settings will require the expansion of current surveillance approaches.
Do the various forms of literary theory - deconstruction, Marxism, new historicism, feminism, post-colonialism, and cultural/digital studies - have anything in common? If so, what are the fundamental principles of theory? What is its ideological orientation? Can it still be of use to us in understanding basic intellectual and ethical dilemmas of our time? These questions continue to perplex both students and teachers of literary theory. Habib finds the answers in theory's largely unacknowledged roots in the thought of German philosopher Hegel. Hegel's insights continue to frame the very terms of theory to this day. Habib explains Hegel's complex ideas and how they have percolated through the intellectual history of the last century. This book will interest teachers and students of literature, literary theory and the history of ideas, illuminating how our modern world came into being, and how we can better understand the salient issues of our own time.