Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-07-04T10:54:17.607Z Has data issue: false hasContentIssue false

Use of whole-genome sequencing to guide a Clostridioides difficile diagnostic stewardship program

Published online by Cambridge University Press:  15 May 2019

Kunal K. Jakharia
Affiliation:
Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC
Ghassan Ilaiwy
Affiliation:
Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC
Siobhan S. Moose
Affiliation:
Departments of Infection Prevention and Infectious Diseases, MedStar Washington Hospital Center, Washington, DC
Masashi Waga
Affiliation:
Department of Pathology and Laboratory Medicine, MedStar Washington Hospital Center, Washington, DC
Lakshmi Appalla
Affiliation:
Multi-Drug Resistant Organism Repository and Surveillance Network (MRSN), Walter Reed Army Institute of Research, Silver Spring, MD
Joel D. McAlduff
Affiliation:
Information Services, MedStar Health, Columbia, Maryland
Lynne V. Karanfil
Affiliation:
Infection Prevention, MedStar Institute for Quality and Safety, Columbia, Maryland
Patrick T. McGann
Affiliation:
Multi-Drug Resistant Organism Repository and Surveillance Network (MRSN), Walter Reed Army Institute of Research, Silver Spring, MD
Glenn W. Wortmann*
Affiliation:
Departments of Infection Prevention and Infectious Diseases, MedStar Washington Hospital Center, Washington, DC Infection Prevention, MedStar Institute for Quality and Safety, Columbia, Maryland
*
Author for correspondence: Glenn W. Wortmann, Email: Glenn.W.Wortmann@medstar.net

Abstract

Whole-genome sequencing (WGS) has yielded new insights into the transmission patterns of healthcare facility-onset Clostridioides difficile infection (HO-CDI). WGS results prompted a focused diagnostic stewardship program, which was associated with a significant and sustained decrease in HO-CDI at large, urban hospital.

Type
Concise Communication
Creative Commons
This work is classified, for copyright purposes, as a work of the U.S. Government and is not subject to copyright protection within the United States.
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PREVIOUS PRESENTATION. Preliminary results of this work were presented at the 2018 Infectious Diseases Society of America meeting on October 4, 2018, in San Francisco, California.

References

McDonald, LC, Gerding, DN, Johnson, S, et al. Clinical practice guidelines for Clostridium difficile Infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clostridium difficile 2018;66:987994.Google Scholar
Eyre, DW, Fawley, WN, Rajgopal, A, et al. Comparison of control of Clostridium difficile infection in six english hospitals using whole-genome sequencing. Clin Infect Dis 2017;65:433441.CrossRefGoogle ScholarPubMed
Snesrud, E, Ong, AC, Corey, B, et al. Analysis of serial isolates of mcr-1-positive Escherichia coli reveals a highly active ISApl1 transposon. Antimicrob Agents Chemother 2017;61(5):pii: e0005617.CrossRefGoogle ScholarPubMed
Laing, C, Buchanan, C, Taboada, EN, et al. Pan-genome sequence analysis using Panseq: an online tool for the rapid analysis of core and accessory genomic regions. BMC Bioinformatics 2010;11:461.CrossRefGoogle ScholarPubMed
Kearse, M, Moir, R, Wilson, A, et al. Geneious Basic: an integrated and extendable desktop software platform for the organization and analysis of sequence data. Bioinformatics 2012;28:16471649.CrossRefGoogle ScholarPubMed
Croucher, NJ, Page, AJ, Connor, TR, et al. Rapid phylogenetic analysis of large samples of recombinant bacterial whole genome sequences using Gubbins. Nucleic Acid Res 2015;43(3):e15.CrossRefGoogle ScholarPubMed
Kociolek, LK, Gerding, DN, Espinosa, RO, Patel, SJ, Shulman, ST, Ozer, EA. Clostridium difficile whole genome sequencing reveals limited transmission among symptomatic children: a single-center analysis. Clin Infect Dis 2018;67:229234.CrossRefGoogle ScholarPubMed
Quan, KA, Yim, J, Merrill, D, et al. Reductions in Clostridium difficile infection (CDI) rates using real-time automated clinical criteria verification to enforce appropriate testing. Infect Control Hosp Epidemiol 2018;39:625627.CrossRefGoogle ScholarPubMed
Truong, CY, Gombar, S, Wilson, R, et al. Real-time electronic tracking of diarrheal episodes and laxative therapy enables verification of Clostridium difficile clinical testing criteria and reduction of Clostridium difficile infection rates. J Clin Microbiol 2017;55:12761284.CrossRefGoogle ScholarPubMed