Ms Megan Gritt1, Ms Jaimie M. Yamada1, Ms Denise Del Rosario Kelly1, Ms Susan C. McLellan1, Ms Nhu Q. Doan1,2, Ms Mariel Beiers1,2, Ms Jane Hawkey1,2, Ms Pauline Bass1, Professor Anton Y. Peleg1,2, Associate Professor Andrew J. Stewardson1,2, Dr Nenad Maćešić1,2
1Alfred Health, Melbourne, Australia, 2Monash University, Melbourne, Australia
Biography:
Megan is an Infection Prevention Nurse Consultant at Alfred Health with a strong background in infectious diseases. She is passionate about mentoring staff, and improving practices around MROs. With experience across clinical care, project coordination, she is committed to making infection prevention both practical and impactful.
Abstract:
Problem/Issue Identified
In July 2024, we identified an increase in NDM-1 carbapenemase-producing Enterobacterales (CPE) at Alfred Health. Active surveillance and clinical samples suggested a large-scale multi-species plasmid outbreak.
What Was Done to Rectify the Problem/Issue
An outbreak response team set out to create effective communication, screening prioritisation, and result reporting processes between the Infection Prevention and Healthcare Epidemiology team (IPHE) and our Clinical Infectious Diseases (ID) Genomics service and the hospital executive.
The Results
During a multi-species plasmid outbreak, detailed genomic analysis was required to confirm or exclude each potential new case. Using in-house whole genome sequencing (WGS) allowed distinguishing between NDM variants, which we were previously not able to achieve via the hospital clinical laboratory. We observed a reduction in time from sample collection to WGS reports; from 7–28 days with the state reference laboratory to 4–10 days with in-house sequencing. Faster turn-around time allowed agile prioritisation of isolates for WGS based on epidemiological risk. The early identification of true outbreak cases provided insight to transmission pathways and facilitated allocation of resources and mitigation strategies.
Conclusion
Our findings highlight how timely WGS reporting during an outbreak response can significantly enhance rapid identification of true cases and assist in allocation of resources.
Lessons Learnt
Creating a streamlined communication and reporting process between IPHE and our in-house genomics service was critical for effective prioritisation of sequencing efforts and timely result reporting, allowing for appropriate mitigation resources to be focused on areas with high suspicion of transmission.