Dr Courtney Lane1
1AMR & International Program, Centre for Pathogen Genomics & WHO Collaborating Centre for AMR
Biography:
Courtney is Lead Epidemiologist and early career researcher at the WHO Collaborating Centre for Antimicrobial Resistance (AMR) at the Peter Doherty Institute for Infection & Immunity. Courtney is a qualified field epidemiologist (MAE 2014, PhD 2024) and works primarily on antimicrobial resistance surveillance and the implementation of pathogen genomics into public health practice. Courtney leads several translational research projects, including the Victorian Carbapenemase-producing Enterobacterales Cohort Study and maintains membership on national and international committees, including leading development of a WHO Guidance on AMR Surveillance in the Western Pacific Region.
Abstract:
Carbapenemase-producing organisms (CPOs) are designated a WHO ‘critical’ priority pathogen, due to few remaining treatment options, high disease burden, and rapid spread. Control of CPOs relies on isolating colonised patients on hospital admission to reduce transmission. However, further evidence is needed to inform isolation guidelines and target scarce infection control resources to those most at risk of long-term carriage.
The Victorian CPE Cohort Study (CPECS) aims to determine duration of colonisation and risk factors for long-term carriage of CPOs, using a diverse surveillance cohort.
Patients identified with a CPO in Victoria since 2012 were invited to participate. Faecal specimens, along with medical and travel history, were collected and tested for the presence of CPE on enrolment and again 12 to 24 months later.
Of the 100 pilot participants, 9 (9%) were CPO positive on enrolment screening. Of those eligible for repeat screening 3/41 (7.3%) were positive, including one participant who had screened negative on enrolment. Of the total 10/100 (10%) CPO positive at either time point, median duration between initial detection and most recent positive screen was 3.99 years (range 1.35-8.06), compared to 4.49 years (range 0.80-9.56) for those who screened negative. Of note, CPO gene and/or species identified differed to those observed at initial detection in 4/10 (40%) of positive participants.
Recruitment is ongoing, however preliminary results indicate that findings of repeat CPO detection may represent persistent carriage of a single CPO clone, as well as intra-patient movement of CPO genes between species, missed CPO diversity on initial detection, and/or re-acquisition due to repeat exposure and continued risk.
Results from subsequently enrolled participants, and factors associated with persistent CPO carriage will also be discussed.