Use of genomic analysis in informing practice to prevent healthcare worker infection and transmission – A case report
Donya Eghrari1,2, Norelle Sherry2,3, Anne Watt2, Ben Howden2, Angeline Ferdinand1,21Centre for Health Policy, Melbourne School of Population and Global Health, The University Of Melbourne, Parkville Campus, Victoria, Australia2Microbiological Diagnostic Unit, Public Health Laboratory, Peter Doherty Institute for Infection & Immunity, The University of Melbourne, Melbourne, Victoria, Australia3Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia
Introduction
Preventing healthcare worker (HCW) infections is essential for workplace and patient safety, and ensuring the robustness of health systems. Pathogen genomics can better characterise transmission events and help minimise the risk of infection among HCWs. In 2020 and 2021, a number of healthcare facilities (HCF) in Melbourne, Australia, requested genomic sequencing investigation (GSI) for SARS-CoV-2 infections. This study investigated facilitators and barriers to the use of GSI for HCFs, using SARS-CoV-2 as a case study.
Methods
Sixteen semi-structured interviews were conducted with representatives of infection prevention and control (IPC) units of ten HCFs. Previously known networks and snowballing technique were used for recruitment. The Theoretical Domains Framework guided data collection and analysis.
Results
HCFs were motivated to request genomic reporting when there was an outbreak with an unknown infection source or transmission link, when epidemiological data was inconclusive, when identifying new variants or variants of concern, and when responding to issues of liability. Requesting reports was easier with pre-existing relationships. Unavailability of real-time data, and inadequate knowledge about GSI contributed to its limited utilisation.
Conclusion
The use of personal protective equipment and other IPC measures were not directly impacted by genomic data in the majority of healthcare settings that requested GSI. However, GSI was thought to inform and complement infection control practices by increasing confidence in the effectiveness of existing measures. An integrated and timely approach to the use of epidemiological and genomic data, as well as clear pathways for requesting genomic reporting can enhance HCFs’ utilisation of GSI
Biography
Dr Norelle Sherry is an Infectious Diseases Physician & Clinical Microbiologist based at the MDU Public Health Laboratory in Melbourne, with a clinical role at Austin Health. She is involved in pathogen genomic surveillance and implementation for public health and hospitals, including infection control.
Donya Eghrari is an Optometrist and a Public Health researcher based at the University of Melbourne and Peter Doherty Institute. She has research experience in newborn and maternal health, cancer screening, and pathogen genomics, working with diverse communities, as well as experience in collaborative practice curriculum design, implementation and evaluation in medical and allied health.