Genomic Mapping Identifies Interfacility Transfers as Major Culprit in Superbug Transmission
November 29, 2017 | Strategic Insights for Health System
Frequent transfers of "chronically ill, high-risk patients" from one healthcare facility to another were a key driver of a 2008 outbreak of carbapenem-resistant Klebsiella pneumoniae, reports a November 22, 2017, news release from the University of Minnesota. The outbreak affected 26 hospitals, long-term acute care facilities, and nursing homes across four counties in Illinois and Indiana; 42 patients were infected, 11 of whom died. An earlier study of the same outbreak used epidemiologic methods and less robust molecular identification methods. The earlier study identified one long-term acute care hospital as a major "hub" for transmission; the facility discharged 16 of the patients to six nursing homes and a hospital. However, by cross-referencing whole-genome sequencing data with patient records, the new study, which was published in the November 22, 2017, issue of Science Translational Medicine, provided an even more detailed transmission map—and made some additional discoveries. For example, five patients at one hospital were found to have carbapenem-resistant K. pneumoniae; the initial study had surmised that one of those five patients had brought the organism into the hospital and spread it to the other four.