Surveillance of healthcare-associated pathogens in hospital/community

  • Research type

    Research Study

  • Full title

    A prospective surveillance study to define rates of carriage, transmission and infection by healthcare-associated pathogens in adjacent hospital and community settings

  • IRAS ID

    135252

  • Contact name

    Sharon Peacock

  • Contact email

    sjp97@medschl.cam.ac.uk

  • Research summary

    Study design: A prospective surveillance study to define rates of carriage, transmission and infection by healthcare-associated pathogens in adjacent hospital and community settings

    Study participants:
    1. Patients admitted to Addenbrooke’s Hospital during a one year period (n=65,000)
    2. Residents admitted to a nursing home during a one year period (n=250, estimated)

    Primary objective:
    To determine the rates of carriage, transmission and infection by specified healthcare-associated pathogens (methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, multi-drug resistant Gram-negative bacilli (MDR GNB) and vancomycin-resistant enterococci (VRE)) in hospital and nursing home settings, using a combination of epidemiological investigation and bacterial whole genome sequencing.

    Study procedures:
    Clinical specimens collected from Addenbrooke’s hospital inpatients and residents in the designated nursing home (passive surveillance) will be processed at the Clinical Public Health and Microbiology Laboratory (CPMHL) according to standard laboratory protocols. Once routine diagnostic procedures have been completed, samples containing the target organisms will be transferred to the research laboratory for bacterial storage and DNA extraction. Specimens collected from the nursing home residents (for enhanced surveillance) will be transferred directly to the research laboratory for processing. All bacterial isolates included in the study will be assigned a unique anonymous strain number. In the research laboratory bacterial isolates will undergo identification, antimicrobial susceptibility testing, and DNA extraction. Samples will then be transferred to the Wellcome Trust Sanger Institute for bacterial whole genome sequencing using a high-throughput sequencing platform.

    Interventions: None

    Primary endpoints:
    1. Rate of carriage of MRSA, C. difficile, MDR GNB and VRE over time in hospital and nursing home populations.
    2. Rate of transmission of MRSA, C. difficile, MDR GNB and VRE over time within and between hospital and nursing home populations.
    3. Incidence of healthcare-associated infections by MRSA, C. difficile, MDR GNB and VRE over time in hospital and nursing home populations.

  • REC name

    London - Queen Square Research Ethics Committee

  • REC reference

    13/LO/1278

  • Date of REC Opinion

    3 Feb 2014

  • REC opinion

    Further Information Favourable Opinion