Researchers from the University of Pittsburgh have made significant strides in the fight against nosocomial infections, helping to avert outbreaks, conserve lives, and curtail healthcare expenses. They have designed and trialed an innovative platform for infectious diseases diagnosis, dubbed the Enhanced Detection System for Healthcare-Associated Transmission (EDS-HAT). This system is founded on whole genome sequencing (WGS) technology, a burgeoning, progressively cost-effective solution to bypassing current constraints in infection control. In comparison to conventional hospital detection techniques, EDS-HAT introduces some much-needed improvements in timeliness, accuracy, and predictive capabilities.
Traditional detection systems operate by observing and tracking deviations from a baseline incidence rate of infections. While functional, they fall short in several aspects. Timeliness is often delayed, which can potentially allow for the escalation of outbreaks. Misidentification of outbreaks also occurs, increasing the risk of unnecessary or misguided interventions. Moreover, there may be instances where outbreaks go undetected altogether.
Replacing this reactive approach, EDS-HAT establishes a robust, proactive system that utilises WGS to sequence pathogens with or without an outbreak occurrence. This early identification capacity allows healthcare professionals to halt transmission and assert control as soon as two related cases are detected. The pragmatic value of this technology is immense; it facilitates the pinpointing of epidemiological links between patients with nearly identical infection strains, even in the absence of apparent connections.
Without the benefit of genomic sequencing, it becomes challenging for infection preventionists to discern the relationship between two concurrent infection cases. Coincidence or transmission – EDS-HAT makes the distinction clear. Without this clarity, undetected transmissions can lead to the unchecked proliferation of infections, escalating an outbreak before realization and intervention.
The effectiveness of EDS-HAT was validated over a two-year trial at the UPMC Presbyterian Hospital. The findings, perceptibly detailed in ‘Clinical Infectious Diseases’, demonstrate that EDS-HAT averted 62 infections and prevented five fatalities during the trial period. It also realized potential savings up to nearly $700,000 and presented a 3.2-fold return on investment. This successful trial propels the case for the nationwide adoption of EDS-HAT, alongside a call for the establishment of an early outbreak detection database at the national level.
If adopted widely, EDS-HAT could provide the framework to develop a nationwide system modelled after PulseNet (the CDC’s network for detecting multistate foodborne illness outbreaks). Such a system would be invaluable in nipping nationwide outbreaks in the bud, thereby benefiting not only individuals within the healthcare system, but also those unable to access it.
Of course, the widespread acceptance of prospective WGS surveillance in healthcare settings requires overcoming the barriers of initial investment in WGS infrastructure and incentivizing its utilization. However, in the words of Prof. Lee Harrison from the University of Pittsburgh School of Medicine, the implementation of EDS-HAT in every health care facility across the country simply makes sense.