Industry standards warrant a 6-week period of continual surveillance of a hospital cluster outbreak at the point of last detection, but is that enough? How can we tell if 6 weeks are enough? How can we know if our outbreaks are related to each other or maybe even one extended outbreak? For one hospital, we have been monitoring a persistent MRSA outbreak for over 19 months, with the largest cluster identified containing samples spanning 11 months of separation.

Rather than taking the approach of continued surveillance, our approach used whole genome sequencing and banking of results so when a new outbreak is detected, high resolution clonality analysis could be performed to determine the level of relatedness between new samples and those previously analyzed. Without the ability to go back and identify relatedness of samples at single nucleotide resolution, the distantly obtained samples likely wouldn’t have been deemed related and the infection control protocol would have been different.

As opposed to treating this distantly obtained sample as a lone infection, the hospital knew they already had a persistent outbreak on hand. With this information they were able to take more aggressive measures and expand prevention procedures on the floor to prevent further spread of the identified pathogen, saving time, money, and improving patient outcomes. This far exceeded waiting for subsequent cases to develop in order to declare another cluster outbreak and launch aggressive control measures.

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