Use of WHONET-SaTScan system for simulated real-time detection of antimicrobial resistance clusters in a hospital in Italy, 2012 to 2014.
Resistant pathogens infections cause in healthcare settings, higher patient mortality, longer hospitalisation times and higher costs for treatments. Strengthening and coordinating local, national and international surveillance systems is the cornerstone for the control of antimicrobial resistance (AMR). In this study, the WHONET-SaTScan software was applied in a hospital in Italy to identify potential outbreaks of AMR. Data from San Filippo Neri Hospital in Rome between 2012 and 2014 were extracted from the national surveillance system for antimicrobial resistance (AR-ISS) and analysed using the simulated prospective analysis for real-time cluster detection included in the WHONET-SaTScan software. Results were compared with the hospital infection prevention and control system. The WHONET-SaTScan identified 71 statistically significant clusters, some involving pathogens carrying multiple resistance phenotypes. Of these 71, three were also detected by the hospital system, while a further 15, detected by WHONET-SaTScan only, were considered of relevant importance and worth further investigation by the hospital infection control team. In this study, the WHONET-SaTScan system was applied for the first time to the surveillance of AMR in Italy as a tool to strengthen this surveillance to allow more timely intervention strategies both at local and national level, using data regularly collected by the Italian national surveillance system.
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Alessandra
A
Natale
Brigham and Women's Hospital, WHO Collaborating Centre for Surveillance of Antimicrobial Resistance, Microbiology Laboratory, Boston, Massachusetts, United States.
John
J
Stelling
San Filippo Neri Hospital, Roma 1 Health Authority, Rome, Italy.
Marcello
M
Meledandri
Department of Disease Control, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Louisa A
LA
Messenger
National Surveillance Centre of Epidemiology, Surveillance and Health Promotion (CNESPS), Department of Epidemiology and Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.|Ministry of Health, General Directorate of Health Prevention, Rome, Italy.
Fortunato
F
D'Ancona
D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D024881:Drug Resistance, Bacterial; D006801:Humans; D017053:Infection Control; D007558:Italy / Q000453:epidemiology; D008962:Models, Theoretical; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D012984:Software
Italian national surveillance; WHONET SaTScan; antimicrobial resistance clusters; automated surveillance; infection control; outbreaks