Antimicrobial resistance has been identified as a key public health concern, with infections caused by Multi-Drug Resistant Organisms (MDRO) posing a significant threat to patient outcome and to the management of healthcare settings. Carbapenem resistant Gram-negative organisms are of particular concern as they are increasingly associated with hospital outbreaks.
These outbreaks can be caused by direct spread of closely related organisms or can involve sharing of several resistance genes, carried by mobile genetic element, between unrelated bacteria; as a result, sensitive bacteria can acquire resistance to many different antibiotics by the simple acquisition of a mobile element.
During outbreaks it is crucial to rapidly gather information about relatedness of different isolates and the mobile element they carry. Newer sequencing technologies allow now to better decipher means of transmission and therefore guiding strategies to prevent further spread of infections. In addition, complete genome sequences of outbreak organisms can reveal a more detailed picture about the pool of resistance determinants than existing methods.
The ARGENT project aims to develop a genomics based typing service to support outbreak investigation in Welsh healthcare settings. The first few years focussed on carbapenem- resistant Acinetobacter baumannii, Pseudomonas aeruginosa and vancomycin-resistant Enterococci.
Although the service is not yet fully operational, it has already supported recent outbreak investigations across Wales. As part of the project, representative bacterial isolates from blood cultures (except coagulase-negative Staphylococci and anaerobes) are now being sequenced in order to identify strains (regardless of their antibiotic resistance profile) that maybe spreading across different healthcare settings. All laboratories across Wales are encouraged to submit blood culture isolates for one year using the form below.