Microbial genotyping systems for infection control

Abstract

Microbial genotyping in hospital infection control is traditionally used to confirm outbreaks that have been identified using spatiotemporal surveillance data. However, for organisms of high endemicity, such as methicillin-resistant Staphylococcus aureus (MRSA), this approach may have limited usefulness due to the inability to even suspect outbreaks without first performing molecular typing. New PCR based typing methods have a much faster turn-around time and higher throughput than traditional methods, and open the door to the possibility of performing universal typing rather than the traditional targeted strategy. However, using a universal strategy requires a more robust approach to result interpretation to avoid falsely calling outbreaks of organisms that have similar molecular profiles by chance. This chapter discusses both the targeted and universal approaches to molecular typing in hospital infection control, and the interpretation of typing results using a probabilistic framework. Lastly, the continuous integration of clinical data from electronic medical records with spatiotemporal and molecular surveillance data to produce a complete microbial genotyping system will be explored. © 2010 Springer-Verlag New York.