Institute of Virology, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Institute of Medical Microbiology and Hospital Hygiene, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Clin Infect Dis. 2022 Mar 23;74(6):1039-1046. doi: 10.1093/cid/ciab588.
Tracing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission chains is still a major challenge for public health authorities, when incidental contacts are not recalled or are not perceived as potential risk contacts. Viral sequencing can address key questions about SARS-CoV-2 evolution and may support reconstruction of viral transmission networks by integration of molecular epidemiology into classical contact tracing.
In collaboration with local public health authorities, we set up an integrated system of genomic surveillance in an urban setting, combining a) viral surveillance sequencing, b) genetically based identification of infection clusters in the population, c) integration of public health authority contact tracing data, and d) a user-friendly dashboard application as a central data analysis platform.
Application of the integrated system from August to December 2020 enabled a characterization of viral population structure, analysis of 4 outbreaks at a maximum care hospital, and genetically based identification of 5 putative population infection clusters, all of which were confirmed by contact tracing. The system contributed to the development of improved hospital infection control and prevention measures and enabled the identification of previously unrecognized transmission chains, involving a martial arts gym and establishing a link between the hospital to the local population.
Integrated systems of genomic surveillance could contribute to the monitoring and, potentially, improved management of SARS-CoV-2 transmission in the population.
当偶然接触者未被回忆或未被视为潜在的风险接触者时,追踪严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的传播链仍然是公共卫生当局的主要挑战。病毒测序可以解决有关 SARS-CoV-2 进化的关键问题,并通过将分子流行病学纳入经典的接触者追踪,支持重建病毒传播网络。
我们与当地公共卫生当局合作,在城市环境中建立了一个综合的基因组监测系统,该系统结合了 a)病毒监测测序,b)人群中感染集群的遗传鉴定,c)公共卫生当局接触者追踪数据的整合,以及 d)一个用户友好的仪表板应用程序作为中央数据分析平台。
2020 年 8 月至 12 月应用综合系统,能够对病毒种群结构进行特征描述,分析一家重症监护医院的 4 起暴发,以及基于遗传的 5 个潜在人群感染集群的鉴定,所有这些都通过接触者追踪得到证实。该系统有助于制定改进的医院感染控制和预防措施,并能够识别以前未被发现的传播链,涉及一家武术健身房,并将医院与当地人群联系起来。
综合的基因组监测系统有助于监测和潜在地改善人群中 SARS-CoV-2 的传播管理。