Visualising infection transmission routes in order to identify, monitor and prevent antimicrobial resistant infection

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Healthcare-associated infection (HCAI), and specifically antimicrobial resistance (AMR) is one of the most pressing threats to global public health. The rapid worldwide emergence of AMR may render antibiotics, one of the greatest advances in medicine, obsolete. Approximately 700,000 people die annually as a result of multi-drug resistant bacterial infections; a figure which is estimated to rise to 10 million by 2050. Concurrently HCAIs are the most frequently encountered adverse event to threaten patient safety, affecting 4 million patients in the EU annually and causing an estimated 16 million additional bed-days. A reduction in HCAIs would aid in conserving the use of antibiotics, and therefore curb the spread of AMR in healthcare settings.Estera's proposed research aims to to develop a tool for tracking and visualising infections throughout a healthcare system. Acquiring and analysing timely data which allows the mapping of infection sources and visualisation of transmission routes is a key component of effective responses against AMR. This information can be used to dissect disease spread at an individual-to-individual level, and develop a quantitative evidence base for decision making. A specific area where this can be readily applied is the patient journey through a hospital network. During hospitalisation, patients visit many procedural and diagnostic common areas, presenting opportunities for transmission of infection. However, these potential exposures are not typically captured in analyses evaluating disease transmission. The proposed study will aim to use electronic health record data and in-silico simulations in order to study infectious disease outbreaks and hospital performance on key healthcare quality metrics.Visualisation of these pathways will inform quantitative modelling of HCAI transmission, which will facilitate intervention development and targeting of infection control measures. Ultimately this will enable monitoring, feedback and decision making within hospitals.