WHONET: Tools for a Global Microbial Sensor Network

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DESCRIPTION (provided by applicant): Infectious diseases and resistance to antimicrobial agents grow as threats to human and animal welfare worldwide and drain limited resources. To contain and manage infecting microbes and their resistance genes, we need to know where they are and where they are going. Tens of thousands of microbiology laboratories worldwide reporting results daily to healthcare providers should be viewed as infectious disease sensors, rich sentinel windows into the world's evolving microbial populations. To support the collection, integration, and interpretation of data from disparate data sources, our team at the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance has developed and disseminated the WHONET software for 24 years in collaboration with the World Health Organization. WHONET is the leading free public health software to support laboratory-based surveillance of antimicrobial resistance, and supports surveillance activities in over 110 countries and 2500 hospital, public health, food, and animal laboratories. In our current grant, we have successfully modernized the legacy desktop version of WHONET into a secure, multi-tiered web architecture for data management, analysis, and presentation. With this more mature platform, a grant renewal would permit the expansion of WHONET's scope and impact in a number of areas: 1) data capture from new molecular technologies rapidly transforming routine microbiological practices; 2) improved tools for recognition, geo-tracking, and automated caregiver, infection preventionist, and public health alerts of microbial subtypes from both classic and new molecular phenotyping methods; 3) additional security options for data access and transfer; and 4) pilot implementation in partner networks. The improved definition of strain phenotypes will leverage classical statistical and newer data mining techniques offered by the integration of EpiInfo, R, and Weka routines into the WHONET analysis module. In the past few years, an exciting new direction for WHONET development has been the targeted expansion of capabilities to support laboratory-based public health reporting of healthcare-associated infections, most notably the MDRO/CDI module of the CDC National Healthcare Safety Network (NHSN). This has required the addition of new data feeds for patient movements ("Admission/Discharge/Transfer") and selective clinical data elements. U.S. and international infection prevention colleagues increasingly request the inclusion within WHONET of additional infection reporting modules, especially CLABSI, CAUTI, and SSI, which we will accomplish with this application. Microbes move - between people, hospitals, animals, continents - and evolve. Through automated, real-time mobilization and vigilance of a rich yet largely untapped resource - the cumulative efforts of the world's microbiology laboratories - our goal is the development of free solutions in the public sector that can be applied worldwide to mobilize, share, and interpret these data to guide timely and effective public health action.