An evaluation of the electronic reporting system for the enhanced surveillance of carbapenemase-producing Gram-negative bacteria in England

D. Jermacane, Caroline Coope*, D. Ironmonger, Paul Cleary, Berit Muller-Pebody, Russell Hope, Susan Hopkins, Richard Puleston, R. Freeman, K. L. Hopkins, Alan Johnson, Neil Woodford, Maria Oliver

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: An electronic reporting system (ERS) for the enhanced surveillance of carbapenemase-producing Gram-negative bacteria (CPGNB) was launched by Public Health England in May 2015. Aim: This evaluation aimed to assess uptake, timeliness and completeness of data provided and explore potential barriers and facilitators to adopting the system. Methods: The evaluation comprised a retrospective analysis of surveillance data and semi-structured interviews with ERS users. Findings: The proportion of organisms referred for investigation of carbapenem resistance via ERS increased over the first 12 months post-implementation from 35% to 73%; uptake varied widely across regions of England. Completeness of enhanced data fields was poor in 78% of submitted isolates. The median number of days to report confirmatory test results via ERS was 1 day for the regional service and nine days for the national reference laboratory, which additionally conducts phenotypic testing to confirm carbapenemase negativity. Hindrances to ERS utility included: a lack of designated, ongoing resource for system maintenance, technical support and development; uncertainty about how and when to use ERS and workload. Incomplete data prevented gaining a better understanding of important risk factors and transmission routes of CPGNB in England. Conclusion: The ERS is the only surveillance system in England with the potential to gather intelligence on important risk factors for CPGNB to inform public health measures to control their spread. Although the ERS captures more information on CPGNB than other surveillance systems, timeliness and completeness of the enhanced data require substantial improvements in order to deliver the desired health benefits.

Original languageEnglish
Pages (from-to)17-24
Number of pages8
JournalJournal of Hospital Infection
Volume102
Issue number1
DOIs
Publication statusPublished - May 2019

Bibliographical note

Funding Information:
This work was supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol , in partnership with Public Health England (PHE) [ HPRU-2012-10026 ]. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health or Public Health England.

Funding Information:
C.M. Coope reports grants from the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE) [HPRU-2012-10026], during the conduct of the study. N. Woodford and K.L. Hopkins report grants from Momentum Bioscience, grants from Tetraphase Pharmaceuticals, grants from Bio-rad, grants from Bio Merieux, grants from Meiji Seika Pharma Co, grants from Accelerate Diagnostics, grants from Wockhardt Ltd, grants from Check-points, grants from Helperby Therapeutics groups, grants from Merck Sharpe & Dohme Corp., grants from Roch Ltd, grants from Venato Rx Pharmaceuticals, grants from Astrazeneca, grants from Paratek, grants from Shionogi, grants from Neem Bioteck Ltd, grants from Glaxo Smithkline, grants from Innovate UK, grants from Kalidex Pharmaceuticals, grants from Melinta, grants from Mobidiag, grants from Rokitan Ltd, grants from Trius Therapeutics, grants from VenatoRx pharmaceuticals, grants from Paratek, from Rabiotics Rx, outside the submitted work. All other authors have no conflicts of interest to declare.This work was supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE) [HPRU-2012-10026]. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health or Public Health England. The authors are indebted to the participant NHS acute hospital Trusts and all of the people who contributed to the evaluation. Thanks to Peter Staves who provided the AMRHAI data for the study.

Funding Information:
C.M. Coope reports grants from the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol , in partnership with Public Health England (PHE) [ HPRU-2012-10026 ], during the conduct of the study. N. Woodford and K.L. Hopkins report grants from Momentum Bioscience , grants from Tetraphase Pharmaceuticals , grants from Bio-rad , grants from Bio Merieux , grants from Meiji Seika Pharma Co , grants from Accelerate Diagnostics , grants from Wockhardt Ltd , grants from Check-points , grants from Helperby Therapeutics groups , grants from Merck Sharpe & Dohme Corp. , grants from Roch Ltd , grants from Venato Rx Pharmaceuticals , grants from Astrazeneca , grants from Paratek , grants from Shionogi , grants from Neem Bioteck Ltd , grants from Glaxo Smithkline , grants from Innovate UK , grants from Kalidex Pharmaceuticals , grants from Melinta , grants from Mobidiag , grants from Rokitan Ltd , grants from Trius Therapeutics , grants from VenatoRx pharmaceuticals , grants from Paratek , from Rabiotics Rx , outside the submitted work. All other authors have no conflicts of interest to declare.

Funding Information:
C.M. Coope reports grants from the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE) [HPRU-2012-10026], during the conduct of the study. N. Woodford and K.L. Hopkins report grants from Momentum Bioscience, grants from Tetraphase Pharmaceuticals, grants from Bio-rad, grants from Bio Merieux, grants from Meiji Seika Pharma Co, grants from Accelerate Diagnostics, grants from Wockhardt Ltd, grants from Check-points, grants from Helperby Therapeutics groups, grants from Merck Sharpe & Dohme Corp., grants from Roch Ltd, grants from Venato Rx Pharmaceuticals, grants from Astrazeneca, grants from Paratek, grants from Shionogi, grants from Neem Bioteck Ltd, grants from Glaxo Smithkline, grants from Innovate UK, grants from Kalidex Pharmaceuticals, grants from Melinta, grants from Mobidiag, grants from Rokitan Ltd, grants from Trius Therapeutics, grants from VenatoRx pharmaceuticals, grants from Paratek, from Rabiotics Rx, outside the submitted work. All other authors have no conflicts of interest to declare.This work was supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE) [HPRU-2012-10026]. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health or Public Health England.

Publisher Copyright:
© 2019

Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.

Keywords

  • Carbapenemase-producing Gram-negative bacteria
  • Electronic reporting system
  • Evaluation
  • Public Health England
  • Surveillance

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