Exploiting network analysis to create a novel sentinel surveillance system for efficient, rapid detection of emerging Clostridioides difficile strains in England

Exploiting network analysis to create a novel sentinel surveillance system for efficient, rapid detection of emerging Clostridioides difficile strains in England | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Exploiting network analysis to create a novel sentinel surveillance system for efficient, rapid detection of emerging Clostridioides difficile strains in England Diane Pople, Tjibbe Donker, Olisa Nsonwu, Dakshika Jeyaratnam, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7140391/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted You are reading this latest preprint version Abstract Whole genome sequencing is being introduced in England to support national surveillance of key hospital-acquired pathogens, starting with Clostridiodes difficile, to facilitate novel strain identification and enable timely interventions. However sequencing capacity is limited. Symptomatic and asymptomatic patients attending multiple hospitals can act as inter-facility transmission vectors; we therefore identified the empirical network of shared patients from analysing national admission data and simulated spread of a hypothetical novel strain. Algorithmically optimising detection, incorporating logistical constraints, we identified sentinel sites which detected a novel strain 27% faster than random sentinel selection, whilst sequencing <15% cases. Sensitivity and scenario analyses using a range of plausible pathogen characteristics and historical networks confirmed epidemiologically- and longitudinally-robust sentinel selection and performance. The new surveillance system, established from our findings, benefits from stress-tested sentinel set selection to deliver rapid, efficient identification of novel strains within real world constraints, to inform control interventions, and provides a roadmap for future hospital-acquired pathogen surveillance. Health sciences/Health care/Public health/Epidemiology Health sciences/Diseases/Infectious diseases/Clostridium difficile Full Text Additional Declarations There is NO Competing Interest. Supplementary Files 202507POPLEmanuscriptsupplementary.docx Exploiting network analysis to create a novel sentinel surveillance system for efficient, rapid detection of emerging Clostridioides difficile strains in England Cite Share Download PDF Status: Under Review Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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