Active surveillance is critical for detecting and preventing the spread of multidrug-resistant organisms (MDRO) globally and in the clinic. The Multidrug-Resistant Organism Repository and Surveillance Network (MRSN) is the primary surveillance organization for the DoD and collects MDROs from an extensive network of healthcare facilities in the continental US and overseas. Recently the MRSN developed an approach for the routine detection, in near real-time, of possible MDRO outbreaks. This service does not depend on human pattern detection but employs systematic genomic comparison of newly received MDROs to a private repository of >65,000 historical isolates. Upon detection of highly genetically related isolates, epidemiological analyses are initiated, and hospitals are immediately alerted. Among the successful outcomes, a multi-ward outbreak involving six patients caused by a carbapenem-resistant A. baumannii was detected early, tracked in the hospital environment, and successfully eradicated. Other outcomes included the detection of a carbapenem-resistant P. aeruginosa clone for which retrospective analysis, together with Bayesian phylogenetics and environmental sampling, revealed an outbreak with cases spanning decades from 20+ wards and all floors of a single hospital.
Dr. Francois Lebreton obtained his PhD in microbiology from the University of Caen (France) and completed his postdoctoral training with Mike Gilmore and Ashlee Earl at Harvard Medical School and The Broad Institute. Since 2019, Dr. Lebreton is the head of bioinformatics within the Multidrug-resistant organism Repository & Surveillance Network (MRSN) at the Walter Reed Army Institute of Research. His team uses next generation sequencing and comparative genomics to provide routine, real-time surveillance and detection of MDR bacterial outbreaks in a large network of military treatment facilities, in continental USA and overseas. His research focuses on conducting retrospective and prospective outbreak analyses to identify the factors that influence the emergence of MDR populations, their distinguishing characteristics, and the evolutionary drivers that shape them.