Infections due to multidrug-resistant infectious diseases are a growing, silent pandemic, causing millions of deaths worldwide. An estimated 14,000 Canadians died due to drug-resistant bacterial infections in 2018. Hospital-associated (also known as nosocomial) drug-resistant infections burden healthcare systems due to severe medical complications and death. Management of these infections is estimated to cost hundreds of billions of dollars in the upcoming decades to the Canadian health-care system.

Amongst the various drug-resistant bacteria is an emerging threat called carbapenemase-producing organisms (CPOs) that can cause severe infections such as pneumonia, meningitis, and sepsis. The World Health Organization (WHO) has categorized CPOs as a critical threat due to their increasing worldwide incidence and limited treatment options. Complicating the control of CPO spread is their ability to establish reservoirs in healthcare environments, such as in sinks and drains, such that their spread is not always directly due to patient-to-patient or patient-to-healthcare worker contact.

Both the Alberta Public Health Laboratory (Alberta ProvLab) and the BC Centre for Disease Control Public Health Laboratory (BCCDC PHL) have recognized the threat that CPOs pose and established routine genomic surveillance of these pathogens to better understand circulating organisms. This project will evaluate Alberta and BC’s CPO genomic surveillance programs from a health economics perspective, comparing the current “reactive” response to CPO cases with a proactive approach that detects early transmission events and prevents further spread of infection. The outcomes will inform the cost-benefit of a proactive genomics-based CPO surveillance strategy and generate results that will guide best practices for genomic surveillance, applicable both nationally and internationally.