INTerrupting prolifERation of Carbapenem resistance in Indonesia: clinical and genomic Evaluation of Pathways of Transmission (INTERCEPT)
Observational cohort study of patients colonised with carbapenem resistant bacteria (INTERCEPT-transmission) and patients with Gram-negative bacteraemia(INTERCEPT-bacteraemia).
INTERCEPT -transmission (hospital): Participants will be asked to provide up to seven stool or rectal swab samples during the six week sampling time-frame provided they remain an inpatient on the ward being studied. There is no follow-up. INTERCEPT-transmission(staff): Staff will be asked to provide up to two nasopharyngeal swabs during the six week sampling period. There is no follow-up. INTERCEPT -transmission (community): a random cross-sectional sample of community members will be recruited and asked to provide a single stool sample. There is no follow-up. INTERCEPT-intervention (qualitative): Purposively selected participants will be invited to take part in a semi-structured interview or focus group led by a researcher. There is no follow-up.
INTERCEPT-transmission (hospital) 1. Hospitalised adults aged 18+ 2. Admitted to the general ward or ICU where recruitment is taking place 3. Able to consent or be consented by a legal representative 4. Able to understand indonesian or english 5. Willing to provide rectal swab at intervals whilst an inpatient 5. Not receiving end of life care or expected to die within 24 hours INTERCEPT-transmission(staff) 1. Hospital staff aged 18+ 2. Able to consent 3. Willing to provide a nasopharyngeal swab sample INTERCEPT -transmission (community) 1. Adults aged 18+ 2. Living in the community surrounding the hospital 3. Not hospitalised in the previous year 4. Able to consent 5. Willing to provide a single stool sample INTERCEPT-bacteraemia 1. All patients with gram-negative bloodstream infection during 6-week recruitment period NB. anonymised isolates collected from microbiology laboratory only INTERCEPT-intervention 1. Key stakeholders across hospital sites (including but not limited to: managers, policymakers, infection prevention and control staff, nurses, clinicians, pharmacists) 2. Willing to consent to be interviewed or join a focus group discussion
INTERCEPT-transmission(hospital) 1.unable to understand indonesian or english 2. unable to consent themselves or via a legal representative 3. receiving end of life care or anticipated to die within 24 hours of recruitment INTERCEPT -transmission (community) 1. unable to understand indonesian or english 2. hospital admission during previous 12 months