Carbapenem-Resistant Acinetobacter baumannii
Multi-Hospital Outbreak Investigation

EURGen-RefLabCap Multidisciplinary WGS Training Workshop Β· January 2024

πŸ›οΈ Statens Serum Institut / DTU πŸ‡ͺπŸ‡Ί EURGen-RefLabCap 🧬 WGS-based outbreak analysis πŸ”¬ Fictitious training scenario

ℹ️ About this resource

This site presents the genomic epidemiology analysis of a fictional CRAB outbreak exercise run as part of the EURGen-RefLabCap EQA programme. The data, hospitals, patients, and country names are entirely fictitious and designed for training purposes. This analysis was reproduced independently using open bioinformatics tools.

36
WGS isolates
6
Hospitals
31
OXA-23 CRAB
49
AMR genes detected
1000Γ—
Bootstrap replicates
🌳

Interactive Dashboard

Explore the complete genomic dataset interactively β€” phylogenetic tree, AMR resistance heatmap, SNP distance matrix, and sample timeline. Click any isolate to view full details.

Open Dashboard β†’
πŸ“‹

Outbreak Investigation Report

Step-by-step walk-through of how the outbreak was solved: from epidemiological curve construction to WGS-based cluster confirmation across all six hospitals.

Read Report β†’

Exercise Overview

1

Inject 1 β€” Epidemiological Data

The NRL receives records for 71 A. baumannii cases from 6 hospitals (Jan–Dec 2023). Participants construct epicurves and select 36 priority isolates for WGS based on dates, hospitals, travel history, and antibiograms.

2

Inject 2 β€” Hospital A Sequencing (18 isolates)

WGS data (FASTQ + FASTA) for Hospital A isolates AB_23–AB_40 are released. Participants perform MLST, AMR annotation, and SNP-based phylogenetics to identify within-hospital clusters.

3

Inject 3.1 β€” Hospital B & C Sequencing (10 isolates)

Sequences for AB_41–AB_50 (Hospital B and C) are provided. The outbreak investigation expands to determine links between hospitals and patients with travel history to Country Z.

4

Inject 3.2 β€” Hospital D, E & F Sequencing (8 isolates)

Final sequences (AB_51–AB_58) complete the dataset. A full phylogenomic view reveals the scope of the multi-hospital outbreak, inter-hospital transmission routes, and sporadic non-outbreak cases.

Bioinformatics Pipeline

Assemblies (36 Γ— FASTA) β†’ MLST (mlst 2.33, Pasteur scheme)
Assemblies β†’ AMR Profiling (Abricate 1.0.1, CARD database)
Assemblies β†’ Core-genome alignment (Parsnp 2.1.1, 75,985 SNP sites)
SNP alignment β†’ ML Phylogeny (IQ-TREE2, GTR+G, 1000 ultrafast bootstrap)
ML distances β†’ Pairwise SNP matrix (IQ-TREE mldist Γ— 4 Mb genome)