{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:46:06Z","timestamp":1777898766607,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"5-6","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["CK-19-1904"],"award-info":[{"award-number":["CK-19-1904"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>\n                      Epidemiologic investigations of multidrug-resistant organism (MDRO) clusters depend on a thorough history of health care exposures for case patients; however, histories are often incomplete. We describe how the robust influx of longitudinal infectious disease surveillance data from the COVID-19 pandemic improved whole-genome sequence\u2013related cluster investigations and validated single nucleotide polymorphism (SNP) cluster definition thresholds for carbapenem-resistant\n                      <jats:italic toggle=\"yes\">Acinetobacter baumannii<\/jats:italic>\n                      (CRAB) in Massachusetts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used data from infectious disease laboratory test results reported through an integrated person-based surveillance system. We extracted all results from January 1, 2019, through March 19, 2024, for each CRAB case patient in a cluster to identify health care exposures. In addition, we extracted data from epidemiologic investigations. We used data to identify spatial links between cases. We combined timelines with whole-genome sequence data to determine whether genetically related cases were spatially linked.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We extracted 2354 test results for 69 CRAB case patients across 9 clusters; 2007 test results were from COVID-19 events. Three-quarters (n\u2009=\u20091775) of test results indicated a health care exposure not identified through standard investigation. Fifty-five case patients had a spatial link with at least 1 other case patient in their cluster. The median number of SNP differences between all spatially linked cases and all non\u2013spatially linked cases was 4 SNPs and 10 SNPs, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practice Implications:<\/jats:title>\n                    <jats:p>Using longitudinal surveillance data identified possible CRAB transmission events undetected through standard investigation. Comparing the median SNP differences between spatially linked and non\u2013spatially linked cases confirmed that the 10-SNP threshold was appropriate for defining CRAB clusters. Health departments can apply this method to enhance infectious disease investigations and determine appropriate SNP thresholds for infectious disease clusters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549251358652","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T13:19:29Z","timestamp":1754918369000},"page":"461-467","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Using Pandemic-Era Longitudinal Surveillance Data to Improve Investigations of Carbapenem-Resistant\n                    <i>Acinetobacter baumannii<\/i>\n                    Clusters"],"prefix":"10.1177","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0203-0767","authenticated-orcid":false,"given":"Danielle","family":"Chaney","sequence":"first","affiliation":[{"name":"Division of Epidemiology, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6073-7237","authenticated-orcid":false,"given":"Matthew","family":"Doucette","sequence":"additional","affiliation":[{"name":"State Public Health Laboratory, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3420-9780","authenticated-orcid":false,"given":"Christina","family":"Brandeburg","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8545-1000","authenticated-orcid":false,"given":"Melissa","family":"Cumming","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0482-4398","authenticated-orcid":false,"given":"Barbara","family":"Bolstorff","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4264-8734","authenticated-orcid":false,"given":"Shauna","family":"Onofrey","sequence":"additional","affiliation":[{"name":"Office of the State Epidemiologist and Scientific Support, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4581-5342","authenticated-orcid":false,"given":"Esther","family":"Fortes","sequence":"additional","affiliation":[{"name":"State Public Health Laboratory, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Epie","sequence":"additional","affiliation":[{"name":"State Public Health Laboratory, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1736-4607","authenticated-orcid":false,"given":"Jessica","family":"Leaf","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"WHO Bacterial Priority Pathogens List 2024: Bacterial Pathogens of Public Health Importance, to Guide Research, Development, and Strategies to Prevent and Control Antimicrobial Resistance","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. 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