show Abstracthide AbstractAntimicrobial resistance (AMR) is a global public health emergency that challenges the safe delivery of modern medical care. The rapid diagnosis of multidrug-resistant organisms (MDRO) and institution of appropriate antimicrobial therapy is essential for clinical management of patients. Rapid investigation of outbreaks of MDRO and implementation of appropriate infection control measures is essential to prevent spread of these MDRO pathogens between patiens and bring outbreaks under control. Surveillance for MDRO is crucial to detect the emergence and spread of new / virulent pathogeneic clones, and to inform infection control and antimicrobial policies. Microbial whole genome sequencing (WGS) is a technology that can be used in all of these scenarios, and a number of research studies have demonstrated its benefit. The challenge now is to translate this potential from a research setting into a clinical environment in order to benefit patient management and inform infection control practice and policy. This project aims to translate WGS from the research laboratory to a tool in the clinical environment in order to: 1, Investigate suspected outbreaks of MDRO at Addenbrooke's hospital 2. Rapidly diagnose MDRO and inform clinical management of patients 3. Conduct surveillance for MDRO at Addenbrooke's hospital 4. Speed up the impact of WGS in a clinical setting This project will explore the epidemiology of invasive infections within a typical large teaching hospital. To this end we will whole genome sequence representative bacteria as they are isolated in the diagnostic laboratory, looking at approximately 100 isolates per month over one year. The aim will be to identify specific clades of bacteria that are circulating and determine their antibiotic resistance genotype. Isolates covered will include E. coli, Klebsiellas and Staphylococci although other species will be included.