Enhanced Epidemiology and Prevention - An Issue of Quality Control

The latest Global Burden of Disease data show that, after the COVID-19 pandemic, life expectancy has returned to pre-pandemic levels in most countries. However, despite some improvements, infectious diseases and nosocomial infections still appear among the top ten causes of health loss worldwide. The burden of infectious diseases—and the consequences of increasing antimicrobial resistance—includes significant morbidity and mortality for patients, increased healthcare costs, and prolonged hospital stays.

To effectively control pathogen outbreaks and disrupt transmission chains in infectious diseases, it is essential to rapidly identify the molecular epidemiology of microbes, their possible transmission routes, and their reservoirs, so that appropriate countermeasures can be implemented quickly. Traditionally, such investigations have been carried out using clinical epidemiological methods, such as line lists and two-by-two tables, and subsequently confirmed by labor-intensive technologies long considered the gold standard in epidemiological analytics.

In recent years, this diagnostic strategy has shifted. New and innovative methods such as whole genome sequencing (WGS), Fourier Transform Infrared Spectroscopy (FTIS), and microbiome analytics have gained significant relevance as highly reliable tools for epidemiological investigations and strain typing. Due to their markedly higher accuracy, improved availability, and reduced costs, next-generation sequencing (NGS) is now considered the “new” gold standard for determining the epidemiological and phylogenetic relationships of infectious agents. The fight against infectious diseases is far from over, and cuts to development assistance for health threaten countries’ progress in these areas.

The implementation of new diagnostic methods must go hand in hand with appropriate internal and external quality control measures to ensure the highest possible quality of such techniques. Additionally, these methods require complex bioinformatics, powerful computing resources, and qualified personnel with expertise in highly complex molecular epidemiological data. All of this must be quality-controlled and standardized to establish a common foundation for the reliability and comparability of such complex investigations. As a result, establishing these new technologies at the local level remains challenging, particularly in many resource-constrained public health laboratories. Furthermore, despite major technological advances, the preparation and execution of these processes remain time-consuming, which can lead to delays in the delivery of critical information.

In this special issue, we compile information on external quality control measures and real-world performance data for new epidemiological methods, and we discuss insights gained from proficiency testing in routine microbiological laboratories as part of their services in clinical infection control. This information aims to promote the successful implementation of groundbreaking technologies in advanced epidemiology and the prevention of infectious diseases within modern public health laboratories.

This Research Topic on external quality control in advanced epidemiology and prevention is devoted to providing an overview of the impact and importance of implementing and proficiency testing new epidemiological diagnostics in public health. We encourage authors from across epidemiological research and infection control to contribute to a comprehensive picture of quality control and real-world performance data in this vibrant and rapidly evolving field. Most importantly, we invite contributors to share their critical thoughts and perspectives on current practices and the future opportunities these new technologies may bring.

NOTE: We acknowledge the support of INSTAND e.V, a non-profit organization, for funding the article processing charges for some of the manuscripts submitted to this Research Topic. Two of the Guest Editors, Dr. Klaus-Peter Hunfeld and Dr. Nathalie Weiss, are affiliated with INSTAND e.V. INSTAND e.V has had no role in the editorial assessment, decision-making, or handling of individual manuscripts. All submissions have been evaluated objectively and independently of the policies or opinions of INSTAND e.V.