Sequencing can now be done in less than a day, which means that information is produced in time to influence clinical practice.
-Sharon Peacock
A lethal combination of factors threatens the future of global health – the inexorable emergence and spread of pathogenic drug-resistant bacteria, and a slowdown in the development of new antibiotic drugs that are effective against these superbugs. The era of the ready and rapid cure of common bacterial infections may be coming to an end, heralding a return to a time when such diseases were the most common cause of death.
Why are bacteria so successful in fighting back? Many bacteria can divide as fast as every 20 minutes under ideal conditions, which allows them to adapt very rapidly to adverse environments. By acquiring pieces of DNA from other bacteria, strains are selected that have a fitness advantage and over time can build up a catalogue of genes that help them to survive. Acquiring DNA that codes for antibiotic resistance is a prime example of this process, and is fuelled by antibiotic use.
Halting the current emergence of ever-more resistant bacterial pathogens requires attention to the root cause, which means rigorous control of antibiotic use. This is difficult to achieve on a global scale and has had little success in much of the developing world where antibiotics are available over the counter. In the meantime, control efforts rely on tracking the emergence and spread of multidrug-resistant strains, and the rapid detection and containment of outbreaks. Researchers at the University of Cambridge believe that this is where technologies based on whole genome sequencing (WGS) could really make a difference.
Outbreaks of infection caused by multidrug-resistant bacteria create notable problems in hospitals where antibiotic use is high and patients are prone to hospital-acquired infections, but detecting these outbreaks quickly so that they can be efficiently controlled has proved challenging.
A team of researchers from the Department of Medicine, the Wellcome Trust Sanger Institute and Cambridge University Hospitals has been using advanced WGS technologies to sequence the genomes of a range of multidrug-resistant bacteria associated with hospital outbreaks, to find out whether this approach could be used to confirm rapidly and accurately that an outbreak is taking place.
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Credit: The District
Reproduced courtesy of the University of Cambridge
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