| LONDON, June 13
LONDON, June 13 Scientists have used genome
sequencing technology to control an outbreak of the superbug
MRSA in a study that could point to faster and more efficient
treatment of a range of diseases.
The work adds to a burgeoning body of research into better
techniques for diagnosing disease more quickly and at an earlier
stage to allow more effective treatment and reduce healthcare
Much of this is being driven by whole genome sequencing,
which has enabled scientists to identify the genetic markers for
a range of afflictions.
MRSA, or Methicillin-Resistant Staphylococcus Aureus, is a
drug-resistant bacterial infection, or superbug, and major
public health problem. When outbreaks occur in hospitals it can
lead to the closure of whole wards and lengthy investigations.
The bug kills an estimated 19,000 people in the United
States alone each year, and even when the infection is
successfully treated it can double the average length of a
hospital stay and thereby increase healthcare costs.
A team of scientists from the Wellcome Trust Sanger
Institute, the University of Cambridge and genome sequencing
company Illumina Inc, used samples from a 2009 MRSA
outbreak in a hospital neo-natal intensive care ward to recreate
and respond to it, as if in real time.
They found that genome sequencing produced results in
roughly 24 hours, using the latest technology from Illumina,
gave much more detailed information.
The researchers were able to identify the particular strain
of MRSA causing the outbreak, and which strains were not,
quickly enough to feed back into treatment and nip the outbreak
in the bud faster than current clinical testing methods.
"I think we are at the very beginning of an explosion of
evidence to support the use of whole genome sequencing in public
health," Sharon Peacock of Cambridge University, who led the
study, told Reuters.
The research, published in the New England Journal of
Medicine, comes hot on the heals of similar work done on MRSA
and Clostridium difficile by a team from Oxford University with
Illumina and a group of hospitals in Britain.
That study was published earlier this month in the journal
BMJ Open. Oxford microbiologist Derrick Crook, who worked on
that project, said that as recently as two years ago "it would
have taken months and thousands of pounds to process such
informative sequence information on hospital infections."
Until recently, genetic analysis was more often done after
outbreaks of MRSA and other infections to draw lessons for the
future, but advances in sequencing have made the process much
Experts say current techniques for analysing MRSA do not
give such detailed data meaning they are a blunt tool for
dealing with an outbreak.
"Quick action is essential to control a suspected outbreak,
but it is of equal importance to identify unrelated strains to
prevent unnecessary ward closures and other disruptive control
measures," said Julian Parkhill, who worked on the study at the
The researchers say this kind of fast genome sequencing
could eventually form the basis for a regional or national
infection surveillance programme designed to head off MRSA
outbreaks before they happen. It could also be used for
outbreaks of food-borne infections like salmonella or E.coli.
Genome sequencing was used in an E.coli outbreak in Europe
in 2011 but only in the latter stages to help identify the
But there are a number of hurdles before the new technique
becomes a routine part of monitoring in hospitals.
Peacock says the next stage is to develop software that
interprets the data in a way doctors can both understand and use
in a hospital.
She also points out that while the study indicates this kind
of sequencing is cheaper than existing, less detailed, tests,
there will also need to be rigorous cost-benefit analysis.
Nevertheless, Illumina's senior director of research
Geoffrey Smith, who co-led the study, said the results
demonstrate "how advances in whole genome sequencing can provide
essential information to help combat hospital outbreaks in
clinically relevant turnaround times."