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开发一种扩增子纳米孔测序策略,用于检测金黄色葡萄球菌株中对万古霉素具有中介耐药性的突变。

Development of an Amplicon Nanopore Sequencing Strategy for Detection of Mutations Conferring Intermediate Resistance to Vancomycin in Staphylococcus aureus Strains.

机构信息

Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA.

Microbiology and Molecular Genetics (MMG), Graduate Division of Biological and Biomedical Sciences (GDBBS), Emory University, Atlanta, Georgia, USA.

出版信息

Microbiol Spectr. 2023 Feb 14;11(1):e0272822. doi: 10.1128/spectrum.02728-22. Epub 2023 Jan 23.

Abstract

Staphylococcus aureus is a major cause of bacteremia and other hospital-acquired infections. The cell-wall active antibiotic vancomycin is commonly used to treat both methicillin-resistant (MRSA) and sensitive (MSSA) infections. Vancomycin intermediate S. aureus (VISA) variants can arise through mutations. Here, we performed pilot experiments to develop a combined PCR/long-read sequencing-based method for detection of previously known VISA-causing mutations. Primers were designed to generate 10 amplicons covering 16 genes associated with the VISA phenotype. We sequenced amplicon pools as long reads with Oxford Nanopore adapter ligation on Flongle flow cells. We then detected mutations by mapping reads against a parental consensus or known reference sequence and comparing called variants against a database of known VISA mutations from laboratory selection. Each amplicon in the pool was sequenced to high (>1,000×) coverage, and no relationship was found between amplicon length and coverage. We also were able to detect the causative mutation ( 646C>G) in a VISA mutant derived from the USA300 strain (N384-3 from parental strain N384). Mixing mutant (N384-3) and parental (N384) DNA at various ratios from 0 to 1 mutant suggested a mutation detection threshold of the average minor allele frequency (6.5%) at 95% confidence (two standard errors above mean mutation frequency). The study lays the groundwork for direct S. aureus antibiotic resistance genotype inference using rapid nanopore sequencing from clinical samples. Bacteremia mortality is known to increase rapidly with time after infection, making rapid diagnostics and treatment necessary. Successful treatment depends on correct administration of antibiotics based on knowledge of strain antibiotic susceptibility. Staphylococcus aureus is a major causative agent of bacteremia that is also commonly antibiotic resistant. In this work, we develop a method to accelerate detection of a complex, polygenic antibiotic resistance phenotype in S. aureus, vancomycin-intermediate resistance (VISA), through long-read genomic sequencing of amplicons representing genes most commonly mutated in VISA selection. This method both rapidly identifies VISA genotypes and incorporates the most comprehensive database of VISA genetic determinants known to date.

摘要

金黄色葡萄球菌是菌血症和其他医院获得性感染的主要原因。细胞壁活性抗生素万古霉素通常用于治疗耐甲氧西林金黄色葡萄球菌(MRSA)和敏感金黄色葡萄球菌(MSSA)感染。万古霉素中介金黄色葡萄球菌(VISA)变体可通过突变产生。在这里,我们进行了初步实验,以开发一种基于聚合酶链反应/长读测序的方法来检测先前已知的导致 VISA 的突变。设计引物以产生覆盖与 VISA 表型相关的 16 个基因的 10 个扩增子。我们在 Flongle 流动池上用 Oxford Nanopore 接头连接对扩增子池进行长读测序。然后,我们通过将读取映射到亲本共识或已知参考序列并将调用的变体与来自实验室选择的已知 VISA 突变数据库进行比较来检测突变。池中的每个扩增子都以高(>1,000×)覆盖率进行测序,并且没有发现扩增子长度和覆盖率之间的关系。我们还能够检测来自 USA300 株(亲本株 N384 的 N384-3)的 VISA 突变体的致病突变(646C>G)。以 0 到 1 突变体的各种比例混合突变体(N384-3)和亲本(N384)DNA 表明,在 95%置信度(平均突变频率的两个标准误差以上)下,突变检测阈值为平均次要等位基因频率(6.5%)。该研究为使用快速纳米孔测序从临床样本中直接推断金黄色葡萄球菌抗生素耐药基因型奠定了基础。众所周知,菌血症感染后随着时间的推移死亡率迅速增加,因此需要快速诊断和治疗。成功的治疗取决于基于菌株抗生素敏感性知识正确使用抗生素。金黄色葡萄球菌是一种主要的菌血症病原体,通常也具有抗生素耐药性。在这项工作中,我们通过代表 VISA 选择中最常突变的基因的扩增子的长读基因组测序,开发了一种加速检测金黄色葡萄球菌中复杂多基因抗生素耐药表型(万古霉素中介耐药性(VISA)的方法)。该方法不仅快速识别 VISA 基因型,而且还包含迄今为止已知的最全面的 VISA 遗传决定因素数据库。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/583e/9927139/c4ad471e5748/spectrum.02728-22-f001.jpg

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