Nanopore-based enrichment of antimicrobial resistance genes : a case-based study

Affiliation
Institute of Medical Microbiology and Virology, University Hospital Leipzig, Leipzig
Viehweger, Adrian;
GND
1240919840
ORCID
0000-0003-4344-8289
Affiliation
Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena
Marquet, Mike;
Affiliation
MF1 Bioinformatics, Robert Koch Institute, Berlin
Hölzer, Martin;
Affiliation
Institute of Medical Microbiology and Virology, University Hospital Leipzig, Leipzig
Dietze, Nadine;
GND
123964334
ORCID
0000-0001-8157-2753
Affiliation
Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena
Pletz, Mathias W.;
GND
1164030272
Affiliation
Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena
Brandt, Christian

Rapid screening of hospital admissions to detect asymptomatic carriers of resistant bacteria can prevent pathogen outbreaks. However, the resulting isolates rarely have their genome sequenced due to cost constraints and long turn-around times to get and process the data, limiting their usefulness to the practitioner. Here we used real-time, on-device target enrichment (“adaptive”) sequencing as a highly multiplexed assay covering 1,147 antimicrobial resistance genes. We compared its utility against standard and metagenomic sequencing, focusing on an isolate of Raoultella ornithinolytica harbouring three carbapenemases (NDM, KPC, VIM). Based on this
experimental data, we then modelled the influence of several variables on the enrichment results and predicted the large effect of nucleotide identity (higher is better) and read length (shorter is better). Lastly, we showed how all relevant resistance genes are detected using adaptive sequencing on a miniature (“Flongle”) flow cell, motivating its use in a clinical setting to monitor similar cases and their surroundings.

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