Nature Reviews Microbiology: Within-host evolution of bacterial pathogens

Our new review of what genomics has taught us about Within-host evolution of bacterial pathogens has been published in Nature Reviews Microbiology.

The role of hospital transmission in Clostridium difficile infection

This week the Modernising Medical Microbiology consortium at Oxford published the findings of a six-year study into the transmission of the hospital "superbug" Clostridium difficile. The research, which appears in the New England Journal of Medicine, shows that the majority of new cases cannot be traced to other infections in hospital, and indicates instead that there must be a large, as yet unidentified, reservoir of C. difficile infectious to humans. This finding is important because it suggests that there is a limit to which more and more intense hospital cleaning - important though it has been - can continue to have in reducing C. difficile infection.

The research, which is the result of a tireless effort by a large number of my colleagues - notably David Eyre, Tim Peto and Sarah Walker - used bacterial whole genome sequencing to detect within-hospital transmission by searching for extremely closely related bacterial strains among more than 1200 cases of C. difficile infection that occurred in Oxfordshire between September 2007 and March 2011. The consortium is currently developing the approach for routine microbiology diagnostics and infection control, with a view to eventual roll-out across the NHS.

Nature Reviews Genetics: Transforming Clinical Microbiology

My colleagues Xavier Didelot, Rory Bowden, Tim Peto, Derrick Crook and I have just published a review online ahead of print in Nature Reviews Genetics called Transforming clinical microbiology with bacterial genome sequencing.

You might also be interested to read a similarly themed review recently published by our friends at the University of Cambridge and Wellcome Trust Sanger Institute in PLoS Pathogens titled Routine use of microbial whole genome sequencing in diagnostic and public health microbiology.

These review articles follow hot on the heels of a pair of research articles published by our two groups: A pilot study of rapid benchtop sequencing of Staphylococcus aureus and Clostridium difficile for outbreak detection and surveillance in BMJ Open and Rapid whole-genome sequencing for investigation of a neonatal MRSA outbreak in the New England Journal of Medicine. The common thread is the impact of near-to-real-time whole genome sequencing on outbreak detection and other translational activities in hospitals and public health laboratories.