Dataset Information

The Transformation of Reference Microbiology Methods and Surveillance for Salmonella With the Use of Whole Genome Sequencing in England and Wales.

ABSTRACT: The use of whole genome sequencing (WGS) as a method for supporting outbreak investigations, studying Salmonella microbial populations and improving understanding of pathogenicity has been well-described (1-3). However, performing WGS on a discrete dataset does not pose the same challenges as implementing WGS as a routine, reference microbiology service for public health surveillance. Challenges include translating WGS data into a useable format for laboratory reporting, clinical case management, Salmonella surveillance, and outbreak investigation as well as meeting the requirement to communicate that information in an understandable and universal language for clinical and public health action. Public Health England have been routinely sequencing all referred presumptive Salmonella isolates since 2014 which has transformed our approach to reference microbiology and surveillance. Here we describe an overview of the integrated methods for cross-disciplinary working, describe the challenges and provide a perspective on how WGS has impacted the laboratory and surveillance processes in England and Wales.

SUBMITTER: Chattaway MA

PROVIDER: S-EPMC6881236 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

The Transformation of Reference Microbiology Methods and Surveillance for <i>Salmonella</i> With the Use of Whole Genome Sequencing in England and Wales.

Chattaway Marie Anne MA Dallman Timothy J TJ Larkin Lesley L Nair Satheesh S McCormick Jacquelyn J Mikhail Amy A Hartman Hassan H Godbole Gauri G Powell David D Day Martin M Smith Robert R Grant Kathie K

Frontiers in public health 20191121

The use of whole genome sequencing (WGS) as a method for supporting outbreak investigations, studying <i>Salmonella</i> microbial populations and improving understanding of pathogenicity has been well-described (1-3). However, performing WGS on a discrete dataset does not pose the same challenges as implementing WGS as a routine, reference microbiology service for public health surveillance. Challenges include translating WGS data into a useable format for laboratory reporting, clinical case man ...[more]

PMID: 31824904

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Project description:BackgroundMicrobial genome sequencing is now being routinely used in many clinical and public health laboratories. Understanding how to report complex genomic test results to stakeholders who may have varying familiarity with genomics-including clinicians, laboratorians, epidemiologists, and researchers-is critical to the successful and sustainable implementation of this new technology; however, there are no evidence-based guidelines for designing such a report in the pathogen genomics domain. Here, we describe an iterative, human-centered approach to creating a report template for communicating tuberculosis (TB) genomic test results.MethodsWe used Design Study Methodology-a human centered approach drawn from the information visualization domain-to redesign an existing clinical report. We used expert consults and an online questionnaire to discover various stakeholders' needs around the types of data and tasks related to TB that they encounter in their daily workflow. We also evaluated their perceptions of and familiarity with genomic data, as well as its utility at various clinical decision points. These data shaped the design of multiple prototype reports that were compared against the existing report through a second online survey, with the resulting qualitative and quantitative data informing the final, redesigned, report.ResultsWe recruited 78 participants, 65 of whom were clinicians, nurses, laboratorians, researchers, and epidemiologists involved in TB diagnosis, treatment, and/or surveillance. Our first survey indicated that participants were largely enthusiastic about genomic data, with the majority agreeing on its utility for certain TB diagnosis and treatment tasks and many reporting some confidence in their ability to interpret this type of data (between 58.8% and 94.1%, depending on the specific data type). When we compared our four prototype reports against the existing design, we found that for the majority (86.7%) of design comparisons, participants preferred the alternative prototype designs over the existing version, and that both clinicians and non-clinicians expressed similar design preferences. Participants showed clearer design preferences when asked to compare individual design elements versus entire reports. Both the quantitative and qualitative data informed the design of a revised report, available online as a LaTeX template.ConclusionsWe show how a human-centered design approach integrating quantitative and qualitative feedback can be used to design an alternative report for representing complex microbial genomic data. We suggest experimental and design guidelines to inform future design studies in the bioinformatics and microbial genomics domains, and suggest that this type of mixed-methods study is important to facilitate the successful translation of pathogen genomics in the clinic, not only for clinical reports but also more complex bioinformatics data visualization software.

Project description:Passerine salmonellosis is a well-recognized disease of birds in the order Passeriformes, which includes common songbirds such as finches and sparrows, caused by infection with Salmonella enterica serovar Typhimurium. Previous research has suggested that some subtypes of S Typhimurium-definitive phage types (DTs) 40, 56 variant, and 160-are host adapted to passerines and that these birds may represent a reservoir of infection for humans and other animals. Here, we have used the whole-genome sequences of 11 isolates from British passerines, five isolates of similar DTs from humans and a domestic cat, and previously published S Typhimurium genomes that include similar DTs from other hosts to investigate the phylogenetic relatedness of passerine salmonellae to other S Typhimurium isolates and investigate possible genetic features of the distinct disease pathogenesis of S Typhimurium in passerines. Our results demonstrate that the 11 passerine isolates and 13 other isolates, including those from nonpasserine hosts, were genetically closely related, with a median pairwise single nucleotide polymorphism (SNP) difference of 130 SNPs. These 24 isolates did not carry antimicrobial resistance genetic determinants or the S Typhimurium virulence plasmid. Although our study does not provide evidence of Salmonella transmission from passerines to other hosts, our results are consistent with the hypothesis that wild birds represent a potential reservoir of these Salmonella subtypes, and thus, sensible personal hygiene precautions should be taken when feeding or handling garden birds. IMPORTANCE:Passerine salmonellosis, caused by certain definitive phage types (DTs) of Salmonella Typhimurium, has been documented as a cause of wild passerine mortality since the 1950s in many countries, often in the vicinity of garden bird feeding stations. To gain better insight into its epidemiology and host-pathogen interactions, we sequenced the genomes of a collection of 11 isolates from wild passerine salmonellosis in England and Wales. Phylogenetic analysis showed these passerine isolates to be closely related to each other and to form a clade that is distinct from other strains of S Typhimurium, which included a multidrug-resistant isolate from invasive nontyphoidal Salmonella disease that shares the same phage type as several of the passerine isolates. Closely related to wild passerine isolates and within the same clade were four S Typhimurium isolates from humans as well as isolates from horses, poultry, cattle, an unspecified wild bird, and a domestic cat and dog with similar DTs and/or multilocus sequence types. This suggests the potential for cross-species transmission, and the genome sequences provide a valuable resource to investigate passerine salmonellosis further.

Project description:BackgroundBovine tuberculosis (bTB) is a zoonotic disease of cattle caused by Mycobacterium bovis, widespread in England and Wales. It has high incidence towards the South West of England and Wales, with much lower incidence to the East and North. A stochastic simulation model was developed to simulate M. bovis transmission among cattle, transfer by cattle movements and transmission from environmental reservoirs (often wildlife and especially badgers). It distinguishes five surveillance streams, including herd tests, pre-movement testing and slaughter surveillance. The model thereby simulates interventions in bTB surveillance and control, and generates outputs directly comparable to detailed disease records. An anonymized version of the executable model with its input data has been released. The model was fitted to cattle bTB records for 2008-2010 in a cross-sectional comparison, and its projection was compared with records from 2010 to 2016 for validation.ResultsThe fitted model explained over 99% of the variation among numbers of breakdowns in four defined regions and surveillance streams in 2010. It classified 7800 (95% confidence interval c. 5500 - 14,000) holdings within high incidence regions as exposed to infectious environmental reservoirs, out of over 31,000 cattle holdings identified as potentially exposed to such sources. The model was consistent with previous estimates of low M. bovis transmission rate among cattle, but cattle to cattle transmission was clearly required to generate the number of cattle cases observed. When projected to 2016, the model as fitted to 2010 continued to match the distribution of bTB among counties, although it was notable that the actual distribution of bTB in 2010 was itself a close match for its distribution in 2016.ConclusionsThe close model fit demonstrated that cattle movements could generate breakdowns as observed in low incidence regions, if persistent environmental reservoirs such as wildlife maintained infection levels in the high incidence regions. The model suggests that environmental reservoirs may be a challenge for control, because, although many holdings are exposed to infection from wildlife or the environment, they are a minority of holdings. Large impacts on disease in wildlife will be required to avoid each individual transmission event to cattle.

Dataset Information

The Transformation of Reference Microbiology Methods and Surveillance for Salmonella With the Use of Whole Genome Sequencing in England and Wales.

Publications

The Transformation of Reference Microbiology Methods and Surveillance for <i>Salmonella</i> With the Use of Whole Genome Sequencing in England and Wales.

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