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Accuracy of Different Bioinformatics Methods in Detecting Antibiotic Resistance and Virulence Factors from Staphylococcus aureus Whole-Genome Sequences.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Foster, Dona 
Bradley, Phelim 
Golubchik, Tanya 
Doumith, Michel 

Abstract

In principle, whole-genome sequencing (WGS) can predict phenotypic resistance directly from a genotype, replacing laboratory-based tests. However, the contribution of different bioinformatics methods to genotype-phenotype discrepancies has not been systematically explored to date. We compared three WGS-based bioinformatics methods (Genefinder [read based], Mykrobe [de Bruijn graph based], and Typewriter [BLAST based]) for predicting the presence/absence of 83 different resistance determinants and virulence genes and overall antimicrobial susceptibility in 1,379 Staphylococcus aureus isolates previously characterized by standard laboratory methods (disc diffusion, broth and/or agar dilution, and PCR). In total, 99.5% (113,830/114,457) of individual resistance-determinant/virulence gene predictions were identical between all three methods, with only 627 (0.5%) discordant predictions, demonstrating high overall agreement (Fleiss' kappa = 0.98, P < 0.0001). Discrepancies when identified were in only one of the three methods for all genes except the cassette recombinase, ccrC(b). The genotypic antimicrobial susceptibility prediction matched the laboratory phenotype in 98.3% (14,224/14,464) of cases (2,720 [18.8%] resistant, 11,504 [79.5%] susceptible). There was greater disagreement between the laboratory phenotypes and the combined genotypic predictions (97 [0.7%] phenotypically susceptible, but all bioinformatic methods reported resistance; 89 [0.6%] phenotypically resistant, but all bioinformatics methods reported susceptible) than within the three bioinformatics methods (54 [0.4%] cases, 16 phenotypically resistant, 38 phenotypically susceptible). However, in 36/54 (67%) cases, the consensus genotype matched the laboratory phenotype. In this study, the choice between these three specific bioinformatic methods to identify resistance determinants or other genes in S. aureus did not prove critical, with all demonstrating high concordance with each other and phenotypic/molecular methods. However, each has some limitations; therefore, consensus methods provide some assurance.

Description

Keywords

Staphylococcus aureus, antibiotic resistance, bioinformatics, whole-genome sequencing, Anti-Bacterial Agents, Computational Biology, Drug Resistance, Bacterial, Genome, Bacterial, Genotype, Humans, Microbial Sensitivity Tests, Phenotype, Sensitivity and Specificity, Sequence Analysis, DNA, Software, Staphylococcal Infections, Staphylococcus aureus, Virulence Factors

Journal Title

Journal of Clinical Microbiology

Conference Name

Journal ISSN

0095-1137
1098-660X

Volume Title

56

Publisher

American Society for Microbiology

Rights

All rights reserved
Sponsorship
Medical Research Council (G0800778)
Medical Research Council (G0800778/1)
This research was supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Oxford University in partnership with Public Health England ([PHE] grant HPRU-2012-10041) and the NIHR Oxford Biomedical Research Centre; D.C. and T.P. are NIHR senior investigators.