Hospitals are losing the race to identify and contain outbreaks of tuberculosis, MRSA, and diarrhoeal infections because the current methods for telling bacterial strains apart are too slow and unreliable. This matters because without rapid, precise strain typing, doctors cannot track how an infection is spreading through a ward or community. Existing typing schemes cannot reliably distinguish between closely related strains, so outbreaks go unrecognised until they are widespread. The researchers plan to collect bacterial samples from major UK hospitals, sequence their entire genomes using high-throughput technology, and match each strain to the clinical details of the patient who carried it. This will reveal exactly how the bugs move from person to person. If successful, the project will produce rapid, real-time typing techniques that allow infection control teams to spot an outbreak as it begins and interrupt transmission rationally. The team will also build a national web-based database so that hospitals across the country can share and compare typing data on a single system. The result could be fewer hospital-acquired infections, shorter patient stays, and lower healthcare costs—without waiting for a vaccine or a new antibiotic.
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Successful control of infectious diseases depends on completely understanding how they are transmitted. The major challenges posed by tuberculosis, MRSA and hospital acquired diarrhoeas (C. Difficile and norovirus) would be easier to tackle if we could recognise individual outbreaks of infection with different strains. However, current typing schemes, which try to classify how different bugs are related to each other, are too slow and inadequate to reliably do this. High-throughput sequencing of the human genome has revolutionised scientific research. We intend to exploit these advances to improve infectious diseases clinical practice. We will systematically collect strains of four pathogens from major UK hospitals and the clinical details of each case. The genomic techniques will allow us to precisely type large numbers of isolates so that we can track individual local outbreaks even if the bugs are very closely related. Better descriptions of routes of transmission will identify where guidelines for infection control can be improved. We will then develop rapid typing techniques so that infection outbreaks can be recognised and followed in real-time, and then successfully interrupted in a rational way. We will develop a web-based computer database so that a single system can be used across the country.
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