A patient survives life-threatening trauma, is intubated in the intensive care unit (ICU) to support his or her affected vital functions, starts to recover, and then develops pneumonia. It’s a scenario well-known to physicians, who understand that the development of ventilator-associated pneumonia in critically ill patients often results in significant morbidity, mortality and additional healthcare costs.
An interdisciplinary team of George Washington University (GW) researchers are investigating more accurate and rapid methods of identification of bacterial pathogens in patients with pulmonary infections, which could lead to more targeted antimicrobial therapy with potentially less adverse effects and lower costs. Next-generation sequencing (NGS) of samples from the sputum of intubated patients, as outlined in their recently published paper in the Journal of Clinical Microbiology, may enable more focused treatment of pneumonia in the critically ill, which has the potential to reduce healthcare spending, as well as improve survival.
“Currently, patients who develop pneumonia after entering the ICU are subjected to broad-spectrum antibiotics, which adds costs, potentially increases the risk of development of antimicrobial resistance, and creates a greater likelihood of an adverse effect attributable to the antibiotics,” says co-author Gary Simon, MD, PhD, the Walter G. Ross Professor of Medicine and director of the Division of Infectious Diseases at the GW School of Medicine and Health Sciences (SMHS). “In our paper, we show these methods could improve if we establish a more precise microbiologic cause.”
NGS, or the process of determining the DNA sequence of a patient’s genome and microbiome, provides the means to establish a more precise microbiologic cause, according to co-author Timothy McCaffrey, PhD, professor of medicine and director of the Division of Genomic Medicine at GW SMHS.
“Through analyzing the data provided by the NGS, we were able to identify bacteria not previously identified through standard microbiological methods,” says McCaffrey.
As technical advances reduce the processing and sequencing times, NGS-based methods may ultimately be able to provide clinicians with rapid, precise, culture-independent identification of bacterial, fungal, and viral pathogens and their antimicrobial sensitivity profiles.
“This will allow for a more precise patient population to be treated for pneumonia,” says co-author Marc Siegel, MD, assistant professor of medicine at GW SMHS. “Using this technology, physicians in the future should be able to make a more accurate diagnosis of the cause of what the pneumonia is and tailor their therapy accordingly.”
Ian Toma, MD, PhD, MSHS, visiting assistant professor in the Division of Genomic Medicine and Department of Physical Therapy and Health Care Sciences at GW SMHS, developed the NGS procedure using the most advanced sequencing methods available. “It was a challenging proof-of-concept study and a truly interdisciplinary translational research effort that will likely be implemented into clinical practice within the near future,” he said.
Keith Crandall, PhD, director of the Computational Biology Institute - a new interdisciplinary research strategic initiative at GW - and his group of researchers contributed to the NGS data analysis with their unique bioinformatics tool “PathoScope,” a promising application for identification of pathogens.
“Our tool provides a powerful statistical approach for sifting through NGS data and quickly identifying and characterizing pathogens from a patient’s sample,” says Crandall. “This is truly ‘personalized medicine’ as we identify specific strains of bacteria infecting individual patients and provide physicians with targeted information for antibiotic treatments for each individual.”
This research was funded in part through a Children’s National Health System and GW Clinical and Translational Science Award grant and by private funding provided by the Abramson Family Foundation, Inc.
Source: George Washington School of Medicine and Health Sciences:
Dear Helpdesk: Working in a Toxic Health Care Environment
March 28th 2024Dear Helpdesk is your steadfast companion, offering life coaching and workplace advice from 2 seasoned IPs for some of your most challenging real-life situations. Let us help you navigate the intersection between work and life, guiding you to navigate the dynamic world of infection prevention with confidence and grace. This article is on handling a toxic health care environment.
Product Locator: Spring and Early Mother's Day Gift Guide for Infection Prevention Personnel
March 27th 2024Whether it's a spring holiday, birthdays, or no reason at all, infection prevention personnel love to give and receive gifts that help at the end of a stressful day. Infection Control Today® offers some gift ideas for infection prevention personnel and their families.
Catching Up With Vangie Dennis, AORN 2022-2023 President at AORN 2024
March 26th 2024Infection Control Today (ICT) had the privilege of catching up with Vangie Dennis, MSN, RN, CNOR, CMLSO, at the Association of periOperative Registered Nurses' (AORN’s) International Surgical Conference & Expo 2024. As the former president of AORN and an esteemed figure in perioperative services, Vangie Dennis shared insights into her recent endeavors and the exciting new chapter she's embarked upon.
How To Optimize Your Time Management Strategies for the Busy Infection Preventionist
March 25th 2024Is your calendar resembling a chaotic masterpiece of overlapping tasks? Join the club of infection preventionists striving to balance responsibilities. Dive into proven strategies from a fellow infection preventionist to reclaim control of your time, streamline tasks, and boost productivity effectively. This is an IP Lifeline article.