Sepsis-associated Escherichia coli whole-genome sequencing analysis using in-house developed pipeline and 1928 diagnostics tool

Abstract: Sepsis is a life-threatening condition that is caused by a dysregulated host response to infection. Timely detection of sepsis and antibiotic treatment is important for the patient’s recovery from sepsis. Usually, when sepsis is detected, immediate antibiotic treatment is started with broad-spectrum antibiotics as it takes time to determine the correct antibiotic susceptibility. To overcome this problem, next-generation sequencing is seen as one possible development in clinical diagnostics in the future. Automated bioinformatics pipelines could be used initially for surveillance purposes but eventually for rapid clinical diagnosis. Therefore, the results of 1928 Diagnostics, an automated pipeline for whole-genome sequencing (WGS) data analysis, were compared with the results of an in-house developed pipeline for manual data processing by analyzing sepsis-associated Escherichia coli (SEPEC) WGS data. The pipelines were compared by assessing their predicted antimicrobial resistance (AMR) genes, virulence genes and epidemiological relatedness. In addition, the predicted resistance genes were compared to phenotypic antimicrobial susceptibility testing (AST) data from the clinical microbiology laboratory. All the results obtained from the 1928 Diagnostics and in-house pipeline were similar but differed in the number of virulence/predicted AMR genes, AMR gene variants, detection of species and epidemiologically related E. coli samples. Moreover, the predicted AMR genes from both pipelines did not show a good overall relation to the phenotypic AST result. More studies are needed to make predictions of genes from the WGS analysis more reliable so that WGS analysis can be used as a diagnostics tool in clinical laboratories in the future.