Microbiology: A Whistle-Stop Tour of GOSH Pathology
Elaine Cloutman-Green |
We have quite an interesting way of approaching microbiology here at GOSH. We’re trying to incorporate new rapid diagnostics, while simultaneously looking at new combined omics approaches to aid clinical interpretation. When we began to look at bacterial whole genome sequencing, for instance, we quickly realized that we couldn’t look at that data in isolation. Genetically, the profiles were showing antimicrobial resistance (AMR) – but, when we conducted sensitivity testing, that’s not what we saw. To clear up the confusion, we sent our samples for LC-MS/MS to look at proteomic expression profiles, and compared that data with our sequences to see what additional information we could glean and how essential it might be. What did we find? It turned out to be key, which is why we’re now exploring how to use tools like MALDI-TOF MS for rapid CRE expression diagnostics. It’s easy to miss things by looking at either DNA markers or expression profiles alone, so we are always trying to pair the two together. We really need to know what’s functional to make reliable clinical decisions about patient treatment.
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