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Mutschler E, Roloff T, Neves A, Vangstein Aamot H, Rodriguez-Sanchez B, Ramirez M, Rossen J, Couto N, Novais Â, Howden BP, Brisse S, Reuter S, Nolte O, Egli A, Seth-Smith HMB. Towards unified reporting of genome sequencing results in clinical microbiology. PeerJ 2024; 12:e17673. [PMID: 39131622 PMCID: PMC11317035 DOI: 10.7717/peerj.17673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/12/2024] [Indexed: 08/13/2024] Open
Abstract
Whole genome sequencing (WGS) has become a vital tool in clinical microbiology, playing an important role in outbreak investigations, molecular surveillance, and identification of bacterial species, resistance mechanisms and virulence factors. However, the complexity of WGS data presents challenges in interpretation and reporting, requiring tailored strategies to enhance efficiency and impact. This study explores the diverse needs of key stakeholders in healthcare, including clinical management, laboratory work, public surveillance and epidemiology, infection prevention and control, and academic research, regarding WGS-based reporting of clinically relevant bacterial species. In order to determine preferences regarding WGS reports, human-centered design approach was employed, involving an online survey and a subsequent workshop with stakeholders. The survey gathered responses from 64 participants representing the above mentioned healthcare sectors across geographical regions. Key findings include the identification of barriers related to data accessibility, integration with patient records, and the complexity of interpreting WGS results. As the participants designed their ideal report using nine pre-defined sections of a typical WGS report, differences in needs regarding report structure and content across stakeholders became evident. The workshop discussions further highlighted the need to feature critical findings and quality metrics prominently in reports, as well as the demand for flexible report designs. Commonalities were observed across stakeholder-specific reporting templates, such as the uniform ranking of certain report sections, but preferences regarding the depth of content within these sections varied. Using these findings, we suggest stakeholder-specific structures which should be considered when designing customized reporting templates. In conclusion, this study underscores the importance of tailoring WGS-based reports of clinically relevant bacteria to meet the distinct needs of diverse healthcare stakeholders. The evolving landscape of digital reporting increases the opportunities with respect to WGS reporting and its utility in managing infectious diseases and public health surveillance.
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Affiliation(s)
- Eugenio Mutschler
- Institute of Medical Microbiology, University of Zürich, Zurich, Switzerland
| | - Tim Roloff
- Institute of Medical Microbiology, University of Zürich, Zurich, Switzerland
| | - Aitana Neves
- Swiss Institute of Bioinformatics, Geneva, Switzerland
| | | | | | - Mario Ramirez
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - John Rossen
- University Medical Center Groningen, Zwolle, Netherlands
| | - Natacha Couto
- Centre for Genomic Pathogen Surveillance, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
| | - Ângela Novais
- UCIBIO. Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | | | | | - Sandra Reuter
- Medical Center, University of Freiburg, Freiburg, Germany
| | - Oliver Nolte
- Institute of Medical Microbiology, University of Zürich, Zurich, Switzerland
| | - Adrian Egli
- Institute of Medical Microbiology, University of Zürich, Zurich, Switzerland
| | | | - the ESCMID Study Group for Epidemiological Markers (ESGEM), and ESCMID Study Group for Genomic and Molecular Diagnostics (ESGMD)
- Institute of Medical Microbiology, University of Zürich, Zurich, Switzerland
- Swiss Institute of Bioinformatics, Geneva, Switzerland
- Akershus University Hospital, Lorenskog, Norway
- Hospital Gregorio Marañon, Madrid, Spain
- Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- University Medical Center Groningen, Zwolle, Netherlands
- Centre for Genomic Pathogen Surveillance, Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- UCIBIO. Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- University of Melbourne, Parkville, Australia
- Institut Pasteur, Paris, France
- Medical Center, University of Freiburg, Freiburg, Germany
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2
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Wegner F, Cabrera-Gil B, Tanguy A, Beckmann C, Beerenwinkel N, Bertelli C, Carrara M, Cerutti L, Chen C, Cordey S, Dumoulin A, du Plessis L, Friedli M, Gerth Y, Greub G, Härri A, Hirsch H, Howald C, Huber M, Imhof A, Kaiser L, Kufner V, Leib SL, Leuzinger K, Lleshi E, Martinetti G, Mäusezahl M, Moraz M, Neher R, Nolte O, Ramette A, Redondo M, Risch L, Rohner L, Roloff T, Schläepfer P, Schneider K, Singer F, Spina V, Stadler T, Studer E, Topolsky I, Trkola A, Walther D, Wohlwend N, Zehnder C, Neves A, Egli A. How much should we sequence? An analysis of the Swiss SARS-CoV-2 surveillance effort. Microbiol Spectr 2024; 12:e0362823. [PMID: 38497714 PMCID: PMC11064629 DOI: 10.1128/spectrum.03628-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/01/2024] [Indexed: 03/19/2024] Open
Abstract
During the SARS-CoV-2 pandemic, many countries directed substantial resources toward genomic surveillance to detect and track viral variants. There is a debate over how much sequencing effort is necessary in national surveillance programs for SARS-CoV-2 and future pandemic threats. We aimed to investigate the effect of reduced sequencing on surveillance outcomes in a large genomic data set from Switzerland, comprising more than 143k sequences. We employed a uniform downsampling strategy using 100 iterations each to investigate the effects of fewer available sequences on the surveillance outcomes: (i) first detection of variants of concern (VOCs), (ii) speed of introduction of VOCs, (iii) diversity of lineages, (iv) first cluster detection of VOCs, (v) density of active clusters, and (vi) geographic spread of clusters. The impact of downsampling on VOC detection is disparate for the three VOC lineages, but many outcomes including introduction and cluster detection could be recapitulated even with only 35% of the original sequencing effort. The effect on the observed speed of introduction and first detection of clusters was more sensitive to reduced sequencing effort for some VOCs, in particular Omicron and Delta, respectively. A genomic surveillance program needs a balance between societal benefits and costs. While the overall national dynamics of the pandemic could be recapitulated by a reduced sequencing effort, the effect is strongly lineage-dependent-something that is unknown at the time of sequencing-and comes at the cost of accuracy, in particular for tracking the emergence of potential VOCs.IMPORTANCESwitzerland had one of the most comprehensive genomic surveillance systems during the COVID-19 pandemic. Such programs need to strike a balance between societal benefits and program costs. Our study aims to answer the question: How would surveillance outcomes have changed had we sequenced less? We find that some outcomes but also certain viral lineages are more affected than others by sequencing less. However, sequencing to around a third of the original effort still captured many important outcomes for the variants of concern such as their first detection but affected more strongly other measures like the detection of first transmission clusters for some lineages. Our work highlights the importance of setting predefined targets for a national genomic surveillance program based on which sequencing effort should be determined. Additionally, the use of a centralized surveillance platform facilitates aggregating data on a national level for rapid public health responses as well as post-analyses.
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Affiliation(s)
- Fanny Wegner
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Blanca Cabrera-Gil
- Clinical Bioinformatics, SIB Swiss Institute of Bioinformatics, Geneva, Switzerland
| | | | | | - Niko Beerenwinkel
- Department of Biosystems Science and Engineering, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Claire Bertelli
- Clinical Microbiology, University Hospital, Lausanne, Switzerland
| | - Matteo Carrara
- NEXUS Personalized Health Technologies, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | | | - Chaoran Chen
- Department of Biosystems Science and Engineering, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Samuel Cordey
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Louis du Plessis
- Department of Biosystems Science and Engineering, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | | | - Yannick Gerth
- Humanmedizinische Mikrobiologie, Zentrum für Labormedizin, St. Gallen, Switzerland
| | - Gilbert Greub
- Clinical Microbiology, University Hospital, Lausanne, Switzerland
| | | | - Hans Hirsch
- Clinical Virology, University Hospital, Basel, Switzerland
| | | | - Michael Huber
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | - Laurent Kaiser
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
| | - Verena Kufner
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Stephen L. Leib
- Institute for Infectious Diseases (IFIK), University of Bern, Bern, Switzerland
| | | | - Etleva Lleshi
- Microbiology Department, Synlab, Bioggio, Switzerland
| | - Gladys Martinetti
- Department of Laboratory Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | | | - Milo Moraz
- Valais Hospital, Central Institute, Sion, Switzerland
| | - Richard Neher
- Biozentrum, University of Basel, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Oliver Nolte
- Humanmedizinische Mikrobiologie, Zentrum für Labormedizin, St. Gallen, Switzerland
| | - Alban Ramette
- Institute for Infectious Diseases (IFIK), University of Bern, Bern, Switzerland
| | | | | | | | - Tim Roloff
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | | | | | - Franziska Singer
- NEXUS Personalized Health Technologies, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Valeria Spina
- Department of Laboratory Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Tanja Stadler
- Department of Biosystems Science and Engineering, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Erik Studer
- Federal Office of Public Health, Bern, Switzerland
| | - Ivan Topolsky
- Department of Biosystems Science and Engineering, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Alexandra Trkola
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Daniel Walther
- Clinical Bioinformatics, SIB Swiss Institute of Bioinformatics, Geneva, Switzerland
| | | | | | - Aitana Neves
- Clinical Bioinformatics, SIB Swiss Institute of Bioinformatics, Geneva, Switzerland
| | - Adrian Egli
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - the SPSP consortium
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
- Clinical Bioinformatics, SIB Swiss Institute of Bioinformatics, Geneva, Switzerland
- Genesupport, Geneva, Switzerland
- Viollier AG, Allschwil, Switzerland
- Department of Biosystems Science and Engineering, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
- Clinical Microbiology, University Hospital, Lausanne, Switzerland
- NEXUS Personalized Health Technologies, ETH Zurich, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
- Health2030 Genome Center, Geneva, Switzerland
- Laboratory of Virology, Geneva University Hospitals, Geneva, Switzerland
- Valais Hospital, Central Institute, Sion, Switzerland
- Humanmedizinische Mikrobiologie, Zentrum für Labormedizin, St. Gallen, Switzerland
- Biolytix, Witterswil, Switzerland
- Clinical Virology, University Hospital, Basel, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
- Spitalregion Oberaargau, Langenthal, Switzerland
- Institute for Infectious Diseases (IFIK), University of Bern, Bern, Switzerland
- Microbiology Department, Synlab, Bioggio, Switzerland
- Department of Laboratory Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Federal Office of Public Health, Bern, Switzerland
- Biozentrum, University of Basel, Switzerland & SIB Swiss Institute of Bioinformatics, Basel, Switzerland
- Labor Dr. Risch, Buchs, Switzerland
- Clinical Microbiology, University Hospital, Basel, Switzerland
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3
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Neves A, Cuesta I, Hjerde E, Klemetsen T, Salgado D, van Helden J, Rahman N, Fatima N, Karathanasis N, Zmora P, Åkerström WN, Grellscheid SN, Waheed Z, Blomberg N. FAIR+E pathogen data for surveillance and research: lessons from COVID-19. Front Public Health 2023; 11:1289945. [PMID: 38074768 PMCID: PMC10703184 DOI: 10.3389/fpubh.2023.1289945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
The COVID-19 pandemic has exemplified the importance of interoperable and equitable data sharing for global surveillance and to support research. While many challenges could be overcome, at least in some countries, many hurdles within the organizational, scientific, technical and cultural realms still remain to be tackled to be prepared for future threats. We propose to (i) continue supporting global efforts that have proven to be efficient and trustworthy toward addressing challenges in pathogen molecular data sharing; (ii) establish a distributed network of Pathogen Data Platforms to (a) ensure high quality data, metadata standardization and data analysis, (b) perform data brokering on behalf of data providers both for research and surveillance, (c) foster capacity building and continuous improvements, also for pandemic preparedness; (iii) establish an International One Health Pathogens Portal, connecting pathogen data isolated from various sources (human, animal, food, environment), in a truly One Health approach and following FAIR principles. To address these challenging endeavors, we have started an ELIXIR Focus Group where we invite all interested experts to join in a concerted, expert-driven effort toward sustaining and ensuring high-quality data for global surveillance and research.
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Affiliation(s)
- Aitana Neves
- SIB Swiss Institute of Bioinformatics, Clinical Bioinformatics, Geneva, Switzerland
| | - Isabel Cuesta
- Bioinformatics Unit, Institute of Health Carlos III, Madrid, Spain
| | - Erik Hjerde
- Institute of Chemistry, The Arctic University of Norway, Tromsø, Norway
| | - Terje Klemetsen
- Institute of Chemistry, The Arctic University of Norway, Tromsø, Norway
| | - David Salgado
- CNRS, Institut Français de Bioinformatique, IFB-core, UMS 3601, Evry, France
| | - Jacques van Helden
- CNRS, Institut Français de Bioinformatique, IFB-core, UMS 3601, Evry, France
- Aix-Marseille Univ, INSERM, Lab. Theory and Approaches of Genome Complexity (TAGC), Marseille, France
| | - Nadim Rahman
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Nazeefa Fatima
- ELIXIR Norway, Centre for Bioinformatics, University of Oslo, Oslo, Norway
| | - Nestoras Karathanasis
- Bioinformatics Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Pawel Zmora
- Department of Molecular Virology, Institute of Bioorganic Chemistry Polish Academy of Sciences, Poznan, Poland
| | - Wolmar Nyberg Åkerström
- NBIS National Bioinformatics Infrastructure Sweden, SciLifeLab, Uppsala University, Uppsala, Sweden
| | | | - Zahra Waheed
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Niklas Blomberg
- ELIXIR Hub, Wellcome Genome Campus, Cambridge, United Kingdom
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