ISGP Podcast: Hard to Resist

Antibiotic resistance is a serious and growing public health concern. Infections caused by methicillin resistant Staphylococcus aureus (a.k.a. MRSA) and those associated with multidrug-resistant gram-negative bacteria are increasingly limiting the utility of antibiotics in fighting many, many infections. The rapid emergence of resistance reveals a need for monitoring the spread of antibiotic resistance genes and DNA sequencing is the most rigorous means of tracking the spread of these genes. With thousands of unique resistance genes known, only DNA sequencing can provide the level of detailed genetic information required to reach a precise conclusion about a given resistance mechanism.

However, the U.S. Centers for Disease Control and Prevention (CDC) has questioned the need for expansion of sequencing if simpler diagnostics could be effective. The amount of data that comes from DNA sequencing is exceptional, but may be excessive.

As DNA sequencing technologies continue to improve, sequencing could become a routine diagnostic tool used to identify bacterial species as well as possible antibiotic resistance mechanisms. This will lead to an opportunity to use DNA sequence information to guide treatment. Information-based, targeted therapies could then decrease inappropriate antibiotic use ... and thus decrease the spread of antibiotic resistance.

International DNA sequencing would create an enormous global data base and questions arise about egalitarianism. Although computational challenges will likely be addressed by the continued and often exponential expansion of computing power, establishing a infrastructure able to manage the amount and complexity of data is an imminent need.

In the end, debaters generally agreed that reducing antimicrobial resistance will likely require a two-part strategy: first, by addressing overall use of antibiotics, and then, by coordinating an international surveillance system that integrates and adds data for global use.

These ideas and others were presented by a policy position paper, Mitigating Antibiotic Resistance with DNA Sequence Information, that was debated at the Institute on Science for Global Policy’s (ISGP) conference on Emerging and Persistent Infectious Disease: Focus on Antimicrobial Resistance. The program was convened by the ISGP in partnership with Baylor College of Medicine in Houston, Texas, and the paper was written by Dr. Timothy Palzkill, Professor and Chair of the Department of Pharmacology at Baylor.

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