Mitigating Antibiotic Resistance with DNA Sequence Information

Professor and Chair, Department of Pharmacology Baylor College of Medicine, Houston, Texas, United States

Summary

Antibiotic resistance is a growing problem, particularly among gram-negative bacteria (a distinct class of bacteria distinguished by differences in the cell wall) from hospital-acquired infections. There is a clear need for new drugs. However, the pipeline for new drugs, and especially novel molecular entities, is low. Since an outpouring of new drugs is not going to occur in the near future, it will be important to manage the development of resistance to currently available drugs. A possible way to control the spread of resistance is to take advantage of the tremendous improvements in DNA sequencing technology to identify resistance genes in real time in the clinical setting. With real time information on what genes are present in an infecting bacterium, an informed decision on which antibiotic to use for treatment could be made. DNA sequencing is becoming a feasible tool for use in clinical microbiology laboratories and its widespread use as a diagnostic and surveillance tool is a reasonable expectation in the next several years. The successful use of DNA sequencing will release a vast amount of information on antibiotic resistance genes. To take advantage of this information to slow the evolution and spread of antibiotic resistance, it will be critical to have well-designed databases of resistance sequence determinants.