One Day in Denmark: Nationwide point-prevalence survey of human bacterial isolates and comparison of classical and whole-genome sequence-based species identification methods

PLoS One. 2022 Feb 11;17(2):e0261999. doi: 10.1371/journal.pone.0261999. eCollection 2022.

Abstract

Objectives: Implementing whole-genome sequencing (WGS) technologies in clinical microbiology laboratories can increase the amount and quality of information available for healthcare practitioners. In this study, we analysed the applicability of this method and determined the distribution of bacterial species processed in clinical settings in Denmark.

Methods: We performed a point-prevalence study of all bacterial isolates (n = 2,009) processed and reported in the Clinical Microbiology Laboratories in Denmark in one day in January 2018. We compared species identification as performed by classical methods (MALDI-TOF) and by bioinformatics analysis (KmerFinder and rMLST) of WGS (Illumina NextSeq) data. We compared the national point-prevalence of bacterial isolates observed in clinical settings with the research attention given to those same genera in scientific literature.

Results: The most prevalent bacterium was Escherichia coli isolated from urine (n = 646), followed by Staphylococcus spp. from skin or soft tissues (n = 197). The distribution of bacterial species throughout the country was not homogeneous. We observed concordance of species identification for all methods in 95.7% (n = 1,919) of isolates, furthermore obtaining concordance for 99.7% (n = 1,999) at genus level. The number of scientific publications in the country did not correlate with the number of bacterial isolates of each genera analysed in this study.

Conclusions: WGS technologies have the potential to be applied in clinical settings for routine diagnostics purposes. This study also showed that bioinformatics databases should be continuously improved and results from local point-prevalence surveys should not be applied at national levels without previously determining possible regional variations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteria / genetics
  • Bacteria / isolation & purification*
  • Bacterial Infections / epidemiology
  • Bacterial Infections / microbiology*
  • Bacterial Infections / pathology
  • Computational Biology
  • DNA, Bacterial / chemistry*
  • DNA, Bacterial / metabolism
  • Denmark / epidemiology
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification
  • Humans
  • Prevalence
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Staphylococcus / genetics
  • Staphylococcus / isolation & purification
  • Whole Genome Sequencing

Substances

  • DNA, Bacterial

Grants and funding

This project was supported by The Novo Nordisk Foundation - Global Surveillance of Antimicrobial Resistance (NNF16OC0021856) attributed to FMA (https://novonordiskfonden.dk/en/), and the H2020 project VEO grant (874735) attributed to FMA (https://www.veo-europe.eu/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.