Use of bacterial whole-genome sequencing to understand and improve the management of invasive Staphylococcus aureus infections

ABSTRACT

Introduction: Management of invasive Staphylococcus aureus infections is complex. Dramatic improvements in bacterial whole genome sequencing (WGS) offer new opportunities for personalising the treatment of S. aureus infections.

Areas covered: We address recent achievements in S. aureus genomics, describe genetic determinants of antibiotic resistance and summarise studies that have defined molecular characteristics associated with risk and outcome of S. aureus invasive infections. Potential clinical use of WGS for resistance prediction, infection outcome stratification and management of persistent /relapsing infections is critically discussed.

Expert commentary: WGS is not only providing invaluable information to track the emergence and spread of important S. aureus clones, but also allows rapid determination of resistance genotypes in the clinical environment. An evolving opportunity is to infer clinically important outcomes and optimal therapeutic approaches from widely available S. aureus genome data, with the goal of individualizing management of invasive S. aureus infections.

KEYWORDS:

• Staphylococcus aureus
• bacteremia
• whole genome sequencing
• resistance
• virulence

Declaration of interest

S.G. Giulieri is supported by the Lausanne University Hospital and the SICPA Foundation, both in Lausanne, Switzerland. The Microbiological Diagnostic Unit Public Health Laboratory is funded by the Department of Health and Human Services, Victoria. Doherty Applied Microbial Genomics is funded by the Department of Microbiology and Immunology at The University of Melbourne. The National Health and Medical Research Council, Australia funded a Senior Research Fellowship (GNT1008549) to T.P Stinear, Practitioner Fellowship (GNT1105905) to B.P Howden, and ECR Research Fellowship (GNT1073378) to N.E. Holmes. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was supported by the National Health and Medical Research Council, Australia [grant numbers: 1008549, 1073378, 1105905] and the SICPA Foundation, Switzerland.