Real-Time Genomic Technology Enhances Detection of Golden Staph Resistance to Improve Treatment Outcomes

Australian researchers, in collaboration with seven major Victorian hospitals, are pioneering the use of real-time genome sequencing to combat severe Staphylococcus aureus infections, commonly known as "golden staph." This advanced approach allows clinicians to observe bacterial mutations as they occur, providing immediate insights into how the bacteria evolve during infection. Typically responsible for life-threatening conditions such as sepsis, pneumonia, and heart valve infections, golden staph bacteria are notorious for their rapid adaptation and antibiotic resistance.

Unlike traditional laboratory tests that identify bacterial types, genome sequencing reveals a detailed genetic profile, including traits that influence the bacteria's response to antibiotics. Led by Dr. Stefano Giulieri from The University of Melbourne and the Doherty Institute, the team collected bacterial samples from patients at the point of treatment failure. By comparing strains from the infection's start and during relapse, they identified that, in about one-third of cases, the bacteria developed mutations that significantly increased resistance.

One notable case involved a patient whose infection recurred two months after stopping antibiotics. Sequencing revealed that during this period, the bacteria had become 80 times more resistant to the antibiotics initially used, with each recurrence harboring new resistance mutations. This real-time observation enabled the clinical team to adjust treatment strategies effectively, ultimately curing the infection.

This study marks a first in demonstrating that directly tracking bacterial evolution during infection via genome sequencing can help doctors stay ahead of bacterial tricks used to survive treatments. The findings suggest that incorporating genomic data can refine antibiotic choices, reduce unnecessary medication, limit side effects, and curb further resistance development.

A survey of 25 infectious disease specialists globally indicated that genomic reports were rated highly useful, influencing treatment decisions in over a third of cases. Experts like Professor Eugene Athan from the University Hospital Geelong see this approach as a leap toward precision medicine in infectious diseases, comparable to advancements in cancer genomics. Professor Benjamin Howden from the Doherty Institute highlighted its potential to transform infection management and encourage widespread adoption, with Victorian hospitals leading a world-first implementation of this cutting-edge microbiology method.