Festival of Genomics 2024

I will be talking at the Festival of Genomics on Wednesday 24 January about Identifying virulence and antimicrobial resistance genes in bacterial using genome-wide association studies. You can preview my talk here.

New paper: Antimicrobial resistance determinants are associated with Staphylococcus aureus bacteraemia and adaptation to the healthcare environment

Staphylococcus aureus is a leading cause of infectious disease deaths in all countries, with bloodstream infection leading to sepsis a major concern. This new study, published in November in Microbial Genomics, reports genes and genetic variants in Staph. aureus associated severe disease vs asymptomatic carriage, and healthcare vs community carriage.

Our genome-wide association study of 2000 bacterial genomes showed that antibiotic resistance in Staph. aureus is associated with severe disease and the hospital environment:

• A mutation conferring trimethoprim resistance (dfrB F99Y) and the presence of a gene conferring methicillin resistance (mecA) were both associated with bloodstream infection vs asymptomatic nose carriage.
• Separately, we demonstrated that a mutation conferring fluoroquinolone resistance (gyrA L84S) and variation in a gene involved in resistance to multiple antibiotics (prsA) were preferentially associated with healthcare-associated carriage vs community-acquired carriage.

The implication – that antibiotic resistance genes may provide survival advantages which mechanistically contribute to the development of disease – is important in the face of the continued global rise of antibiotic resistance.

We were also able to shed light on a controversy as to whether different strains of Staph. aureus differ in their propensity to cause severe disease. Interest in this question dates back decades in the literature, and contradictory studies, often based on modest sample sizes, have reached different conclusions. Our comparatively large study, using a whole-genome method that we previously published in Nature Microbiology, found that all strains of Staph. aureus are equally likely to cause severe disease vs asymptomatic carriage.

New paper: Genome-wide association studies reveal the role of polymorphisms affecting factor H binding protein expression in host invasion by Neisseria meningitidis

In this paper, published in October in PLOS Pathogens, we discovered a novel genetic association between life-threatening invasive meningococcal disease (IMD) and bacterial genetic variation in factor H binding protein (fHbp) through two bacterial genome-wide association studies (GWAS), which we validated experimentally. This was a collaboration with the groups of Chris Tang and Martin Maiden, with the work in my group led by Sarah Earle.

fHbp is an important component of meningococcal vaccines that directly interacts with human complement factor H (CFH). Intriguingly, our discovery that bacterial genetic variation in fHbp associates with increased virulence mirrors an earlier discovery that human genetic variation in CFH associates with increased susceptibility to IMD (Nature Genetics 42: 772).

Our experiments showed that the fHbp risk allele increased expression. Interestingly, increased susceptibility to IMD has been previously associated with elevated CFH expression. Therefore over-expression of either fHbp by the bacterium or CFH by the host appears to increase the risk of IMD. Since complement evasion is necessary for pathogenesis, these insights offer new leads for improving treatment.

Key results from the paper:

• A GWAS for IMD in 261 meningococci from the Czech Republic highlighted a highly polygenic architecture of meningococcal virulence (see Figure), including capsule biosynthesis genes, the meningococcal disease association island and the new signal near the fba and fHbp genes.
• A replication GWAS for IMD in 1295 meningococcal genomes belonging to strain ST41/44 downloaded from pubMLST.org validated the novel signal of association near fba and fHbp.
• SHAPE reactivity analyses revealed that IMD-associated variation in the regulatory region of fHbp disrupted the ability of the cell machinery to commence gene expression.
• Flow cytometry assays of newly constructed genetically engineered strains, in different temperatures and in the presence and absence of human serum, attributed changes in gene expression to a non-synonymous candidate mutation in the fHbp gene.

In this study, our GWAS relied exclusively on publicly available genome sequences and metadata, highlighting the untapped potential of large-scale open source databases like pubMLST.org, and the value of big data for improving our understanding of disease.

The Rsp virulence regulator: new review in Trends in Microbiology

In the September issue of Trends in Microbiology, Mark Smeltzer casts the spotlight on the story of rsp, a virulence regulator in Staphylococcus aureus that evolves within infected patients and may play a role in disease.

The new review covers recent work on the rsp gene including a series papers that my collaborators and my group have contributed: 
Natural mutations in a Staphylococcus aureus virulence regulator attenuate cytotoxicity but permit bacteremia and abscess formation.
Das, S., Lindemann, C., Young, B. C., Muller, J., Österreich, B., Ternette, N., Winkler, A.-C., Paprotka, K., Reinhardt, R., Förstner, K. U., Allen, E., Flaxman, A., Yamaguchi, Y., Rollier, C. S., Van Diemen, P., Blättner, S., Remmele, C. W., Selle, M., Dittrich, M., Müller, T., Vogel, J., Ohlsen, K., Crook, D., Massey, R., Wilson, D. J., Rudel, T., Wyllie, D. H., and M. J. Fraunholz (2016)
Proceedings of the National Academy of Sciences USA 113: E3101–E3110. (abstract pdf)

Evolutionary trade-offs underlie the multi-faceted virulence of Staphylococcus aureus.
Laabei, M., Uhlemann, A.-C., Lowy, F. D., Austin, E. D., Yokoyama, M., Ouadi, K., Feil, E., Thorpe, H. A., Williams, B., Perkins, M., Peacock, S. J., Clarke, S. R., Dordel, J., Holden, M., Votintseva, A. A., Bowden, R., Crook, D. W., Young, B. C., Wilson, D. J., Recker, M. and R. C. Massey (2015)
PLoS Biology 13: e1002229. (abstract pdf)

Evolutionary dynamics of Staphylococcus aureus during progression from carriage to disease.
Young, B. C., Golubchik, T., Batty, E. M., Fung, R., Larner-Svennson, H., Votintseva, A., Miller, R. R., Godwin, H., Knox, K., Everitt, R. G., Iqbal, Z., Rimmer, A. J., Cule, M., Ip C. L. C., Didelot, X., Harding, R. M., Donnelly, P. J., Peto, T. E., Crook, D. W., Bowden, R. and D. J. Wilson (2012)
Proceedings of the National Academy of Sciences USA 109: 4550-4555. (abstract pdf F1000)

New paper: How low-toxic Staph. aureus mutants cause severe infections

Published today in PNAS Early Edition, our new paper that reveals naturally occurring mutations in the poorly-described rsp gene of Staph. aureus
reduce toxicity while maintaining the ability to survive, proliferate and cause infection within the human body.

In previous work, we have found that Staph. aureus evolves by mutation within the body quickly enough to influence the progression of disease, and that diversity generated by evolution in the body is a widespread phenomenon. In the case of one patient who we followed longitudinally for over a year, we identified that bacteria in the bloodstream differed from those in the nose by several mutations, of which a loss-of-function mutation in the rsp regulatory gene represented the most likely candidate for playing a possible role in causing severe infection.

We collaborated with Ruth Massey at Bath who discovered to our surprise that while rsp loss-of-function mutants do indeed show differences in toxicity - one of several traditional correlates of virulence readily measured in the laboratory - they showed reduced toxicity. Going further, Ruth and her collaborators showed that bloodstream infections in general show reduced toxicity compared to milder skin infections and asymptomatically carried nose populations, overturning previous views on the relationship between Staph. aureus toxicity and virulence.

Today's new paper offers a detailed dissection of rsp. Working with Claudia Lindemann and David Wyllie at the University of Oxford and Martin Fraunholz and collaborators at the University of Würzburg, we found that although rsp mutants show reduced toxicity, crucially they retain their capacity to survive, grow, spread through the body and cause abscesses. In other words, rsp uncouples toxicity from pathogenicity. This decoupling could be important for evading the immune system and establishing severe infections. To find out more, see the full paper.

PLoS Biology: Staphylococcus aureus invading the blood are less toxic

Toxicity in nose, blood and skin bacteria.

Collaborative work with Ruth Massey's group at the University of Bath taking forward a study of within-host evolution of Staphylococcus aureus during infection has been published in PLoS Biology. Previously we reported in PNAS that in one patient, bacteria causing a serious bloodstream infection differed by just eight mutations from a persistently carried nose population. We identified one of those mutations as playing a potentially causative role in transforming the nose bacteria into a form capable of bloodstream infection - a regulatory protein called rsp. To investigate further, Ruth applied a number of tests to characterize bacteria taken prior to and during infection. In this new paper, we report the surprising result that the bloodstream isolates show reduced toxicity and that rsp is the responsible for this change.

The notion that isolates responsible for serious human infection are less toxic challenges some long-held beliefs about the mechanism of disease in Staphylococcus aureus infections. Most models of disease assume a straightforward relationship between increased toxicity and greater virulence - the propensity to cause, or severity of, disease.

To test her observation, Ruth collaborated with groups from New York and Cambridge to investigate whether the pattern observed in one patient held more generally across 134 Staphylococcus aureus belonging to the notorious USA300 strain. It did.

Curiously, bacteria isolated from the skin and from superficial infections were equally toxic to nose bacteria. These findings raise new questions about the role of toxicity in colonization, transmission and serious infections of Staphylococcus aureus. One possibility that we wish to investigate further is whether toxicity might be required for the usual transmission of Staphylococcus aureus populations in the nose, skin or superficial infections (such as impetigo), whereas loss of toxicity may promote transition to deep tissue and bloodstream infections by evading immune defences.

Postdoctoral Position in Statistical Genomics

The position of Postdoctoral Scientist is available in my group to lead research on the Wellcome Trust and Royal Society funded project Statistical Methods for Whole Genome Phenotype Mapping in Bacterial Populations.

Bacteria cause disease throughout the world. Different strains vary in disease severity, but the genetic variants responsible remain largely undiscovered. Recent breakthroughs in whole genome sequencing provide new opportunities for discovery, but the lack of statistical analysis tools tailored to the special structure of bacterial populations presents a roadblock. The goal of the project is to develop an analysis framework for mapping genes underlying naturally variable traits in bacterial populations. Focusing on the hospital-associated pathogens Staphylococcus aureus and Clostridium difficile, we will investigate the role of bacterial variants on disease severity.

The role of the Postdoctoral Scientist is to develop novel statistical methods for analysing genotype-phenotype associations in bacteria at the whole genome level. The successful candidate will write software implementing the statistical methods and apply them to design and carry out investigations into the genetic basis of virulence in natural populations of bacterial pathogens. The ideal candidate would be a recently graduating PhD student with experience of statistical genetics and computer programming, with evidence of publicly released software. Experience of population genetics or microbiology would be advantageous but is not essential.

The post is available immediately, and is available for up to 3 years in the first instance. For more details on this position, including salary, job description, selection criteria and how to apply, please see the University of Oxford recruitment page.

Applications for this vacancy are to be made online. The closing date is 12.00 noon on Monday 4 November 2013. Applicants will be asked to upload a CV and a supporting statement as part of the online application. For informal enquiries, please email me. More information about the group's research is available here.

Sir Henry Dale Fellowship

I am pleased to report that I have been awarded a Wellcome Trust and Royal Society funded Sir Henry Dale Fellowship. The subject of the fellowship, to be held in the Nuffield Department of Medicine at the University of Oxford, is Statistical Methods for Whole Genome Phenotype Mapping in Bacterial Populations.

The project addresses the question of how to detect genes or mutations in bacteria responsible for variability in important traits such as the tendency to cause human disease. Focusing on the hospital-associated pathogens Staphylococcus aureus and Clostridium difficile, the project has the potential to help identify genetic variants that explain why some bacteria cause more severe infections, knowledge that could help develop new drugs and tests that improve patient treatment.

The fellowship runs for five years, and includes support for a postdoctoral research assistant and laboratory costs. I will be advertising a position shortly. If you are interested, please get in touch.

I want to thank the funders and reviewers for supporting this project, and my colleagues who helped me write and re-write the research proposal.