Development of diagnostic and sequencing tools for STIs
Research type
Research Study
Full title
Development of bacterial enrichment techniques to enable direct sequencing of sexually transmitted infections from clinical samples
IRAS ID
287636
Contact name
S Tariq Sadiq
Contact email
Sponsor organisation
St George's University of London
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Curable sexually transmitted infections (STIs), such as Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) are a global health concern and untreated infection can result in serious reproductive health consequences. Emergence of new infections such as Mycoplasma genitalium (MG) combined with the growing threat of antimicrobial resistance (AMR), particularly in NG, dictate that STI testing, reporting and accurate surveillance of AMR are integral to the overall management of these infections. Fast and accurate identification and strain-level differentiation of STIs enables monitoring of spread of infections, identification of appropriate therapy options and prevention of infection outbreaks. Currently, gold standard methods for surveillance rely on DNA sequencing, in particular whole genome sequencing, as it provides the highest discriminatory power to understand strain types, AMR and geographical spread of infection. However, as well as high expense and being largely impractical in many settings, bacterial culture is usually required to provide enough pathogenic material and reduce the interference from non-target DNA. Enrichment techniques which enable sequencing directly from clinical samples are an attractive option particularly for bacterial STIs such as CT and MG, as culture is either highly specialized, expensive, has a high failure rate or completely impractical.
Alongside diagnosis and surveillance, sequencing analysis can provide understanding of the microbiome. Maintenance of a healthy low diversity vaginal microbiome has been shown to play a protective role against infection. Better understanding of microbiome changes associated with STI acquisition could provide insight into inflammatory responses, pathogenesis of infection or perhaps guide alternative therapy options to antibiotics.
Through a pilot study, based at St George's University of London, we will develop and evaluate the utility of different enrichment methods to enable sequencing directly from clinical sample and identify species of CT, MG, NG and TV sub-types, AMR markers and microbiome composition, using previously characterised, fully anonymised clinical samples.REC name
South Central - Berkshire B Research Ethics Committee
REC reference
20/SC/0459
Date of REC Opinion
31 Dec 2020
REC opinion
Favourable Opinion