VTEC strains typing: from traditional methods to NGS

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VTEC strains typing: from traditional methods to NGS 2 nd course on bioinformatics tools for Next Generation Sequencing data mining: use of bioinformatics tools for typing pathogenic E. coli ISS, Rome 16-17 June 2016

Subtyping: microbiological and molecular methods for differentiating bacterial species below the species level Laboratory methods that can differentiate pathogenic microbes (fingerprint) are useful to: investigate on the transmission of human infectious diseases from different sources identify community-wide outbreaks Investigate on the circulation/persistence of specific clones

characteristics for a typing method Discriminatory power Reproducibility and repeatability Speed Low cost Ease Automation Validation and standardization Backward compatibility with historical data

determination of O- and H- Antigens (Phenotypic and Molecular methods) E. coli O antigens: O1 to O188 and H antigens: H1 to H56 Phenotypic assay: agglutination with antisera Molecular assay: amplification of O-associated (mainly wzx and wzy)and flic genes

Serotyping Advantages Represents the basis for VTEC strains characterisation PCR and RT PCR are easy assays It is of support in epidemiological investigations Drawbacks Costly, labour-intensive, cross reaction between different antigens, O non-typeable availability of antisera in the lab lack of PCR tests for the determination of the whole panel Complete serotyping of E. coli O and H antigens is achieved in a few laboratories

Phage typing It is a phenotyping method that distinguishes E. coli O157 in about 80 PTs based on the susceptibility to the infection of a set of bacteriophages It represented the gold standard basinc characterisation of E. coli O157 Characterises O157 strains only Performed only in a few reference laboratories

Virulotyping Mainly obtained by the amplification of virulence genes, to a lesser extent by hybridisation Verocytotoxin-coding genes: vtx Colonisation-associated genes: eae, aggr, aaic, aat, saa, tia, iha, paa Plasmid-borne genes: e-hly, katp, etpd, toxb Other toxin-coding genes: subab, asta, cdt Advantages Rapid and easy assays Availability of a huge amount of already described primer pairs high throughput Real Time PCR system and microarrays But also.

Drawbacks Which targets to characterise the full virulome of STEC?? vtx-phage LEE plasmid OI#122 OI#57 Different alleles of the virulence genes exist vtx, eae, toxb, subab Troubleshooting connected with PCR technique It may be expensive

Pulsed Field Gel Electrophoresis Set up 30 years ago Technique to separate long strands of DNA through an agarose gel by applying a pulsed electric field PFGE resolves extremely large DNA, raising the upper size limit of DNA separation in agarose from 30-50 kb to well over 10 Mb (10,000 kb) the most commonly used typing method for outbreak identification, surveillance and investigation for a number of important pathogens, in particular Salmonella, VTEC and Listeria PFGE currently represents the gold standard for the molecular typing of VTEC and is the method indicated for VTEC in the joint ECDC- EFSA molecular typing data collection

PFGE analysis at a glance Bacterial cell suspension Mix with agarose Plugs preparation Lysis and washing Bacterial DNA in plugs Bacterial DNA is embedded in agarose plugs to avoid shearing and restricted with rarecutting Endonuclease Parameters affecting the gel run: buffer, agarose, angle of the field, voltage, time switch, temperature, time DNA restriction plugs are loaded onto agarose gel PFGE run Adequate gel staning/de-staining Gel image aquisition Image Analysis

Advantages Easily applied to different species Existance of standard operative procedures Good discriminatory power, useful in outbreak investigations: the use of PFGE allowed an efficient tracing back of the source of infection in a number of cases Drawbacks Labor-intensive Time-consuming One mutation can yield differences in fragments Interpretation of results impossible to automate

Multi-locus variable number tandem repeat (VNTR) analysis (MLVA) Tandem repeats (TRs) are short DNA sequences repeated end-to-end occurring at specific sites (loci) on the genome; the number of the reapets at each locus can vary The thechnique consists in PCR amplification of specific loci, with labelled primers, capillary electrophoresis in a DNA sequencer, Bionumerics calculations of number of repeats per locus. The result consists in a string of numbers Advantages Easy and rapid Good discriminatory power, supporting the epidemiological investigations

Drawbacks Availability of DNA sequencer PulseNet validated protocol for VTEC O157 (Hyytia-Trees et al. 2006) An MLVA scheme was recently published for the typing of VTEC O26 strains (Løbersli et al. 2012) Brand new: Multiple-locus variable-number tandem repeat analysis for strain discrimination of non-o157 Shiga toxin-producing Escherichia coli (Timmons et al. 2016)

Multi-Locus Sequence Typing (MLST) MLST: analysis of the sequences of internal fragments of seven house-keeping genes (genes necessary for organism survival) PCR Sequencing Electropherograms analysis Uploading sequences on a webserver to obtain the corresponding alleles and STs

Advantages Easy to perform Useful for phylogenetic analyses Drawbacks Availability of a sequencer Not very informative for outbreak investigations

Then comes NGS era Massive sequence output & low cost per base Routine WGS of pathogenic E. coli and other bacterial species at affordable costs

Classical methods and NGS Isolation of the bacterial pathogen Determine the serotype Test suscebtibility to antimicrobial drugs Determine the pathogenic potential Relate the bacterial pathogen to other strains of the same species Multistep process days ---- months All the results derived from sequencing Need for huge preliminary work and of intense data analysis

The potential of WGS-based typing is very high Serotyping Virulence factors determination Multiple resistance genes identification MLVA may be extracted, as well as MLST But also much more.. Correlation between strains based on the SNPs in the WGS Typing based on an extended MLST scheme

Whole genome sequencing typing has the potential to be the new gold-standard for pathogen subtyping BUT There are challenges that need to be addressed Data production Reference laboratories only actively produce data as of today Intrinsic quality of the sequence reads at the nucleotidic level Filtering algorythms to be developed and harmonized Coverage of sequencing reads (when compared to a reference sequence)

Amount of data produced: storage and transfer Each.fastq file covering a 5 Mb genome at 30X weights about 300 MB Amount of data produced: analysis Refinement of existing tools for data analysis and development of new ones Development of analysis pipelines to enhance the assembly, annotation, and interpretation of the data, which will require a coordinated international approach Computationally intense data analysis Accessibility of bioinformatic tools via open-source servers Need for education in bioinformatics

Thank you for your attention!