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Clinical Laboratories and Pathology Groups

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Clinical Laboratories and Pathology Groups

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Mount Sinai Researchers Create a “Smart Tweezer” That Can Isolate a Single Bacterium from a Microbiome Sample Prior to Genetic Sequencing

New technology could enable genetic scientists to identify antibiotic resistant genes and help physicians choose better treatments for genetic diseases

Genomic scientists at the Icahn School of Medicine at Mount Sinai Medical Center in New York City have developed what they call a “smart tweezer” that enables researchers to isolate a single bacterium from a patient’s microbiome in preparation for genetic sequencing. Though primarily intended for research purposes, the new technology could someday be used by clinical laboratories and microbiologists to help physicians diagnose chronic disease and choose appropriate genetic therapies.

The researchers designed their new technology—called mEnrich-seq—to improve the effectiveness of research into the complex communities of microorganisms that reside in the microbiomes within the human body. The discovery “ushers in a new era of precision in microbiome research,” according to a Mount Sinai Hospital press release.

Metagenomics has enabled the comprehensive study of microbiomes. However, many applications would benefit from a method that sequences specific bacterial taxa of interest, but not most background taxa. We developed mEnrich-seq (in which ‘m’ stands for methylation and seq for sequencing) for enriching taxa of interest from metagenomic DNA before sequencing,” the scientists wrote in a paper they published in Nature Methods titled, “mEnrich-seq: Methylation-Guided Enrichment Sequencing of Bacterial Taxa of Interest from Microbiome.”

“Imagine you’re a scientist who needs to study one particular type of bacteria in a complex environment. It’s like trying to find a needle in a large haystack,” said the study’s senior author Gang Fang, PhD (above), Professor of Genetics and Genomic Sciences at Icahn School of Medicine at Mount Sinai Medical Center, in a press release. “mEnrich-seq essentially gives researchers a ‘smart tweezer’ to pick up the needle they’re interested in,” he added. Might smart tweezers one day be used to help physicians and clinical laboratories diagnose and treat genetic diseases? (Photo copyright: Icahn School of Medicine.)

Addressing a Technology Gap in Genetic Research

Any imbalance or decrease in the variety of the body’s microorganisms can lead to an increased risk of illness and disease.

“Imbalance of the normal gut microbiota, for example, have been linked with conditions including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), obesity, type 2 diabetes, and allergies. Meanwhile, the vaginal microbiome seems to impact sexual and reproductive health,” Inside Precision Medicine noted.

In researching the microbiome, many scientists “focus on studying specific types of bacteria within a sample, rather than looking at each type of bacteria present,” the press release states. The limitation of this method is that a specific bacterium is just one part of a complicated environment that includes other bacteria, viruses, fungi and host cells, each with their own unique DNA.

“mEnrich-seq effectively distinguishes bacteria of interest from the vast background by exploiting the ‘secret codes’ written on bacterial DNA that bacteria use naturally to differentiate among each other as part of their native immune systems,” the press release notes. “This new strategy addresses a critical technology gap, as previously researchers would need to isolate specific bacterial strains from a given sample using culture media that selectively grow the specific bacterium—a time-consuming process that works for some bacteria, but not others. mEnrich-seq, in contrast, can directly recover the genome(s) of bacteria of interest from the microbiome sample without culturing.”

Isolating Hard to Culture Bacteria

To conduct their study, the Icahn researchers used mEnrich-seq to analyze urine samples taken from three patients with urinary tract infections (UTIs) to reconstruct Escherichia coli (E. Coli) genomes. They discovered their “smart tweezer” covered more than 99.97% of the genomes across all samples. This facilitated a comprehensive examination of antibiotic-resistant genes in each genome. They found mEnrich-seq had better sensitivity than standard study methods of the urine microbiome. 

They also used mEnrich-seq to selectively examine the genomes of Akkermansia muciniphila (A. muciniphila), a bacterium that colonizes the intestinal tract and has been shown to have benefits for obesity and Type 2 diabetes as well as a response to cancer immunotherapies.

Akkermansia is very hard to culture,” Fang told GenomeWeb. “It would take weeks for you to culture it, and you need special equipment, special expertise. It’s very tedious.”

mEnrich-seq was able to quickly segregate it from more than 99.7% of A. muciniphila genomes in the samples.

Combatting Antibiotic Resistance Worldwide

According to the press release, mEnrich-seq could potentially be beneficial to future microbiome research due to:

  • Cost-Effectiveness: It offers a more economical approach to microbiome research, particularly beneficial in large-scale studies where resources may be limited.
  • Broad Applicability: The method can focus on a wide range of bacteria, making it a versatile tool for both research and clinical applications.
  • Medical Breakthroughs: By enabling more targeted research, mEnrich-seq could accelerate the development of new diagnostic tools and treatments.

“One of the most exciting aspects of mEnrich-seq is its potential to uncover previously missed details, like antibiotic resistance genes that traditional sequencing methods couldn’t detect due to a lack of sensitivity,” Fang said in the news release. “This could be a significant step forward in combating the global issue of antibiotic resistance.”

More research and clinical trials are needed before mEnrich-seq can be used in the medical field. The Icahn researchers plan to refine their novel genetic tool to improve its efficiency and broaden its range of applications. They also intend to collaborate with physicians and other healthcare professionals to validate how it could be used in clinical environments.  

Should all this come to pass, hospital infection control teams, clinical laboratories, and microbiology labs would welcome a technology that would improve their ability to detect details—such as antibiotic resistant genes—that enable a faster and more accurate diagnosis of a patient’s infection. In turn, that could contribute to better patient outcomes.

—JP Schlingman

Related Information:

‘Smart Tweezer’ Can Pluck Out Single Bacterium Target from Microbiome

mEnrich-seq: Methylation-guided Enrichment Sequencing of Bacterial Taxa of Interest from Microbiome

Genomic ‘Tweezer’ Ushers in a New Era of Precision in Microbiome Research

Molecular Tweezers Can Precisely Select Microbiome Bacteria

Identification of DNA Motifs that Regulate DNA Methylation

New Bacterial Epigenetic Sequencing Method Could Be Boon for Complex Microbiome Analyses

Growing Wave of Hospital and Health System Mega-Mergers Means Changing Dynamics for Pathology and Clinical Laboratory Medicine

Accelerating pace of hospital consolidation brings new pressure to pathologists and clinical laboratory directors to maximize the value of pathology services

Large and financially-stable multi-hospital health systems are racing to form regional mega-systems. It’s a strategy to get ahead of the Affordable Care Act’s (ACA) mandate to improve quality and increase efficiency through coordinated care across the entire care continuum.

This growing national trend means further consolidation of clinical laboratory testing services within the merging organizations. For pathology groups, the new super-systems may encourage the different pathology groups within the system to consolidate into a single practice entity. This would help improve how pathology services are more deeply integrated into the care continuum. It would also facilitate contract negotiations between the pathologists and the parent health system. (more…)

New York’s Mount Sinai Medical Center Using Big Data to Improve Clinical Care

Big data is poised to change the healthcare ecosystem and that creates opportunities for forward-looking medical laboratories

First-mover academic center, Mount Sinai Medical Center (MSMC), is taking steps to incorporate “big data” into the daily patient-care setting. For the medical laboratory industry, this is a signal event because a major component of healthcare big data will be patient genetic and molecular information.

Included on MSMC’s big data team are  its genetics laboratory experts. These are high-profile “data scientists” who help doctors make personalized predictions about their patients. This project shows how integrated healthcare informatics—including clinical laboratory test data—will be a key attribute of healthcare moving forward.
(more…)

Consolidation of Big Hospital Systems May Drive Healthcare Costs Even Higher, Say Some Experts

Recent hospital mergers are creating super-sized health systems that immediately gain leverage over insurers when negotiating managed care contracts

Experts say the nation is experiencing its biggest surge in hospital mergers in more than a decade. Moreover, this latest wave of deals is creating supersized hospital systems that are expected to dominate healthcare and possibly lead to higher healthcare costs.

The ongoing consolidation of hospital ownership means further consolidation of the hospital laboratories that find themselves merged into larger health systems. That will have both good and bad consequences for pathologists and medical laboratory managers working within these organizations. (more…)

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