Whole-Genome Sequencing

1. Principle

Determine nearly the entire DNA sequence of an isolate (or metagenome) to identify species, resistance/virulence genes, plasmids, and relatedness for outbreak investigation.

2. Step-by-Step Procedure (clinical overview)

  1. Start from quality specimen/isolate (Sample Types and Specimen Quality).
  2. Extract DNA (DNA Extraction; see also Plasmid DNA Extraction for special plasmid work).
  3. Quantify (Nucleic Acid Quantification) → NGS Library PreparationTargeted Enrichment for low-load targets).
  4. Sequence (short and/or long read — Sequencing Technologies).
  5. Bioinformatic assembly/mapping → species ID, MLST/cgMLST, resistome, virulome, plasmid typing (WGS Bioinformatics Pipeline · Clinical WGS Pipelines).
  6. Interpret in clinical/epidemiologic context; correlate AMR genes with Antimicrobial Susceptibility Testing.

Culture-independent path: Metagenomic NGS from primary specimens.

3. Interpretation

  • Positive utility: High-resolution relatedness; comprehensive gene catalog.
  • Limits: Gene presence ≠ phenotypic resistance always; assembly gaps; contamination; turnaround and expertise needs.
  • Pitfalls: Over-calling resistance without AST correlation; misassigning plasmid vs chromosome without long reads.

4. Clinical Use Cases

5. Comparison with Other Methods

MethodProsCons
WGSMaximal genomic infoCost, time, bioinformatics
PCRFast targeted answersNarrow scope
ASTPhenotype for therapyNo transmission genomics

6. Mnemonic / Visual Aid

Sequence → Species → Resistome → Relatedness — four questions WGS can answer.