Biology subjects

Knaggs, J.

Publications and source records attributed to Knaggs, J..

5 recordsLinked to original sources

bioRxiv2025

An improved catalogue for whole-genome sequencing prediction of bedaquiline resistance in M. tuberculosis using a reproduciblealgorithmic approach.

Bedaquiline (BDQ) has only been approved for use for a little over a decade yet is a key drug for treating multi-drug resistant tuberculosis, however rising levels of resistance threaten to reduce its effectiveness. Catalogues of mutations associated with resistance to bedaquiline are key to detecting resistance genetically for either diagnosis or surveillance. At present building catalogues requires considerable expert knowledge, often requires the use of complex grading rules, and is an irreproducible process. We developed an automated method, catomatic, that associates genetic variants with resistance (or susceptibility) using a two-tailed binomial test with a stated background rate and applied it to a dataset of 11,867 Mycobacterium tuberculosis samples with whole genome and bedaquline susceptibility testing data. Using this framework we investigated how to best classify variants and the phenotypic significance of minor alleles. The genes mmpS5 and mmpL5 are not directly associated with bedaquline resistance, and our catalogue of Rv0678, atpE, and pepQ variants attains a cross-validated sensitivity and specificity of 79.4 {+/-} 1.8 % and 98.5 {+/-} 0.3%, respectively, for 94 {+/-} 0.4% of samples. Identifying samples with subpopulations containing Rv0678 variants improves sensitivity, and detection thresholds in bioinformatic pipelines should therefore be lowered. By using a more permissive and deterministic algorithm trained on a sufficient number of resistant samples we have reproducibly constructed an AMR catalogue for BDQ resistance-associated variants that is comprehensive and accurate. Impact StatementBedaquiline has recently received global endorsement for tuberculosis treatment, yet the genetic determinants of antimicrobial resistance remain incompletely understood. Existing gold-standard methods for building mutation catalogs lack public accessibility and reproducibility. We introduce catomatic, a reproducible and publicly available method that employs simpler statistics to increase sensitivity to resistance-associated variants. This approach has enabled investigations into mechanisms of resistance, the significance of genetic subpopulations, and key data attributes that influence the ease of classifying effects and the accuracy of BDQ resistance phenotype prediction in clinical samples. We strongly emphasise the utility in using reproducible statistics and sustainably developed software in genetics-focussed microbiology.

microbiology↗

bioRxiv2024

Enhancement and validation of the antibiotic resistance prediction performance of a cloud-based genetics processing platform for Mycobacteria

Tuberculosis remains a global health problem. Making it easier and quicker to identify which antibiotics an infection is likely to be susceptible to will be a key part of the solution. Whilst whole-genome sequencing offers many advantages, the processing of the genetic reads to produce the relevant public health and clinical information is, surprisingly, often the responsibility of the end user which inhibits uptake. Here we characterise how well a freely-available tool we have developed, gnomonicus, predicts the antibiotic resistance profile of a sample (given its variant call file) using our implementation of the second edition of the WHO catalogue of resistance-associated variants (WHOv2). To facilitate this, we have constructed a Diverse Testset of 2,663 publicly-available M. tuberculosis samples which have both genetic and drug susceptibility testing (DST) data. We have chosen to apply the catalogue such that our tool will return a result of (i) Fail if there are insufficient reads at a genetic locus associated with resistance, (ii) Unknown if a genetic variant in a resistance gene not listed in the catalogue is encountered and (iii) Resistant if three or more short-reads support the presence of a resistance-associated variant. The last step increases the sensitivity for all 15 antibiotics but only reaches significance in a few in our testset. Comparing our results to those of TB-Profiler, an existing tool, highlights the different design choices and demonstrates the performance of both tools on our Diverse Testset is comparable. By only considering high confidence DST results we show that gnomonicus, in combination with our translation of WHOv2, achieves sensitivities and specificities in excess of 95% for both isoniazid and rifampicin. Impact StatementWhole genome sequencing clinical samples taken from patients with tuberculosis is a potentially fast and accurate method for determining to which antibiotics the infection will be susceptible. Two barriers need to be overcome; the first, which is knowing which mutations are associated with resistance (or not) to a range of antibiotics is well on the way to be solved thanks to the efforts of the World Health Organization (WHO) who have published extensive catalogues containing lists of such mutations. The second barrier is that the processing of the raw genetic files remains a largely manual process overseen by bioinformaticians. Here we describe gnomonicus, our open-source AMR prediction tool, and report the performance of our translation of the second edition of the WHO catalogue using a carefully designed publicly-available dataset of 2,663 M. tuberculosis samples. We hope that not only will this tool be useful but also that this dataset will be used by other researchers to facilitate comparisons between pipelines, approaches and tools. Data SummaryThe attendant GitHub repository1 allows gnomonicus to be rerun on all 2,663 samples in the Diverse Testset; it therefore includes instructions, the necessary input files (all the variant call files, the version of the WHOv2 catalogue and a link to the H37Rv GenBank file used in this study) and also the output JSON files. The ENA accession numbers for all 2,663 samples (including a bash script to download them) and their corresponding phenotypic drug susceptibility testing results are included with the intention that people can either reproduce our results, or use the same dataset for other analyses. The JSON files output by TB-Profiler have also been added for comparison. The repository contains a series of Juypter notebooks containing Python3 code that allows the user to discover and parse the output JSON files from either tool and save the results as data tables. Other notebooks allow the user to reproduce all the analysis underlying this work, including reproducing the figures and many of the tables.

microbiology↗

bioRxiv2024

Addressing pandemic-wide systematic errors in the SARS-CoV-2 phylogeny

The SARS-CoV-2 genome occupies a unique place in infection biology - it is the most highly sequenced genome on earth (making up over 20% of public sequencing datasets) with fine scale information on sampling date and geography, and has been subject to unprecedented intense analysis. As a result, these phylogenetic data are an incredibly valuable resource for science and public health. However, the vast majority of the data was sequenced by tiling amplicons across the full genome, with amplicon schemes that changed over the pandemic as mutations in the viral genome interacted with primer binding sites. In combination with the disparate set of genome assembly workflows and lack of consistent quality control (QC) processes, the current genomes have many systematic errors that have evolved with the virus and amplicon schemes. These errors have significant impacts on the phylogeny, and therefore over the last few years, many thousands of hours of researchers time has been spent in "eyeballing" trees, looking for artefacts, and then patching the tree. Given the huge value of this dataset, we therefore set out to reprocess the complete set of public raw sequence data in a rigorous amplicon-aware manner, and build a cleaner phylogeny. Here we provide a global tree of 4,471,579 samples, built from a consistently assembled set of high quality consensus sequences from all available public data as of June 2024, viewable at https://viridian.taxonium.org. Each genome was constructed using a novel assembly tool called Viridian (https://github.com/iqbal-lab-org/viridian), developed specifically to process amplicon sequence data, eliminating artefactual errors and mask the genome at low quality positions. We provide simulation and empirical validation of the methodology, and quantify the improvement in the phylogeny. We hope the tree, consensus sequences and Viridian will be a valuable resource for researchers.

bioinformatics↗

bioRxiv2023

Mobilisation and analyses of publicly available SARS-CoV-2 data for pandemic responses

The COVID-19 pandemic has seen large-scale pathogen genomic sequencing efforts, becoming part of the toolbox for surveillance and epidemic research. This resulted in an unprecedented level of data sharing to open repositories, which has actively supported the identification of SARS-CoV-2 structure, molecular interactions, mutations and variants, and facilitated vaccine development and drug reuse studies and design. The European COVID-19 Data Platform was launched to support this data sharing, and has resulted in the deposition of several million SARS-CoV-2 raw reads. In this paper we describe (1) open data sharing, (2) tools for submission, analysis, visualisation and data claiming (e.g. ORCiD), (3) the systematic analysis of these datasets, at scale via the SARS-CoV-2 Data Hubs as well as (4) lessons learned. As a component of the Platform, the SARS-CoV-2 Data Hubs enabled the extension and set up of infrastructure that we intend to use more widely in the future for pathogen surveillance and pandemic preparedness.

bioinformatics↗

bioRxiv2022

Repeated evolution of bedaquiline resistance in Mycobacterium tuberculosis is driven by truncation of mmpR5

The antibiotic Bedaquiline (BDQ) is a key component of new WHO regimens for drug resistant tuberculosis (TB) but predicting BDQ resistance (BDQ-R) from genotypes remains challenging. We analysed a collection (n=505) of Mycobacterium tuberculosis from two high prevalence areas in South Africa (Cape Town and Johannesburg, 2019-2020), and found 53 independent acquisitions of 31 different mutations within the mmpR5 regulatory gene, with a particular enrichment of truncated MmpR5 in BDQ-R isolates by either frameshift or introduction of an insertion element. Truncations occurred across three M. tuberculosis lineages, impacting 66% of BDQ-R isolates. Extending our analysis to 1,961 isolates with minimum inhibitory concentrations (MICs) revealed that mmpR5-disrupted isolates had a median BDQ MIC of 0.25 mg/L, compared to the wild-type median of 0.06 mg/L. By matching mmpR5-disrupted isolates with phylogenetically close control isolates without the disruption, we were able to estimate the impact on MIC of individual mutations. In conclusion, as the MIC increase borders the ECOFF threshold for BDQ-R, we recommend the continued use of MICs and detection of MmpR5 truncations to identify modest shifts in BDQ-R.

microbiology↗