MRSA in the NICU
Outbreak or Coincidence?
Author(s)
Abstract
DNA sequencing and analysis (bioinformatics) is an increasingly important tool for understanding biological data, including medical data. In this case study, students will be exposed to DNA sequencing to quickly identify how an outbreak of methicillin-resistant Staphylococcus aureus spreads through a neonatal intensive care unit (NICU). This PowerPoint-driven case is based on an actual outbreak described in the New England Journal of Medicine and students will use the actual DNA sequences from the outbreak that were used by scientists. A handout (Supplemental Materials) provides background and instructions that guide students in how to create and read a phylogenetic tree and use to it identify which organisms are part of the outbreak and which are independent MRSA infections. They will then use this data to assess the containment strategies used at the hospital during the outbreak. Students will learn how DNA sequencing can inform epidemiology to identify outbreak cases, track trajectories of the spreading disease, and quickly put containment measures into place. This case study is especially suited for high school and introductory undergraduate biology classes.
Objectives
- Generate two phylogenetic trees, one based on antibiotic resistance (phenotype), and the other based on DNA sequences from patient infections.
- Interpret the two phylogenetic trees to analyze an outbreak in a hospital environment.
- Analyze the strengths and weaknesses of phenotype (antibiotic resistance profile) vs. genotype-based (DNA sequencing) phylogenetic trees for analyzing a hospital-based outbreak.
- Develop a fuller understanding of evolution by natural selection, phylogenetic trees, bioinformatics tools, and medical applications of bioinformatics tools and information.
Keywords
NICU; outbreak; MRSA; antibiotic resistance; phylogeny; DNA sequencing; bioinformaticsTopical Areas
N/AEducational Level
High school, Undergraduate lower division, Undergraduate upper division, Clinical education, General public & informal educationFormat
PDF, PowerPointType / Methods
Analysis (Issues), Directed, Discussion, Journal ArticleLanguage
EnglishSubject Headings
Biology (General) | Epidemiology | Genetics / Heredity | Medicine (General) | Evolutionary Biology | Public Health | Science (General) |
Date Posted
8/29/2018Teaching Notes
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Supplemental Materials
The following handout and datasets are used in this case study.
mrsa_sequencing.pdf
mrsa_sequencing_phylip.txt
mrsa_sequencing_antibiogram.txt
Answer Key
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