Using genomics to unravel the bacteria causing neonatal meningitis
Neonatal meningitis (NM) is a devastating disease with high rates of mortality and potential long-term detrimental effects on both motor and intellectual skills. The bacteria Escherichia coli is the second most common cause of NM in newborns and the most common cause of meningitis in preterm babies. I work with clinicians at Queensland Children’s Hospital to collect E. coli from the blood or cerebrospinal fluid of babies diagnosed with meningitis. I then sequence the DNA of the E. coli so that we can find out more about them - which type of E. coli is commonly circulating in Queensland, how virulent they are, which antibiotics they are resistant to, and how they compare to other E. coli causing meningitis worldwide. In addition, I also collect faecal samples from babies who relapse with meningitis to investigate whether the bacteria resided in the gut microflora and seeded their relapse.
As John F. Kennedy once said, “Children are the world’s most valuable resource and its best hope for the future.” My work will help clinicians in Queensland to choose the right antibiotic treatments for NM, and the consideration for new therapeutics to mitigate the side effects of antibiotics on gut microflora, and new diagnoses to minimise the risk of relapse infections. Together, we hopefully can reduce or eradicate NM in Queensland, and contribute to keeping Queensland children healthy.
Meningitis is a rare but catastrophic disease with mortality of up to 20 per cent in newborns, and up to a third of the survivors suffer from severe motor and intellectual impairments. 90 per cent of bacterial meningitis occurs in children under five, especially newborns with immature immune systems. When a newborn suffers from bacterial meningitis, an average hospital length of stay is 21 days, a significant cost for the health and the economy as parents stay to care for them. Moreover, severe consequences such as physical and intellectual impairments incur social and economic burdens with the demand for therapists and disability services. Antibiotics are crucial to prevent the severe detrimental effects of the disease.
E. coli is NM’s second most common bacterial pathogen, after Group B Streptococcus (GBS). In Australia, the incidence of GBS-causing meningitis has declined due to the successful prevention program treating pregnant women with urinary tract infections with antibiotics. However, the prevalence of E. coli causing NM remains the same. Moreover, NM due to E. coli often carries a worse prognosis than GBS NM. Through whole genome sequencing of E. coli from NM patients in Queensland, my work has determined the most common E. coli types causing NM circulating in Queensland and characterised the antibiotic resistance genes they carry, which clinicians can use to re-evaluate the current treatments for NM. Although the current treatment is still valid, my work noticed the emergence of a multidrug-resistant E. coli type in NM, which is also an emergent urinary tract infection pathogen. This type of E. coli has been shown to be able to carry multidrug-resistant plasmids containing genes resistant to current treatment worldwide. In addition, my work has shown that despite appropriate antibiotics, E. coli can reside in the microflora of patients and seed relapsed infections. Relapse infections will prolong the length of stay in hospitals, increase the risk of neurological consequences, as well as incur significant burdens on health and economic costs. In addition, my work also shows that antibiotic treatment will cause an imbalance in the gut microflora, which could lead to digestion disorders. These data will help clinicians to consider new diagnostic and therapeutic interventions to mitigate the risk of relapse infections. It also suggests that alternative or additional treatments to antibiotics might be required to minimise the effect on neonatal microflora. Together, these will help to reduce the healthcare and economic costs associated with NM and relapse infections.
Through my journey in science, I can be a good role model for women and girls in STEM. I came to Australia from Vietnam to advance my scientific career. Even in a developed country like Australia, I have realized the dominance of men in science. I saw very few successful women with minority backgrounds. Having been a PhD student with a young kid, I understand the obstacles that women have to work and succeed in STEM. By sharing my journey and my Vietnamese background, who migrated to a new country and has a successful role in science, I hope I can encourage more women and girls, especially those from minority backgrounds, to work in STEM. I do not consider myself as a high flyer, yet my passion and fascination for science will definitely encourage youngsters, especially women and girls to get out of their “STEM-is-just-for-boys" perspective. Working in STEM is not an easy task, but the joy it brings to life is second-to-none. By doing this, I hope there will be more and more women and girls in STEM, which can balance the current imbalance in the workforce in STEM and help to create a more friendly environment for women in science, especially those with families.
When I was young, I was always curious about the surrounding environment. I then discovered the presence of microbes, tiny creatures unseen by bare eyes but play a vital role in all aspects of daily life, and became fascinated by it. I have been particularly interested in microbes that cause diseases in humans, how they cause diseases and how to eradicate them. Despite coming from a non-science working-class family within the entire many-generation family tree, I managed to be the first to graduate from the university with a science degree. Moreover, to fulfil my dream in science, I came to Australia with a PhD program scholarship. I have overcome language and culture barriers as well as family commitments to finish my PhD degree and continue to work as a research officer. In addition, through research, I am able to contribute to improving the health of newborns.
I seize every opportunity to encourage the students to continue and fulfil their dream in science. I shared my journey in science while I tutor and train students in the laboratories. I tell them about obstacles people usually face to succeed in sciences, especially for girls and women. Moreover, I always encourage them, especially female students, to continue their science degrees. Women and girls have instinct characteristics: good at multi-tasking, detailing, concentrating and great responsibility, which are all characteristics of good scientists. I also encourage them to challenge themselves by participating in research projects, exploring their unseen abilities and finding love and passion for science. I also tell them about the rewards of science, when we can see our research outputs contribute to eradicating diseases for a better world.