The Regional Laboratory for Medical Microbiology (RLM) in Dordrecht, Netherlands, is poised to adopt cutting-edge genomic sequencing technology, offering a more detailed and rapid method of identifying infectious diseases. Beginning in 2026, the lab will utilize the MinION device to analyze the complete genetic makeup of pathogens, a capability previously limited to specialized research facilities. This “third generation sequencing” promises to enhance diagnostic accuracy and inform treatment decisions, notably as antibiotic resistance becomes an increasingly pressing global health concern.
DORDRECHT – A new device, roughly the size of a smartphone, will allow the Regional Laboratory for Medical Microbiology (RLM) to map out extensive stretches of genetic material – or even the complete genome – of disease-causing organisms. The lab in Dordrecht plans to implement this “third generation sequencing” technology in specific diagnostic situations beginning in 2026.
The technology, known as MinION, rapidly reads long sequences of DNA or RNA, the unique hereditary code of living organisms. This allows for extremely precise identification of microorganisms. Sequencing, at its core, determines the order of bases – the building blocks of DNA.
This form of molecular diagnostics shares similarities with the PCR tests widely used during the COVID-19 pandemic, but is both more comprehensive and refined, explains medical-molecular microbiologist Tim Schuurman. “With a PCR test, we compare material taken from a patient to a known piece of DNA or RNA from a bacterium or virus. This requires us to pre-determine which pathogen might be responsible. If we don’t know what we’re looking for, we might not use the correct PCR test. Sequencing, on the other hand, directly reads the genetic code of the culprit. The sequences we find are then compared to databases or other identified sequences. This allows for a broader search and provides more detailed information.”
Enhanced Diagnostic Capabilities
The new method won’t entirely replace the RLM’s existing daily bacteriological and molecular diagnostics. “In most cases, current methods are still suitable,” says Schuurman. “However, there are situations where sequencing offers significant advantages. For example, when a specific pathogen is suspected, but a PCR test comes back negative. Or when a pathogen *is* identified, but doesn’t respond to an antibiotic that should normally be effective.”
Sequencing reveals variations and mutations within the DNA, providing insights into antibiotic resistance. This information can help clinicians select alternative treatments. “With sequencing, you learn a great deal,” Schuurman emphasizes.
The technology can also determine if disease-causing organisms are related to one another. “This can help identify and control outbreaks,” Schuurman adds. “For instance, if multiple patients in a ward are infected with the same bacteria, we want to know if they contracted it from a common source or through person-to-person transmission. If the microorganisms are related, it suggests a single source or cause that needs to be addressed. If not, a complex and time-consuming investigation can be avoided.”
How the Technology Works
In simplified terms, the MinION reads DNA or RNA by pulling molecules through a minuscule pore and measuring the changes in electrical current that occur. A connected computer with substantial processing power then deciphers the base sequence. “The method is currently still relatively complex and expensive,” says Tim Schuurman. “But it represents the future.” The RLM will initially use sequencing in cases where it helps deliver the best possible care, or where it can avoid significant effort and costs.
The advent of rapid genomic sequencing promises to improve infection control and treatment strategies, offering a more nuanced understanding of disease outbreaks and antibiotic resistance – critical advancements in the ongoing fight against infectious diseases.
