Description of Medical ServiceThe applicant has described the proposed medical service as 'Sequencing and analysis of the complete nucleotide sequence of the microbial genome (bacterial, mycobacterial, or viral) of an isolate or to characterise an organism from a patient for the purpose of determining the antibiotic resistance markers (resistome) of the isolate to guide the patient’s treatment and/or chemoprophylaxis of close contacts. WGS usually involves ‘shotgun’ sequencing of short reads that are either assembled de novo or mapped onto a high-quality reference genome. Genome-wide analysis can identify changes conferring resistance to standard of care antibiotics as well as newer antimicrobials for which established phenotypic susceptibility testing guidelines or protocols are not available.'
Description of Medical ConditionThe applicant’s response is: ‘Antimicrobial resistance, also referred to as antibiotic resistance, is defined as the ability of a microorganism to reproduce in the presence of a specific antimicrobial compound. Of particular concern is the emergence of multiple drug resistant pathogens associated with the widespread use of antibiotics and high-density clinical care that are capable of causing outbreaks and epidemics. Whole genome sequencing (WGS) provides rapid and simultaneous screening of all clinically-relevant mutations in close to real-time to predict a pathogen’s full resistance profile to multiple drugs (the ‘resistome’) in order to guide a patient’s treatment and/or the chemoprophylaxis of close contacts. The literature describes the use of WGS to determine and characterise resistance in numerous clinically relevant pathogens including, but not limited to: Campylobacter; Escherichia coli; Klebsiella pneumoniae; Enterobacter cloacae; Pseudomonas aeruginosa; Bacteroides; Salmonella; Staphylococcus aureus; Streptococcus pneumoniae; Neisseria gonorrhoeae; Acinetobacter baumannii; Clostridium difficile and Plasmodium falciparum. The most common reported use of WGS for the determination of resistance; however, is for the pathogen Mycobacterium tuberculosis. Given the extensive list of potential pathogens and their associated clinical conditions, this application will focus on Mycobacterium tuberculosis as an exemplar of how WGS provides rapid and accurate characterisation of antimicrobial resistance.’
Reason for ApplicationNew MBS item
Medical Service TypeInvestigative
Previous Application Number/sNot Applicable
Application FormApplication Form (PDF 1397 KB)
Application Form (Word 338 KB)
Consultation SurveyConsultation Survey (PDF 559 KB)
Consultation Survey (Word 70 KB)
MSAC consultation closed 11 February 2022.
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PICO ConfirmationPICO Confirmation (PDF 1579 KB)
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Public Summary DocumentPublic Summary Document (PDF 551 KB)
Public Summary Document (Word 172 KB)