The Plasmid Blind Spot: Latest findings on missed horizontal spread

Time to read: 5 minutes

Last updated: January 2026
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A recent nationwide five-year study in Singapore identified an alarming gap: 60% of carbapenemase gene spread occurred through plasmid-mediated horizontal transfer [1]. Yet standard genomic surveillance still fails to account for it.

The consequences are significant: misidentified outbreak sources, incorrect isolation measures, and avoidable patient-to-patient transmission.

With AMR infections projected to result in US$ 1 trillion in additional healthcare costs by 2050 [2], hospitals can’t afford surveillance blind spots that miss the majority of resistance spread.

The problem with the standard workflow

Standard genomic surveillance in hospitals still ignores plasmids and focuses on predictable clonal transmission. A recent Nature Microbiology review confirmed that incorporating plasmid analysis is essential for accurate transmission detection [3]. Solu addresses this gap by providing plasmid-aware analysis from any sequencing input in minutes.

Solu replaces slow, manual analysis with a fully automated, cloud-based platform that delivers actionable insights. We give your infection control team the power to detect, track, and stop mobile resistance genes in real-time, moving teams from reaction to prevention.

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Real-time surveillance in action

Hospitals globally are already using Solu to detect horizontal transmission events that standard pipelines miss. At Akershus University Hospital in Norway, biomedical laboratory scientist Cecilie Sveen-Ekre and her team updated their workflow with Solu. The transformation was immediate. Cecilie recalls:

"First time logging in, I drag & dropped the files, and got results in minutes. It was like magic,"

The team could detect clusters in real time, compare new isolates, and review findings with infection control faster than ever before.
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Speed of results is just the beginning of Solu’s benefits. With plasmid-aware analysis built in, teams gain insights into horizontal transmission that traditional pipelines miss.

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Start today

The latest research exposes the blind spot: Plasmid-mediated transmission accounts for a significant share of AMR spread in hospital settings. Yet, it is still not efficiently scanned for in standard workflows.
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AMR surveillance isn't about the strain you're fighting. It's about being able to see the genes the strain acquires. Every transmission event missed is a potential outbreak.
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Try our platform for free and discover what your current pipeline is missing.

Still not convinced? Read more about our newest feature for fighting plasmid spread: What is Pulse?

References

Koh V, et al. Plasmid dynamics driving carbapenemase gene dissemination in healthcare environments: a nationwide analysis of closed Enterobacterales genomes. Nature Communications (2025). DOI: 10.1038/s41467-025-64515-7
World Health Organization. Antimicrobial Resistance Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
Hayden MK, Sansom SE, Snitkin ES. Genome sequencing for prevention of healthcare-associated bacterial infections. Nature Reviews Microbiology (2025). DOI: 10.1038/s41579-025-01254-y
Robertson J, Nash JHE. MOB-suite: software tools for clustering, reconstruction, and typing of plasmids from draft assemblies. Microbial Genomics (2018). DOI: 10.1099/mgen.0.000206

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