Genotypic and phenotypic relatedness of Pseudomonas aeruginosa isolates among the major cystic fibrosis patient cohort in Italy

Abstract

BackgroundPseudomonas aeruginosa is the predominant pathogen associated with the decline of pulmonary function in cystic fibrosis (CF) patients. Both environment-to-host acquisition and patient-to-patient transmission have been described for P. aeruginosa infection. Epidemic clones and bacterial phenotypic adaptation to the CF lung have been recognised as independent risk factors for disease progression. So far, there is no established link between genotypic prevalence and phenotypic traits. Here, we look at the major CF patient cohort in Italy to identify shared P. aeruginosa clones and associated common phenotypic traits.ResultsA comprehensive analysis of P. aeruginosa genotypes to determine the presence of high-risk shared clones and their association to specific phenotypic traits has been performed in a major Italian CF centre. Pulsed-field gel electrophoresis (PFGE) of P. aeruginosa isolates from 338 CF subjects identified 43 profiles shared by two or more patients and 214 profiles exclusive to individual patients. There was no evidence of a P. aeruginosa outbreak, but four most prevalent pulsotypes were detected. Common phenotypic traits were recorded intra-pulsotypes, but we detected heterogeneity inter-pulsotypes. Two of the four major pulsotypes included P. aeruginosa isolates with hallmarks of adaptation to the CF airways, including loss of motility, low production of siderophore, pyocyanin and proteases, and antibiotic resistance. One of these pulsotypes grouped a high percentage of hypermutable isolates. No clear correlation between epidemiological and clinical data was found.ConclusionsWe conclude that CF patients of this cohort shared common pulsotypes, but their phenotypic heterogeneity indicates an absence of specific traits associated to P. aeruginosa genotypic prevalence.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-016-0760-1) contains supplementary material, which is available to authorized users.

Genotypic characterisation and antimicrobial resistance of Pseudomonas aeruginosa strains isolated from patients of different hospitals and medical centres from Poland

“…However, there are a number of genotyping studies in which PFGE is still used [43,44]. Although this method was rst introduced in 1986, it is still frequently used for typing clinically relevant microorganisms.…”

Emergence of Antimicrobial Resistance among Pseudomonas aeruginosa: Implications for Therapy

“…155 Several distinct epidemic clones of MDR-PA have disseminated globally among CF patients and centers. [156][157][158][159] Epidemic and nonepidemic strains may differ in virulence, biofilm formation, and antimicrobial susceptibility. 160,161 The importance of PA in evolution of the CF lung lesion is fascinating but is beyond the scope of this article and will not be further discussed herein.…”

“…90,138,274 Several international clones disseminated from hospitals, 90,138 whereas other clones evolved from CF centers. 153,[156][157][158][159] In North America, rates of MDR are modest. 320,321 Data from the Eurofins' Surveillance Network evaluated > 205,000 PA isolates from patients with HAP or BSI from 217 hospitals in the United States from 2005 to 2011.…”

Molecular Identification of Gram-Negative Bacteria in Respiratory Samples of Cystic Fibrosis Patients from a Children Referral Hospital in Tehran

“…P. aeruginosa can persist for a long time as a chronic infection to impair lung function (3,4). This microorganism is acquired from the environment or through patient-to-patient transmission (5). Rarely may Acinetobacter spp.…”

“…prompt institution of appropriate treatment for infected patients. Late detection impedes the eradication of these pathogens and leads to chronic infection (5). Culturebased methods are time-consuming in the detection of bacteria from the airways of CF patients and they usually give false positive and false negative results due to colonization and previous antibiotic use, respectively.…”