Multidimensional Clinical Surveillance of Pseudomonas aeruginosa Reveals Complex Relationships between Isolate Source, Morphology, and Antimicrobial Resistance

Abstract

P. aeruginosa is a leading cause of nosocomial infection and infection in patients with cystic fibrosis. While P. aeruginosa infection and treatment can be complicated by a variety of antimicrobial resistance and virulence mechanisms, pathogen virulence is rarely recorded in a clinical setting.

Model-driven characterization of functional diversity ofPseudomonas aeruginosaclinical isolates with broadly representative phenotypes

“…Therefore, comprehensive investigations of the diverse phenotypes and functional metabolic repertoire of clinically isolated strains of P. aeruginosa from multiple body sites and associated with multiple patient comorbidities are still rare. Moreover, genetic variability, mutations, and recombination events play an important role in the phenotypic diversification and metabolic heterogeneity of P. aeruginosa 22,23 , which is also evident in the phenotypes observed in our previous study with these isolates 10 . These limitations have made it difficult to gain a deeper understanding of P. aeruginosa metabolism and infections that can span many isolation sites in the human body, multiple patient comorbidities, and other host factors, that can affect the observed microbial phenotypes.…”

“…Since the isolates demonstrate some degree of genetic variability, their functional uniqueness might play an important role in the phenotypic diversification and metabolic heterogeneity. The wide range of phenotypic diversity observed in our previous study with these isolates 10 led us to investigate further the correlation between the genome sequence of the isolates and their phenotypes. In addition to the diversity based on whole-genome sequences, multi-locus sequence typing (MLST) 30 was used to evaluate the allelic variation of seven housekeeping genes in the isolate genome sequences, generating the sequence types (STs) to characterize isolates.…”

“…Between February 2019 and February 2020, a total of 971 clinical P. aeruginosa isolates from 590 patients at the University of Virginia (UVA) Health system, were collected as reported previously 10 . For each of the 971 clinical P. aeruginosa isolates, patient demographic profiles (age, sex), comorbidities (cystic fibrosis or diabetes), and isolate phenotypic traits (mucoid phenotype, metallic sheen, pigment production, and hemolytic activity) were collected and tabulated.…”

“…(A) Schematic of the stratified random sampling procedure to select a representative set of 25 isolates from the large isolate collection by Dunphy et al . 10 27,28 (B) Circular comparison of the isolate genomic sequences with PA14 genome sequence as reference (innermost circle) generated by BLAST Ring Image Generator 29 . BLAST rings are arranged in five groups of alternating light and dark grey based on the phenotypic categories from panel C. (C) Morphology and patient metadata associated with the selected 25 isolates.…”

Battle against the superbug: outbreak of resistant Pseudomonas aeruginosa in the United States: a correspondence

“…These include the removal of infected devices, surgical debridement of infected tissues, and the use of antimicrobial peptides or novel therapeutic agents that target the biofilm-forming ability of P. aeruginosa . Precautionary measures are crucial to minimize the spread of the VIM-GES-CRPA strain and prevent further infections 7 . It is important for clinicians to closely monitor and promptly treat any affected individuals, employing alternative treatment options considering the antibiotic resistance exhibited by this strain of P. aeruginosa .…”