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Updated: May 19, 2026

Replication of the Ordered, Nonredundant Library of Pseudomonas aeruginosa strain PA14 Transposon Insertion Mutants
Published on: May 4, 2018
The intestinal environment of surgical injury transforms Pseudomonas aeruginosa into a discrete hypervirulent
Trissa Babrowski1, Kathleen Romanowski, David Fink
1Center for Surgical Infection Research and Therapeutics, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Background:
Secondary peritonitis continues to carry a high mortality rate despite the aggressive use of imaging, drainage, and antibiotics. Although host factors and microbial burden contribute to the outcome of peritonitis, we propose a role for bacterial virulence as a determinant of outcome from peritonitis. Bacterial virulence is an inducible trait that is activated in response to specific local "cues" that we have previously shown to be present in the mouse gut exposed to surgical stress and injury.
Methods:
Pseudomonas aeruginosa was harvested after its intestinal inoculation into the cecum of mice subjected to surgical injury (30% hepatectomy) or sham surgery (controls). Harvested strains were then injected into the peritoneum of noninjured (naïve) mice and mortality determined.
Results:
P. aeruginosa harvested from the intestines of surgically injured mice caused 100% mortality, whereas strains harvested from control mice caused no mortality. Among recovered strains, a distinct P. aeruginosa morphotype (wrinkled shape) was shown to cause lethal peritonitis compared to smooth-shaped strains, which were nonlethal. Wrinkled strains were associated with a tendency to elicit a more proinflammatory response in mice compared to smooth-shaped strains.
Conclusion:
Surgical injury transforms the morphotype of intestinal P. aeruginosa to express a hypervirulent response in the peritoneum of mice. Enhanced virulence of intestinal pathogens in response to surgical injury may play an important role in predicting the outcome of peritonitis.
Insights
Surgical injury transforms intestinal Pseudomonas aeruginosa into a hypervirulent pathogen, increasing peritonitis mortality. This bacterial virulence, influenced by surgical stress, is a key factor in patient outcomes.
Area of Science:
- Microbiology
- Surgical Infections
- Pathogenesis
Background:
- Secondary peritonitis has high mortality despite current treatments.
- Bacterial virulence, not just host factors, may determine peritonitis outcomes.
- Bacterial virulence is inducible by local cues present after surgical stress.
Purpose of the Study:
- To investigate the role of bacterial virulence in peritonitis outcomes.
- To determine if surgical injury alters bacterial virulence.
- To identify specific bacterial morphotypes associated with lethal peritonitis.
Main Methods:
- Pseudomonas aeruginosa was inoculated into mouse ceca.
- Mice underwent surgical injury (hepatectomy) or sham surgery.
- Bacterial strains were harvested and injected into naive mice to assess mortality.
Main Results:
- P. aeruginosa from injured mice caused 100% mortality in naive mice.
- A wrinkled morphotype of P. aeruginosa was lethal, while smooth morphotypes were not.
- Wrinkled strains induced a more proinflammatory response compared to smooth strains.
Conclusions:
- Surgical injury induces hypervirulence in intestinal P. aeruginosa.
- Altered bacterial virulence in response to surgery impacts peritonitis outcomes.
- Bacterial morphotype changes may predict peritonitis severity.
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