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Published on: May 4, 2018
Emergence and Spread of Epidemic Multidrug-Resistant Pseudomonas aeruginosa
Tohru Miyoshi-Akiyama1, Tatsuya Tada2, Norio Ohmagari3
1Pathogenic Microbe Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
Abstract:
Pseudomonas aeruginosa (P. aeruginosa) is one of the most common nosocomial pathogens worldwide. Although the emergence of multidrug-resistant (MDR) P. aeruginosa is a critical problem in medical practice, the key features involved in the emergence and spread of MDR P. aeruginosa remain unknown. This study utilized whole genome sequence (WGS) analyses to define the population structure of 185 P. aeruginosa clinical isolates from several countries. Of these 185 isolates, 136 were categorized into sequence type (ST) 235, one of the most common types worldwide. Phylogenetic analysis showed that these isolates fell within seven subclades. Each subclade harbors characteristic drug resistance genes and a characteristic genetic background confined to a geographic location, suggesting that clonal expansion following antibiotic exposure is the driving force in generating the population structure of MDR P. aeruginosa. WGS analyses also showed that the substitution rate was markedly higher in ST235 MDR P. aeruginosa than in other strains. Notably, almost all ST235 isolates harbor the specific type IV secretion system and very few or none harbor the CRISPR/CAS system. These findings may help explain the mechanism underlying the emergence and spread of ST235 P. aeruginosa as the predominant MDR lineage.
Insights
Multidrug-resistant Pseudomonas aeruginosa (MDR P. aeruginosa) spread is driven by clonal expansion. Whole genome sequencing revealed specific genetic traits in the predominant ST235 lineage, explaining its global dominance as a nosocomial pathogen.
Area of Science:
- Microbiology
- Genomics
- Epidemiology
Background:
- Pseudomonas aeruginosa is a major global nosocomial pathogen.
- The emergence and spread of multidrug-resistant (MDR) strains pose a critical challenge.
- Understanding the drivers of MDR P. aeruginosa population structure is essential.
Purpose of the Study:
- To define the population structure of P. aeruginosa clinical isolates using whole genome sequencing (WGS).
- To identify key features contributing to the emergence and spread of MDR P. aeruginosa, particularly sequence type 235 (ST235).
Main Methods:
- Whole genome sequencing (WGS) of 185 P. aeruginosa clinical isolates.
- Phylogenetic analysis to determine population structure and subclades.
- Analysis of drug resistance genes, genetic background, and specific systems (Type IV secretion, CRISPR/CAS).
Main Results:
- 136 of 185 isolates belonged to the globally common ST235.
- Phylogenetic analysis revealed seven subclades within ST235, each with distinct drug resistance genes and geographic confinement.
- ST235 MDR P. aeruginosa exhibited a higher substitution rate and commonly possessed a Type IV secretion system, while lacking CRISPR/CAS.
- Clonal expansion following antibiotic exposure appears to drive population structure.
Conclusions:
- The findings elucidate the mechanisms behind the emergence and spread of ST235 as a predominant MDR P. aeruginosa lineage.
- Specific genetic characteristics and clonal expansion contribute to the global success of this nosocomial pathogen.
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