Molecular epidemiology and genomic dynamics of Pseudomonas aeruginosa isolates causing relapse infections

作者：Cong Shen, Jinxiang Zeng, Dexiang Zheng, Yinglun Xiao, Jieying Pu, Li Luo, Hongyun Zhou, Yimei Cai, Liling Zhang, Meina Wu, Xuan Zhang, Guangyuan Deng, Song Li, Qiwei Li, Jianming Zeng, Sun Zhaohui, Bin Huang, Chen Cha · 发表于：Microbiology Spectrum · 年份：2023 · DOI：10.1128/spectrum.05312-22 · 被引用次数：7 · 研究领域：Antibiotic Resistance in Bacteria、Bacterial biofilms and quorum sensing、Cystic Fibrosis Research Advances

ABSTRACT Pseudomonas aeruginosa ( P. aeruginosa ) is one of the leading causes of chronic infections, including reinfection, relapse, and persistent infection, especially in cystic fibrosis patients. Relapse P. aeruginosa infections are more harmful because of repeated hospitalization and undertreatment of antimicrobials. However, relapse P. aeruginosa infection in China remains largely unknown. Herein, we performed a 3-year retrospective study from 2019 to 2022 in a tertiary hospital, which included 442 P . aeruginosa isolates from 196 patients. Relapse infection was identified by screening clinical records and whole-genome sequencing (WGS). We found that 31.6% (62/196) of patients had relapsed infections. The relapse incidence of carbapenem-resistant P. aeruginosa infection (51.4%) is significantly higher than that of carbapenem-susceptible P. aeruginosa infection (20.2%, P < 0.0001). These isolates were assigned to 50 distinct sequence types and sporadically distributed in phylogeny, indicating that relapsed infections were not caused by certain lineages. Fast adaptation and evolution of P. aeruginosa isolates were reflected by dynamic changes of antimicrobial resistance, gene loss and acquisition, and single-nucleotide polymorphisms during relapse episodes. Remarkably, a convergent non-synonymous mutation that occurs in a pyochelin-associated virulence gene fptA (T1056C, M252T) could be a considerable target for the diagnosis and treatment of relapse P. aeruginosa infe...