Gut to lung translocation and antibiotic mediated selection shape the dynamics of Pseudomonas aeruginosa in an ICU patient
Wheatley, Rachel M. (University of Oxford, Department of Biology)
Caballero, Julio Diaz (University of Oxford, Department of Biology)
van der Schalk, Thomas E. (University of Antwerp. Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Faculty of Medicine, Wilrijk, Belgium)
De Winter, Fien H. R. (University of Antwerp. Molecular Pathology Group, Laboratory of Cell Biology and Histology, Faculty of Medicine, Wilrijk, Belgium)
Shaw, Liam P. (University of Oxford, Department of Biology)
Kapel, Natalia (University of Oxford, Department of Biology)
Recanatini, Claudia (University Medical Center Utrecht, Utrecht University. Julius Center for Health Sciences and Primary Care, Utrecht)
Timbermont, Leen (University of Antwerp. Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Faculty of Medicine, Wilrijk, Belgium)
Kluytmans, Jan (University Medical Center Utrecht, Utrecht University. Julius Center for Health Sciences and Primary Care, Utrecht)
Esser, Mark (Microbial Sciences, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA)
Lacoma, Alicia (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Prat i Aymerich, Cristina (Universitat Autònoma de Barcelona. Departament de Genètica i de Microbiologia)
Oliver, Antonio (Institut d'Investigació Sanitària Illes Balears, Hospital Universitari Son Espases)
Kumar-Singh, Samir (University of Antwerp. Molecular Pathology Group, Laboratory of Cell Biology and Histology, Faculty of Medicine, Wilrijk, Belgium)
Malhotra-Kumar, Surbhi (University of Antwerp. Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Faculty of Medicine, Wilrijk, Belgium)
Craig MacLean, R. (University of Oxford, Department of Biology)

Date:	2022
Abstract:	Bacteria have the potential to translocate between sites in the human body, but the dynamics and consequences of within-host bacterial migration remain poorly understood. Here we investigate the link between gut and lung Pseudomonas aeruginosa populations in an intensively sampled ICU patient using a combination of genomics, isolate phenotyping, host immunity profiling, and clinical data. Crucially, we show that lung colonization in the ICU was driven by the translocation of P. aeruginosa from the gut. Meropenem treatment for a suspected urinary tract infection selected for elevated resistance in both the gut and lung. However, resistance was driven by parallel evolution in the gut and lung coupled with organ specific selective pressures, and translocation had only a minor impact on AMR. These findings suggest that reducing intestinal colonization of Pseudomonas may be an effective way to prevent lung infections in critically ill patients.
Grants:	European Commission 115737 European Commission 115523
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Antimicrobials ; Infection ; Evolution ; Antimicrobial resistance
Published in:	Nature communications, Vol. 13 (november 2022) , ISSN 2041-1723

DOI: 10.1038/s41467-022-34101-2
PMID: 36414617

11 p, 1.5 MB

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