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Biomedical subjects

Alan R Hauser

Publications and source records attributed to Alan R Hauser.

4 recordsLinked to original sources

Transposon insertion sequencing of Pseudomonas aeruginosa identifies multiple intersecting pathways essential for extreme colistin resistance.

Colistin is used to treat antibiotic resistant gram-negative infections, including those caused by Pseudomonas aeruginosa (Pa). Using a diverse collection of clinical isolates, we identified BWH047, a colistin-resistant isolate with an extremely high minimum inhibitory concentration (MIC, 1280 µg/mL). To characterize the genes conditionally essential for colistin resistance in BWH047, we employed transposon insertion sequencing and identified 20 gene candidates. In-frame deletion validated 75% of the candidates and identified genes in several new pathways that contribute to colistin resistance in Pa, including algU and wapH. We also identified several candidate genes from previously reported colistin resistance pathways (e.g., arn, pmrAB). We further investigated the impact of a colistin resistance-associated inner membrane DedA-family undecaprenyl phosphate flippase, which we named DpcA (DedA of Pseudomonas necessary for colistin resistance A). Deletion of dpcA in BWH047 restored sensitivity to colistin (MIC = 0.5 µg/mL) and resulted in several unique changes to the structure of lipopolysaccharide (LPS), including production of decreased amounts of the colistin resistance-conferring 4-amino-4-deoxy-L-arabinose (L-Ara4N) modification on lipid A. This work represents a robust analysis of colistin resistance in Pa and identifies intersecting pathways that contribute to extreme phenotypic resistance.

Pseudomonas aeruginosa

L2 β-lactamase contributes to ceftolozane-tazobactam resistance in Pseudomonas aeruginosa.

The prevalence of non-susceptibility to ceftolozane-tazobactam (C/T) among Pseudomonas aeruginosa remains low, but novel mechanisms of C/T resistance are of concern. Herein, we describe a novel P. aeruginosa genotype associated with high-level C/T resistance (>256/4 µg/mL) in a single patient. Whole-genome sequencing of the isolate was compared to that of a susceptible isolate cultured from the same patient 2 months earlier. Analysis of the sequences revealed two different P. aeruginosa high-risk clones: sequence type (ST)111 followed by ST235. The C/T-resistant ST235 isolate contained five copies of a genetic element composed of an L2 β-lactamase gene (blaL2) and a truncated ampRL2 transcriptional regulator gene, which are commonly found together in Stenotrophomonas maltophilia strains and have not been reported to mediate resistance to C/T. Comparative genomic analysis with other P. aeruginosa isolates failed to identify alternative explanations for the observed C/T resistance. We found that exogenous expression of blaL2 increased C/T minimum inhibitory concentrations (MICs) in genetically distinct P. aeruginosa strains. A screen of our archived isolates identified two P. aeruginosa clinical isolates, PS2045 and PS2046, with one and two copies, respectively, of the genetic element containing blaL2 and truncated ampRL2. Interestingly, disruption of the gene blaL2 but not the truncated ampRL2 in PS2045 led to a decrease in C/T MIC. Thus, we report a novel mechanism of C/T resistance in P. aeruginosa partially mediated by an L2 β-lactamase independently of its canonical regulator, AmpRL2.

bioinformatics

A novel mechanism of ceftolozane-tazobactam resistance in Pseudomonas aeruginosa mediated by L2 β-lactamase.

The prevalance of non-susceptibility to ceftolozane-tazobactam (C/T) among Pseudomonas aeruginosa remains low but novel mechanisms of C/T resistance are of concern. Herein, we describe a novel Pseudomonas aeruginosa genotype associated with high-level C/T resistance (>256/4 μg/mL) in a single patient. Whole genome sequencing of the isolate was compared to that of a susceptible isolate cultured from the same patient two months earlier. Analysis of the sequences revealed two different P. aeruginosa high-risk clones: ST111 followed by ST235. The C/T-resistant ST235 isolate contained five copies of a genetic element comprised of an L2 β-lactamase gene (bla L2) and a truncated ampR L2 transcriptional regulator gene, which are commonly found together in Stenotrophomonas maltophilia strains and have not been reported to mediate resistance to C/T. Comparative genomic analysis with other P. aeruginosa isolates failed to identify alternative explanations for the observed C/T resistance. We found that exogenous expression of bla L2 modestly increased C/T MICs in genetically distinct P. aeruginosa strains. A screen of our archived isolates identified two P. aeruginosa clinical isolates, PS2045 and PS2046, with one and two copies, respectively, of the genetic element containing bla L2 and truncated ampR L2. Interestingly, disruption of the gene bla L2 but not the truncated ampR L2 in PS2045 led to a significant decrease in C/T MIC. Thus, we report a novel mechanism of C/T resistance in P. aeruginosa mediated by an L2 β-lactamase independently of its canonical regulator AmpR L2.

bioinformatics

Transitions in lung microbiota landscape associate with distinct patterns of pneumonia progression.

The precise microbial determinants driving clinical outcomes in severe pneumonia are unknown. Competing ecological forces produce dynamic microbiota states in health and disease, and a more thorough understanding of these states has the potential to improve pneumonia therapy. Here, we leverage a large collection of bronchoscopic samples from patients with suspected pneumonia to determine lung microbial ecosystem dynamics throughout the course of pneumonia. We combine 16S rRNA gene, metagenomic, and metatranscriptomic sequencing with bacterial-load quantification to reveal clinically relevant drivers of pneumonia progression. Microbiota states are predictive of pneumonia subtypes and exhibit differential stability and pneumonia therapy response. Disruptive forces, such as aspiration, are associated with cohesive changes in gene expression and microbial community structure. In summary, we show that host and microbiota landscapes change in unison with clinical phenotypes and that microbiota state dynamics reflect pneumonia progression. We suggest that distinct pathways of lung microbial community succession mediate pneumonia progression.

Humans