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Background <p><i>Pseudomonas aeruginosa</i> is a major pathogen in cystic fibrosis (CF), where chronic and intermittent infections significantly affect patient outcomes. This study aimed to investigate the molecular epidemiology of <i>P. aeruginosa</i> in CF patients from the Brazilian Amazon, focusing on genotypic diversity, resistance profiles, and virulence factors.</p> Methods <p>A cross-sectional study included 72 <i>P. aeruginosa</i> isolates from 44 CF patients treated at a regional reference center between 2018 and 2019. Antimicrobial susceptibility patterns were determined using VITEK-2 system and Kirby-Bauer disk diffusion. Virulotypes were defined by molecular detection of <i>exoS</i>, <i>exoU</i>, <i>exoT</i>, <i>exoY</i>, <i>algU</i>, and <i>algD</i> genes. Genetic diversity was assessed using multilocus sequence typing (MLST). Demographic data, clinical severity, and spirometry results were also collected.</p> Results <p>Among the patients, 54.55% experienced intermittent infections, while 45.45% had chronic infections. Chronic infections were associated with older age, lower FEV1, and reduced Shwachman-Kulczycki scores. Multidrug resistance was observed in 15.3% of isolates, particularly against ciprofloxacin and piperacillin/tazobactam. The <i>exoU</i> gene was present in 55.56% of isolates, an uncommon finding in CF populations. High genetic diversity was evident, with 37 sequence types (STs), including 14 novel STs. High-risk clones (HRCs) constituted 25% of isolates, with ST274 being the most prevalent (12.5%). Longitudinal analysis revealed transient colonization in intermittent infections, while chronic infections were dominated by stable clones.</p> Conclusion <p>This study highlights the molecular and clinical dynamics of <i>P. aeruginosa</i> in CF patients from the Brazilian Amazon. Chronic infections were linked to severe lung impairment , while intermittent infections were dominated by HRCs. These findings underscore the need for robust&#xa0;genotypic surveillance to mitigate the burden of <i>P. aeruginosa</i> in CF populations.</p>

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Unveiling the molecular epidemiology of Pseudomonas aeruginosa in lung infections among cystic fibrosis patients in the Brazilian Amazon

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月9日

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  • Maria Isabel Montoril Gouveia,
  • Edilene do Socorro Nascimento Falcão Sarges,
  • Herald Souza dos Reis,
  • Danielle Melo Sardinha,
  • Pabllo Antonny Silva dos Santos,
  • Layana Rufino Ribeiro,
  • Marcos Jessé Abrahão Silva,
  • Marcos Vinicios Hino de Melo,
  • Ana Judith Pires Garcia Quaresma,
  • Danielle Murici Brasiliense,
  • Luana Nepomuceno Godim Costa Lima,
  • Karla Valéria Batista Lima,
  • Yan Corrêa Rodrigues

摘要

Background

Pseudomonas aeruginosa is a major pathogen in cystic fibrosis (CF), where chronic and intermittent infections significantly affect patient outcomes. This study aimed to investigate the molecular epidemiology of P. aeruginosa in CF patients from the Brazilian Amazon, focusing on genotypic diversity, resistance profiles, and virulence factors.

Methods

A cross-sectional study included 72 P. aeruginosa isolates from 44 CF patients treated at a regional reference center between 2018 and 2019. Antimicrobial susceptibility patterns were determined using VITEK-2 system and Kirby-Bauer disk diffusion. Virulotypes were defined by molecular detection of exoS, exoU, exoT, exoY, algU, and algD genes. Genetic diversity was assessed using multilocus sequence typing (MLST). Demographic data, clinical severity, and spirometry results were also collected.

Results

Among the patients, 54.55% experienced intermittent infections, while 45.45% had chronic infections. Chronic infections were associated with older age, lower FEV1, and reduced Shwachman-Kulczycki scores. Multidrug resistance was observed in 15.3% of isolates, particularly against ciprofloxacin and piperacillin/tazobactam. The exoU gene was present in 55.56% of isolates, an uncommon finding in CF populations. High genetic diversity was evident, with 37 sequence types (STs), including 14 novel STs. High-risk clones (HRCs) constituted 25% of isolates, with ST274 being the most prevalent (12.5%). Longitudinal analysis revealed transient colonization in intermittent infections, while chronic infections were dominated by stable clones.

Conclusion

This study highlights the molecular and clinical dynamics of P. aeruginosa in CF patients from the Brazilian Amazon. Chronic infections were linked to severe lung impairment , while intermittent infections were dominated by HRCs. These findings underscore the need for robust genotypic surveillance to mitigate the burden of P. aeruginosa in CF populations.