Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples

Background: Pseudomonas aeruginosa is a major cause of hospital-acquired and chronic infections, characterised by an extraordinary capacity to develop antimicrobial resistance through the selection of chromosomal mutations, leading to treatment failure. Here, we designed and tested a hybridisation-b...

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Autores: Cortes-Lara, Sara, Medina Reatiga, Paola, Barrio Tofiño, Ester del, Gomis Font, María A., Cabot, Gabriel, Gómez Romano, Fernando, Ayestarán, Nicolás Eduardo, Colomar, Asunción, Palou Rotger, Alexandre, Oteo Iglesias, Jesús, Campo, Rosa del, Cantón, Rafael, Horcajada Gallego, Juan Pablo, López-Causapé, Carla, Oliver, Antonio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/68493
Acceso en línea:http://hdl.handle.net/10230/68493
http://dx.doi.org/10.1016/j.ebiom.2024.105367
Access Level:acceso abierto
Palabra clave:Antimicrobial resistance development
Chronic infections
Cystic fibrosis
Nosocomial infections
Pseudomonas aeruginosa
Resistome
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spelling Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samplesCortes-Lara, SaraMedina Reatiga, PaolaBarrio Tofiño, Ester delGomis Font, María A.Cabot, GabrielGómez Romano, FernandoAyestarán, Nicolás EduardoColomar, AsunciónPalou Rotger, AlexandreOteo Iglesias, JesúsCampo, Rosa delCantón, RafaelHorcajada Gallego, Juan PabloLópez-Causapé, CarlaOliver, AntonioAntimicrobial resistance developmentChronic infectionsCystic fibrosisNosocomial infectionsPseudomonas aeruginosaResistomeBackground: Pseudomonas aeruginosa is a major cause of hospital-acquired and chronic infections, characterised by an extraordinary capacity to develop antimicrobial resistance through the selection of chromosomal mutations, leading to treatment failure. Here, we designed and tested a hybridisation-based capture system for the enrichment of genes of interest before sequencing to monitor resistant populations genomics directly from clinical samples. Methods: A panel for enrichment before sequencing of close to 200 genes related to P. aeruginosa antimicrobial resistance, multilocus sequence typing, mutability or virulence was designed, synthesised (KAPA HyperCap, Roche) and initially validated in vitro using a multidrug-resistant ST175 isolate and representative isolates from major P. aeruginosa clades. In vivo testing included ventilator associated pneumonia by MDR P. aeruginosa in ICU (3-10 sequential samples from 3 patients) and chronic respiratory infection by hypermutable P. aeruginosa in cystic fibrosis (8 sequential samples from a single patient covering a 4-year period). Results from direct sequencing with the enrichment panel were compared with those of whole genome sequencing (WGS) and phenotypic profiling of 10 isolated colonies per sample. Findings: In vitro assays confirmed the selectivity of the enrichment panel and the correct identification of the vast mutational resistome of ST175, including specific mutations even when introduced in a 1:100 proportion. In vivo performance was at least equivalent to sequencing 10 colonies per sample, including the accurate identification of the sequence types and the basal and acquired mutational resistome. To note, specific resistance mutations, such as those in ampC leading to resistance to novel β-lactams, could be traced even at frequencies of 1%. Moreover, the coselection of mutator populations and antibiotic resistance mutations, predicted in theoretical and in vitro studies, was evidenced in vivo. Interpretation: This proof-of-concept study demonstrates that resistance genomics of P. aeruginosa can be analysed directly from clinical samples, determining not only a considerable reduction in turnaround time and cost from a diagnostics perspective, but also an unprecedented potency for accurate monitoring of in vivo population dynamics in bacterial infections. Funding: Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea-NextGenerationEU.Elsevier202420242024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/68493http://dx.doi.org/10.1016/j.ebiom.2024.105367reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésEBioMedicine. 2024 Oct;108:105367© 2024 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/684932026-05-29T05:05:01Z
dc.title.none.fl_str_mv Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
title Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
spellingShingle Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
Cortes-Lara, Sara
Antimicrobial resistance development
Chronic infections
Cystic fibrosis
Nosocomial infections
Pseudomonas aeruginosa
Resistome
title_short Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
title_full Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
title_fullStr Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
title_full_unstemmed Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
title_sort Monitoring of Pseudomonas aeruginosa mutational resistome dynamics using an enrichment panel for direct sequencing of clinical samples
dc.creator.none.fl_str_mv Cortes-Lara, Sara
Medina Reatiga, Paola
Barrio Tofiño, Ester del
Gomis Font, María A.
Cabot, Gabriel
Gómez Romano, Fernando
Ayestarán, Nicolás Eduardo
Colomar, Asunción
Palou Rotger, Alexandre
Oteo Iglesias, Jesús
Campo, Rosa del
Cantón, Rafael
Horcajada Gallego, Juan Pablo
López-Causapé, Carla
Oliver, Antonio
author Cortes-Lara, Sara
author_facet Cortes-Lara, Sara
Medina Reatiga, Paola
Barrio Tofiño, Ester del
Gomis Font, María A.
Cabot, Gabriel
Gómez Romano, Fernando
Ayestarán, Nicolás Eduardo
Colomar, Asunción
Palou Rotger, Alexandre
Oteo Iglesias, Jesús
Campo, Rosa del
Cantón, Rafael
Horcajada Gallego, Juan Pablo
López-Causapé, Carla
Oliver, Antonio
author_role author
author2 Medina Reatiga, Paola
Barrio Tofiño, Ester del
Gomis Font, María A.
Cabot, Gabriel
Gómez Romano, Fernando
Ayestarán, Nicolás Eduardo
Colomar, Asunción
Palou Rotger, Alexandre
Oteo Iglesias, Jesús
Campo, Rosa del
Cantón, Rafael
Horcajada Gallego, Juan Pablo
López-Causapé, Carla
Oliver, Antonio
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Antimicrobial resistance development
Chronic infections
Cystic fibrosis
Nosocomial infections
Pseudomonas aeruginosa
Resistome
topic Antimicrobial resistance development
Chronic infections
Cystic fibrosis
Nosocomial infections
Pseudomonas aeruginosa
Resistome
description Background: Pseudomonas aeruginosa is a major cause of hospital-acquired and chronic infections, characterised by an extraordinary capacity to develop antimicrobial resistance through the selection of chromosomal mutations, leading to treatment failure. Here, we designed and tested a hybridisation-based capture system for the enrichment of genes of interest before sequencing to monitor resistant populations genomics directly from clinical samples. Methods: A panel for enrichment before sequencing of close to 200 genes related to P. aeruginosa antimicrobial resistance, multilocus sequence typing, mutability or virulence was designed, synthesised (KAPA HyperCap, Roche) and initially validated in vitro using a multidrug-resistant ST175 isolate and representative isolates from major P. aeruginosa clades. In vivo testing included ventilator associated pneumonia by MDR P. aeruginosa in ICU (3-10 sequential samples from 3 patients) and chronic respiratory infection by hypermutable P. aeruginosa in cystic fibrosis (8 sequential samples from a single patient covering a 4-year period). Results from direct sequencing with the enrichment panel were compared with those of whole genome sequencing (WGS) and phenotypic profiling of 10 isolated colonies per sample. Findings: In vitro assays confirmed the selectivity of the enrichment panel and the correct identification of the vast mutational resistome of ST175, including specific mutations even when introduced in a 1:100 proportion. In vivo performance was at least equivalent to sequencing 10 colonies per sample, including the accurate identification of the sequence types and the basal and acquired mutational resistome. To note, specific resistance mutations, such as those in ampC leading to resistance to novel β-lactams, could be traced even at frequencies of 1%. Moreover, the coselection of mutator populations and antibiotic resistance mutations, predicted in theoretical and in vitro studies, was evidenced in vivo. Interpretation: This proof-of-concept study demonstrates that resistance genomics of P. aeruginosa can be analysed directly from clinical samples, determining not only a considerable reduction in turnaround time and cost from a diagnostics perspective, but also an unprecedented potency for accurate monitoring of in vivo population dynamics in bacterial infections. Funding: Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea-NextGenerationEU.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/68493
http://dx.doi.org/10.1016/j.ebiom.2024.105367
url http://hdl.handle.net/10230/68493
http://dx.doi.org/10.1016/j.ebiom.2024.105367
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv EBioMedicine. 2024 Oct;108:105367
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
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application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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