Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections

Objectives: We assessed the association between the lethality of Pseudomonas aeruginosa in a Caenorhabditis elegans model and outcomes of P. aeruginosa bloodstream infections. Methods: A total of 593 P. aeruginosa bloodstream isolates recovered from a prospective Spanish multicentre study were analy...

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Autores: Sanchez-Diener, I, Zamorano, L, Pena, C, Ocampo-Sosa, A, Cabot, G, Gomez-Zorrilla, S, Almirante, B, Aguilar, M, Granados, A, Calbo, E, Rodriguez-Bano, J, Rodriguez-Lopez, F, Tubau, F, Martinez-Martinez, L, Navas, A, Oliver, A
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Recursos:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p2708
Acesso em linha:https://i3pt.portalinvestigacion.com/publicaciones/2708
Access Level:acceso abierto
Palavra-chave:Bloodstream infections
Caenorhabditis elegans
Pseudomonas aeruginosa
Virulence
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spelling Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infectionsSanchez-Diener, IZamorano, LPena, COcampo-Sosa, ACabot, GGomez-Zorrilla, SAlmirante, BAguilar, MGranados, ACalbo, ERodriguez-Bano, JRodriguez-Lopez, FTubau, FMartinez-Martinez, LNavas, AOliver, ABloodstream infectionsCaenorhabditis elegansPseudomonas aeruginosaVirulenceObjectives: We assessed the association between the lethality of Pseudomonas aeruginosa in a Caenorhabditis elegans model and outcomes of P. aeruginosa bloodstream infections. Methods: A total of 593 P. aeruginosa bloodstream isolates recovered from a prospective Spanish multicentre study were analysed. Clinical variables, susceptibility profiles and Type III Secretion System (TTSS) genotypes (exoU/exoS genes) were available from previous studies. A C. elegans virulence score (CEVS) was used, classifying the isolates into high (CEVS 4-5), intermediate (CEVS 3) and low (CEVS 1-2) virulence. The main outcome analysed was 30-day mortality. Results: Up to 75% (446/593) of the isolates showed a high-virulence phenotype, and 17% (101/593) a low-virulence one. No association between virulence phenotype and the main outcome variable (30-day mortality) was found (29/101 (28.7%) versus 127/446 (28.5%), p 1). However, an inverse association between C. elegans virulence and multidrug-resistant and extensively drug-resistant profiles was documented (OR 0.655 (95% CI 0.571-0.751) and OR 0.523 (95% CI 0.436-0.627), p <0.001, respectively), whereas the exoU genotype was significantly more frequent among isolates showing high virulence (10/101 (9.9%) versus 112/446 (25.1%), p <0.001). Moreover, although significance was not reached, strains showing a high-virulence phenotype tended to be associated with community-acquired infections (1/101 (1%) versus 25/446 (5.6%), p 0.065), whereas low-virulence phenotypes tended to be associated with a higher illness severity (such as higher median Pitt score: 2 (1-4) versus 1 (0-3), p 0.036, or initial multiorgan dysfunction: 17/101 (16.8%) versus 41/446 (9.2%), p 0.024), with some underlying conditions (such as chronic renal failure 24/101 (23.8%) versus 59/446 (13.2%), p 0.013), and with the respiratory source of infections (17/101 (16.8%) versus 45/446 (10.1%), p 0.058). Conclusions: Our results indicate that the P. aeruginosa virulence phenotype in a C. elegans model correlates with virulence genotype (TTSS) and resistance profile, but it is a poor prognostic marker of mortality in bloodstream infections. (C) 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.ELSEVIER SCI LTD2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/2708CLINICAL MICROBIOLOGY AND INFECTIONISSN: 1198743XISSNe: 14690691reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p27082026-06-21T15:30:37Z
dc.title.none.fl_str_mv Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
title Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
spellingShingle Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
Sanchez-Diener, I
Bloodstream infections
Caenorhabditis elegans
Pseudomonas aeruginosa
Virulence
title_short Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
title_full Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
title_fullStr Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
title_full_unstemmed Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
title_sort Weighting the impact of virulence on the outcome of Pseudomonas aeruginosa bloodstream infections
dc.creator.none.fl_str_mv Sanchez-Diener, I
Zamorano, L
Pena, C
Ocampo-Sosa, A
Cabot, G
Gomez-Zorrilla, S
Almirante, B
Aguilar, M
Granados, A
Calbo, E
Rodriguez-Bano, J
Rodriguez-Lopez, F
Tubau, F
Martinez-Martinez, L
Navas, A
Oliver, A
author Sanchez-Diener, I
author_facet Sanchez-Diener, I
Zamorano, L
Pena, C
Ocampo-Sosa, A
Cabot, G
Gomez-Zorrilla, S
Almirante, B
Aguilar, M
Granados, A
Calbo, E
Rodriguez-Bano, J
Rodriguez-Lopez, F
Tubau, F
Martinez-Martinez, L
Navas, A
Oliver, A
author_role author
author2 Zamorano, L
Pena, C
Ocampo-Sosa, A
Cabot, G
Gomez-Zorrilla, S
Almirante, B
Aguilar, M
Granados, A
Calbo, E
Rodriguez-Bano, J
Rodriguez-Lopez, F
Tubau, F
Martinez-Martinez, L
Navas, A
Oliver, A
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Bloodstream infections
Caenorhabditis elegans
Pseudomonas aeruginosa
Virulence
topic Bloodstream infections
Caenorhabditis elegans
Pseudomonas aeruginosa
Virulence
description Objectives: We assessed the association between the lethality of Pseudomonas aeruginosa in a Caenorhabditis elegans model and outcomes of P. aeruginosa bloodstream infections. Methods: A total of 593 P. aeruginosa bloodstream isolates recovered from a prospective Spanish multicentre study were analysed. Clinical variables, susceptibility profiles and Type III Secretion System (TTSS) genotypes (exoU/exoS genes) were available from previous studies. A C. elegans virulence score (CEVS) was used, classifying the isolates into high (CEVS 4-5), intermediate (CEVS 3) and low (CEVS 1-2) virulence. The main outcome analysed was 30-day mortality. Results: Up to 75% (446/593) of the isolates showed a high-virulence phenotype, and 17% (101/593) a low-virulence one. No association between virulence phenotype and the main outcome variable (30-day mortality) was found (29/101 (28.7%) versus 127/446 (28.5%), p 1). However, an inverse association between C. elegans virulence and multidrug-resistant and extensively drug-resistant profiles was documented (OR 0.655 (95% CI 0.571-0.751) and OR 0.523 (95% CI 0.436-0.627), p <0.001, respectively), whereas the exoU genotype was significantly more frequent among isolates showing high virulence (10/101 (9.9%) versus 112/446 (25.1%), p <0.001). Moreover, although significance was not reached, strains showing a high-virulence phenotype tended to be associated with community-acquired infections (1/101 (1%) versus 25/446 (5.6%), p 0.065), whereas low-virulence phenotypes tended to be associated with a higher illness severity (such as higher median Pitt score: 2 (1-4) versus 1 (0-3), p 0.036, or initial multiorgan dysfunction: 17/101 (16.8%) versus 41/446 (9.2%), p 0.024), with some underlying conditions (such as chronic renal failure 24/101 (23.8%) versus 59/446 (13.2%), p 0.013), and with the respiratory source of infections (17/101 (16.8%) versus 45/446 (10.1%), p 0.058). Conclusions: Our results indicate that the P. aeruginosa virulence phenotype in a C. elegans model correlates with virulence genotype (TTSS) and resistance profile, but it is a poor prognostic marker of mortality in bloodstream infections. (C) 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
publishDate 2020
dc.date.none.fl_str_mv 2020
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 https://i3pt.portalinvestigacion.com/publicaciones/2708
url https://i3pt.portalinvestigacion.com/publicaciones/2708
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCI LTD
publisher.none.fl_str_mv ELSEVIER SCI LTD
dc.source.none.fl_str_mv CLINICAL MICROBIOLOGY AND INFECTION
ISSN: 1198743X
ISSNe: 14690691
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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