title: Intrinsic and environmental mutagenesis drive diversification and persistence of Pseudomonas aeruginosa in chronic lung infections.
abstract: Pseudomonas aeruginosa is a versatile opportunistic pathogen causing a wide variety of hospital-acquired acute infections in immunocompromised patients as well as chronic respiratory infections in patients suffering from cystic fibrosis or other chronic respiratory diseases. Several traits contribute to its ability to colonize and persist in the lungs of chronically infected patients, including development of high resistance to antimicrobials and hypermutability, biofilm growth, and alginate hyperproduction, or a customized pathogenicity, which may include the loss of classical virulence factors and metabolic changes. Here we argue that a combination of both intrinsic and environmental mutagenesis leads to a high number of mutant variants in the population. The conducive environment then triggers a positive feedback loop leading to adaptation and persistence of P. aeruginosa, rendering these chronic infections almost impossible to eradicate.
authors.affiliation: Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain. arrojas@cnb.csic.es
authors.forename: Alexandro
authors.initials: A
authors.lastname: Rodríguez-Rojas
authors.forename: Antonio
authors.initials: A
authors.lastname: Oliver
authors.forename: Jesús
authors.initials: J
authors.lastname: Blázquez
mesh_terms: D000220:Adaptation, Biological; D018441:Biofilms; D002908:Chronic Disease; D003550:Cystic Fibrosis / Q000150:complications*; D024881:Drug Resistance, Bacterial; D059647:Gene-Environment Interaction; D006801:Humans; D016296:Mutagenesis; D059645:Mutation Rate; D010641:Phenotype; D011552:Pseudomonas Infections / Q000150:complications / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000472:pathogenicity* / Q000502:physiology; D012141:Respiratory Tract Infections / Q000150:complications / Q000382:microbiology*