Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in Brazil

Background: Pseudomonas aeruginosa is a ubiquitous organism with high clinical impact due to its intrinsic resistance to many antimicrobial drugs and ability to acquire antibiotic resistance and virulence genes. The type III secretion system (T3SS) is critical in the pathogenesis of this species, wh...

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Main Authors: Sergio M. Morgado, Nathália M.S. Bighi, Fernanda S. Freitas, Caio Rodrigues, Érica L. Fonseca, Ana Carolina Vicente
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716525000992
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author Sergio M. Morgado
Nathália M.S. Bighi
Fernanda S. Freitas
Caio Rodrigues
Érica L. Fonseca
Ana Carolina Vicente
author_facet Sergio M. Morgado
Nathália M.S. Bighi
Fernanda S. Freitas
Caio Rodrigues
Érica L. Fonseca
Ana Carolina Vicente
author_sort Sergio M. Morgado
collection DOAJ
description Background: Pseudomonas aeruginosa is a ubiquitous organism with high clinical impact due to its intrinsic resistance to many antimicrobial drugs and ability to acquire antibiotic resistance and virulence genes. The type III secretion system (T3SS) is critical in the pathogenesis of this species, where ExoS and ExoU are the main toxins. Strains cocarrying both toxins are considered hypervirulent. However, there is a gap in revealing the coexpression of exoU/exoS. This study characterizes a carbapenem-resistant exoU+/exoS+ P. aeruginosa in Brazil through its expression and genetic context. Methods: Thirty-three P. aeruginosa from Brazil were subjected to antibiotic susceptibility testing and sequencing. The genomes were characterized considering their resistome and virulome, and their phylogeny was established. The expression of exoU/exoS was evaluated by qPCR and the exoU genomic region was analyzed. Results: A carbapenem-resistant strain presented the exoU+/exoS+ genotype, belonging to serotype O4 and ST4996. Although it did not carry carbapenemases, it presented mutations in the porin OprD. The qPCR assay showed that exoU and exoS are coexpressed at higher levels than control strains, although they share the same promoter and relevant ExoU sites with exoU+/exoS- genomes. Three other Brazilian genomes with this trait were identified, also presenting the exoU gene in the context of the PAPI-2 island. Conclusion: P. aeruginosa carrying exoS/exoU in Brazil is rare, although they may occur in the clinic associated with carbapenem resistance. Furthermore, although belonging to a different ST, the Brazilian strain PA27N presented exoS/exoU expression levels similar to the hypervirulent P. aeruginosa strains occurring in China.
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spelling doaj-art-b7a8cccfec504ca39802e383b045dfe52025-08-20T03:30:29ZengElsevierJournal of Global Antimicrobial Resistance2213-71652025-06-014323323610.1016/j.jgar.2025.04.025Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in BrazilSergio M. Morgado0Nathália M.S. Bighi1Fernanda S. Freitas2Caio Rodrigues3Érica L. Fonseca4Ana Carolina Vicente5Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil; Corresponding author. Mailing address: Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, BrazilLaboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, BrazilLaboratório de Bacteriologia - Laboratório Central, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, BrazilLaboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, BrazilLaboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, BrazilBackground: Pseudomonas aeruginosa is a ubiquitous organism with high clinical impact due to its intrinsic resistance to many antimicrobial drugs and ability to acquire antibiotic resistance and virulence genes. The type III secretion system (T3SS) is critical in the pathogenesis of this species, where ExoS and ExoU are the main toxins. Strains cocarrying both toxins are considered hypervirulent. However, there is a gap in revealing the coexpression of exoU/exoS. This study characterizes a carbapenem-resistant exoU+/exoS+ P. aeruginosa in Brazil through its expression and genetic context. Methods: Thirty-three P. aeruginosa from Brazil were subjected to antibiotic susceptibility testing and sequencing. The genomes were characterized considering their resistome and virulome, and their phylogeny was established. The expression of exoU/exoS was evaluated by qPCR and the exoU genomic region was analyzed. Results: A carbapenem-resistant strain presented the exoU+/exoS+ genotype, belonging to serotype O4 and ST4996. Although it did not carry carbapenemases, it presented mutations in the porin OprD. The qPCR assay showed that exoU and exoS are coexpressed at higher levels than control strains, although they share the same promoter and relevant ExoU sites with exoU+/exoS- genomes. Three other Brazilian genomes with this trait were identified, also presenting the exoU gene in the context of the PAPI-2 island. Conclusion: P. aeruginosa carrying exoS/exoU in Brazil is rare, although they may occur in the clinic associated with carbapenem resistance. Furthermore, although belonging to a different ST, the Brazilian strain PA27N presented exoS/exoU expression levels similar to the hypervirulent P. aeruginosa strains occurring in China.http://www.sciencedirect.com/science/article/pii/S2213716525000992MDRIntrinsic carbapenem resistanceT3SSCRPAPAPI-2Toxin
spellingShingle Sergio M. Morgado
Nathália M.S. Bighi
Fernanda S. Freitas
Caio Rodrigues
Érica L. Fonseca
Ana Carolina Vicente
Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in Brazil
Journal of Global Antimicrobial Resistance
MDR
Intrinsic carbapenem resistance
T3SS
CRPA
PAPI-2
Toxin
title Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in Brazil
title_full Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in Brazil
title_fullStr Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in Brazil
title_full_unstemmed Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in Brazil
title_short Carbapenem-resistant hypervirulent P. aeruginosa coexpressing exoS/exoU in Brazil
title_sort carbapenem resistant hypervirulent p aeruginosa coexpressing exos exou in brazil
topic MDR
Intrinsic carbapenem resistance
T3SS
CRPA
PAPI-2
Toxin
url http://www.sciencedirect.com/science/article/pii/S2213716525000992
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