Drug-Driven Phenotypic Convergence Supports Rational Treatment Strategies of Chronic Infections.

Abstract:

:Chronic Pseudomonas aeruginosa infections evade antibiotic therapy and are associated with mortality in cystic fibrosis (CF) patients. We find that in vitro resistance evolution of P. aeruginosa toward clinically relevant antibiotics leads to phenotypic convergence toward distinct states. These states are associated with collateral sensitivity toward several antibiotic classes and encoded by mutations in antibiotic resistance genes, including transcriptional regulator nfxB. Longitudinal analysis of isolates from CF patients reveals similar and defined phenotypic states, which are associated with extinction of specific sub-lineages in patients. In-depth investigation of chronic P. aeruginosa populations in a CF patient during antibiotic therapy revealed dramatic genotypic and phenotypic convergence. Notably, fluoroquinolone-resistant subpopulations harboring nfxB mutations were eradicated by antibiotic therapy as predicted by our in vitro data. This study supports the hypothesis that antibiotic treatment of chronic infections can be optimized by targeting phenotypic states associated with specific mutations to improve treatment success in chronic infections.

journal_name

Cell

journal_title

Cell

authors

Imamovic L,Ellabaan MMH,Dantas Machado AM,Citterio L,Wulff T,Molin S,Krogh Johansen H,Sommer MOA

doi

10.1016/j.cell.2017.12.012

subject

Has Abstract

pub_date

2018-01-11 00:00:00

pages

121-134.e14

issue

1-2

eissn

0092-8674

issn

1097-4172

pii

S0092-8674(17)31492-7

journal_volume

172

pub_type

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