<i>Stenotrophomonas maltophilia</i> natural history and evolution in the airways of adults with cystic fibrosis
Notice bibliographique
Résumé
ABSTRACT Stenotrophomonas maltophilia is an opportunistic pathogen infecting person with cystic fibrosis (pwCF) and portends a worse prognosis. Studies of S. maltophilia infection dynamics have been limited by cohort size and follow-up. We investigated the natural history, transmission potential, and evolution of S. maltophilia in a large Canadian cohort of pwCF over a thirty-seven year period. S. maltophilia was recovered at least once in 25.5% of the cohort. Yearly isolates from 74 pwCF (23%) were typed by pulsed-field gel electrophoresis, and shared pulsotypes underwent whole-genome sequencing. Most pwCF were infected by unique strains, but serial infections with different strains, and strains shared between patients, were observed. In chronic carriage, longer time periods between positive collection dates increased the likelihood that subsequent isolates were unrelated. Isolates from individual pwCF were largely clonal, with genetic diversity driven by gene content differences. Disproportionate progression of CF lung disease was not observed amongst those infected with multiple strains over time (versus a single) or amongst those with shared clones (versus strains only infecting one patient). We did not observe evidence of patient-to-patient transmission despite relatedness between isolates. Instead, genomic analyses suggested common, indirect sources as their origins. Sixteen multi-mutated genes were identified as having a potential role in adaptation of S. maltophilia to CF, including in a regulator of an efflux pump and in an iron acquisition gene cluster. The information derived from a genomics-based understanding of the natural history of S. maltophilia infection within CF provides unique insight into its potential for in-host evolution. IMPORTANCE In this largest and longest single center study of S. maltophilia causing infections in persons with cystic fibrosis, we concluded that patient-to-patient infection transmission had not occurred. We determined that infection by a new S. maltophilia strain was more likely the longer the time between its recovery in sputum, suggesting infection by individual strains is generally short-lived. Amongst bacterial isolates belonging to the same clonal complex, isolates could be better differentiated by their gene content than mutations, suggesting gene gain/loss may contribute more to the genetic diversity of these strains than mutation. Infection by multiple strains, or a shared strain found in at least one other person, was not associated with progression to end-stage lung disease.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».