Division of Combat Wound Repair, U.S. Army Institute of Surgical Research, 3698 Chambers Pass, Building 3610, JBSA Fort Sam Houston, San Antonio, TX 78234-7767, United States.
Fort Gordon DENTAC, 439 Richmond Street Evans, GA 30809, United States.
Pathog Dis. 2024 Feb 7;82. doi: 10.1093/femspd/ftae021.
Cutaneous burn trauma, compromise of dermal layers and immune defense system is a physical and fiscal burden on healthcare systems. Burn-wound infections are a serious complication of thermal injury and contribute significantly to care burden. After burn-induced trauma, sepsis by Pseudomonas aeruginosa impairs patient recovery and contributes to mortality and morbidity. Past studies show positive correlation between detection of Pseudomonas species and healing-impaired traumatic wounds. Pseudomonas aeruginosa is a resilient opportunistic human pathogen and a nosocomial agent involved in pathology of healing-impaired wounds, especially in burn patients. Expansive array of virulence determinants has resulted in gentamicin- and silver-resistant P. aeruginosa outbreaks. Knowledge of molecular dynamics and phylogeny of P. aeruginosa associated with burn wounds is limited. Therefore, we conducted whole-genome sequencing for genotyping and phylogenetic analysis of P. aeruginosa burn-associated strains (n = 19) isolated from 7 burn cases during hospitalization. Comparison of genetic features in P. aeruginosa strains in the core genome and mobilome detected genetic variations within some clonal infections over time. Genetic variations were observed among different burn cases, with some features identified in severe lung infections. Polyclonal infections were also observed, with differing genotypes and virulence potentials, highlighting the importance of reasoned sampling of isolates for clinical testing.
皮肤烧伤创伤，皮肤层和免疫系统受损，给医疗保健系统带来身体和经济负担。烧伤创面感染是热损伤的严重并发症，显著增加了护理负担。在烧伤引起的创伤后，绿脓假单胞菌引起的败血症会影响患者的康复，并导致死亡率和发病率上升。过去的研究表明，假单胞菌属的检测与愈合受损的创伤之间存在正相关。绿脓假单胞菌是一种有弹性的机会性病原体，也是一种与愈合受损伤口相关的医院获得性病原体，尤其是在烧伤患者中。大量的毒力决定因素导致了庆大霉素和银耐药的绿脓假单胞菌爆发。与烧伤相关的绿脓假单胞菌的分子动力学和系统发育的知识有限。因此，我们对 7 例住院烧伤患者的 19 株烧伤相关绿脓假单胞菌进行了全基因组测序，以进行基因分型和系统发育分析。在核心基因组和可移动基因组中比较绿脓假单胞菌菌株的遗传特征，发现某些克隆感染随时间发生遗传变异。在不同的烧伤病例中观察到遗传变异，一些特征与严重的肺部感染有关。还观察到多克隆感染，具有不同的基因型和毒力潜力，这突出了合理选择用于临床检测的分离株的重要性。
