Unveiling the molecular epidemiology of Pseudomonas aeruginosa in lung infections among cystic fibrosis patients in the Brazilian Amazon

Unveiling the molecular epidemiology of Pseudomonas aeruginosa in lung infections among cystic fibrosis patients in the Brazilian Amazon

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Abstract Background Pseudomonas aeruginosa is a major pathogen in cystic fibrosis (CF), where chronic and intermittent infections significantly affect patient outcomes.This study aimed to investigate the molecular epidemiology of P.aeruginosa in CF patients from the Brazilian Amazon, focusing on genotypic diversity, resistance profiles, and virulence factors.Methods A cross-sectional abc material study included 72 P.aeruginosa isolates from 44 CF patients treated at a regional reference center between 2018 and 2019.

Antimicrobial susceptibility patterns were determined using VITEK-2 system and Kirby-Bauer disk diffusion.Virulotypes were defined by molecular detection of exoS, exoU, exoT, exoY, algU, and algD genes.Genetic diversity was assessed using multilocus sequence typing (MLST).Demographic data, clinical severity, and spirometry results were also collected.Results Among the patients, 54.

55% experienced intermittent infections, while 45.45% had chronic infections.Chronic infections were associated with older age, lower FEV1, and reduced Shwachman-Kulczycki scores.Multidrug resistance was observed in 15.3% of isolates, particularly against ciprofloxacin and piperacillin/tazobactam.

The exoU gene was present in 55.56% of isolates, an uncommon finding in CF alphaville clothing populations.High genetic diversity was evident, with 37 sequence types (STs), including 14 novel STs.High-risk clones (HRCs) constituted 25% of isolates, with ST274 being the most prevalent (12.5%).

Longitudinal analysis revealed transient colonization in intermittent infections, while chronic infections were dominated by stable clones.Conclusion This study highlights the molecular and clinical dynamics of P.aeruginosa in CF patients from the Brazilian Amazon.Chronic infections were linked to severe lung impairment , while intermittent infections were dominated by HRCs.These findings underscore the need for robust genotypic surveillance to mitigate the burden of P.

aeruginosa in CF populations.