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New Pseudomonas infections drive Pf phage transmission in CF airways
Julie D. Pourtois, … , Paul L. Bollyky, Elizabeth B. Burgener
Julie D. Pourtois, … , Paul L. Bollyky, Elizabeth B. Burgener
Published April 22, 2025
Citation Information: JCI Insight. 2025;10(11):e188146. https://doi.org/10.1172/jci.insight.188146.
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Research Article Infectious disease Microbiology

New Pseudomonas infections drive Pf phage transmission in CF airways

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Abstract

Pf bacteriophages, lysogenic viruses that infect Pseudomonas aeruginosa (Pa), are implicated in the pathogenesis of chronic Pa infections; phage-infected (Pf+) strains are known to predominate in people with cystic fibrosis (pwCF) who are older and have more severe disease. However, the transmission patterns of Pf underlying the progressive dominance of Pf+ strains are unclear. In particular, it is unknown whether phage transmission commonly occurs horizontally between bacteria via viral particles within the airway or whether Pf+ bacteria are mostly acquired via de novo Pseudomonas infections. Here, we studied Pa genomic sequences from 3 patient cohorts totaling 662 clinical isolates from 105 pwCF. We identified Pf+ isolates and analyzed transmission patterns of Pf within patients between genetically similar groups of bacteria called “clone types.” We found that Pf was predominantly passed down vertically within Pa clone types and rarely via horizontal transfer between clone types within the airway. Conversely, we found extensive evidence of Pa de novo infection by a new, genetically distinct Pf+ Pa. Finally, we observed that clinical isolates showed reduced activity of type IV pili and reduced susceptibility to Pf in vitro. These results cast light on the transmission of virulence-associated phages in the clinical setting.

Authors

Julie D. Pourtois, Naomi L. Haddock, Aditi Gupta, Arya Khosravi, Hunter A. Martinez, Amelia K. Schmidt, Prema S. Prakash, Ronit Jain, Piper Fleming, Tony H. Chang, Carlos Milla, Patrick R. Secor, Giulio A. De Leo, Paul L. Bollyky, Elizabeth B. Burgener

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Figure 3

Pf prophages are maintained within clone types within patients.

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Pf prophages are maintained within clone types within patients.
Presence...
Presence or absence of 5 different Pf types, as defined by their integrase, for 1 clone type and patient in the California cohort (A), Denmark cohort (B), and Italy cohort (C). Sample dates are shown at the end of each branch. (D) Proportion of Pa isolate pairs with identical Pf infection patterns (same number and type of Pf phages, as determined by their integrase) for isolates of the same clone type and in the same patient. (E) Number of non-identical nucleotides (including SNPs and large insertions/deletions) for pairwise comparisons of Pf genomes of the same phage type (using the same integrase) for Pf infecting the same patient and Pa clone type, and for Pf infecting different clone types. Pf phages were more likely to share more of their genome if they infected the same clone type in the same patient. ***P < 0.001 by Wilcoxon’s rank-sum test. Boxes show the median (horizontal lines) and interquartile range (bounds of the boxes) and all data points are shown. (F) Proportion of Pa isolate pairs of the same clone type but in different patients with identical Pf infection patterns (same number and type of Pf phages, as determined by their integrase).

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