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Infect. Immun. doi:10.1128/IAI.01282-06
Copyright (c) 2007, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Molecular Epidemiology and Dynamics of Pseudomonas aeruginosa Populations in Cystic Fibrosis Lungs

Infection Microbiology Group, BioCentrum-DTU, Technical University of Denmark, Lyngby, Denmark; Copenhagen CF Centre, Department of Clinical Microbiology, Rigshospitalet; Institute of Medical Microbiology and Immunology, Panum Institute, University of Copenhagen, Denmark; Department of Veterinary Pathobiology, The Royal Veterinary and Agricultural University, DK-1870 Frederiksberg C, Denmark

^* To whom correspondence should be addressed. Email: sm{at}biocentrum.dtu.dk.

	Abstract

The ability to establish life-long persistent infections is a fundamental aspect of the interactions between many pathogenic microorganisms and their mammalian hosts. One example is chronic lung infections by the opportunistic pathogen Pseudomonas aeruginosa in cystic fibrosis (CF) patients. This infection process is associated with extensive genetic adaptation and micro-evolution of the infecting bacteria. Through investigations of P. aeruginosa populations and infection dynamics in a group of CF patients followed at the Danish CF Clinic in Copenhagen, we have identified two distinct and dominant clones that have evolved into highly successful colonizers of CF airways. A significant component of the evolutionary success of these two clones has been their efficient transmissibility among the CF patients. The two clones have been present and transmitted among different CF patients for more than two decades. Our data also suggest that the P. aeruginosa population structure in the CF airways has been influenced by competition between different clones and that the two dominant clones have been particularly competitive within the lungs, which may add to their overall establishment success. In contrast, we show that adaptive traits commonly associated with establishment of chronic P. aeruginosa infections of CF patients, such as transition to the mucoid phenotype and production of virulence factors, play minor roles for the ability of the two dominant clones to spread among patients and cause long-term chronic infections. These findings suggest that hitherto unrecognized evolutionary pathways may be involved in development of successful and persistent P. aeruginosa colonizers of CF lungs.

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