1. Mutational signature analysis predicts bacterial hypermutation and multidrug resistance.
- Author
-
Hall KM, Williams LG, Smith RD, Kuang EA, Ernst RK, Bojanowski CM, Wimley WC, Morici LA, and Pursell ZF
- Subjects
- Humans, Pseudomonas Infections microbiology, Pseudomonas Infections drug therapy, Microbial Sensitivity Tests, DNA Mutational Analysis, Bacterial Proteins genetics, Bacterial Proteins metabolism, Drug Resistance, Multiple, Bacterial genetics, Pseudomonas aeruginosa genetics, Pseudomonas aeruginosa drug effects, DNA Mismatch Repair genetics, Mutation, Anti-Bacterial Agents pharmacology
- Abstract
Bacteria of clinical importance, such as Pseudomonas aeruginosa, can become hypermutators upon loss of DNA mismatch repair (MMR) and are clinically correlated with high rates of multidrug resistance (MDR). Here, we demonstrate that hypermutated MMR-deficient P. aeruginosa has a unique mutational signature and rapidly acquires MDR upon repeated exposure to first-line or last-resort antibiotics. MDR acquisition was irrespective of drug class and instead arose through common resistance mechanisms shared between the initial and secondary drugs. Rational combinations of drugs having distinct resistance mechanisms prevented MDR acquisition in hypermutated MMR-deficient P. aeruginosa. Mutational signature analysis of P. aeruginosa across different human disease contexts identified appreciable quantities of MMR-deficient clinical isolates that were already MDR or prone to future MDR acquisition. Mutational signature analysis of patient samples is a promising diagnostic tool that may predict MDR and guide precision-based medical care., Competing Interests: Competing interests: K.M.H., L.G.W., Z.F.P., and L.A.M. are inventors of patent application #PCT/US2024/014280. K.M.H. and L.G.W. are employed by and are shareholders of Informuta, Inc. The remaining authors declare no competing interests., (© 2024. The Author(s).)
- Published
- 2025
- Full Text
- View/download PDF