Metabolic Adaptation in Methicillin-Resistant Staphylococcus aureus Pneumonia.

Publication Type Academic Article
Authors Gabryszewski S, Wong Fok Lung T, Annavajhala M, Tomlinson K, Riquelme S, Khan I, Noguera L, Wickersham M, Zhao A, Mulenos A, Peaper D, Koff J, Uhlemann A, Prince A
Journal Am J Respir Cell Mol Biol
Volume 61
Issue 2
Pagination 185-197
Date Published 08/01/2019
ISSN 1535-4989
Keywords Cystic Fibrosis, Lung Diseases, Methicillin-Resistant Staphylococcus aureus, Pneumonia, Staphylococcal, Staphylococcal Infections
Abstract Methicillin-resistant Staphylococcus aureus (MRSA) is a versatile human pathogen that is associated with diverse types of infections ranging from benign colonization to sepsis. We postulated that MRSA must undergo specific genotypic and phenotypic changes to cause chronic pulmonary disease. We investigated how MRSA adapts to the human airway to establish chronic infection, as occurs during cystic fibrosis (CF). MRSA isolates from patients with CF that were collected over a 4-year period were analyzed by whole-genome sequencing, transcriptional analysis, and metabolic studies. Persistent MRSA infection was associated with staphylococcal metabolic adaptation, but not changes in immunogenicity. Adaptation was characterized by selective use of the tricarboxylic acid cycle cycle and generation of biofilm, a means of limiting oxidant stress. Increased transcription of specific metabolic genes was conserved in all host-adapted strains, most notably a 10,000-fold increase in fumC, which catalyzes the interconversion of fumarate and malate. Elevated fumarate levels promoted in vitro biofilm production in clinical isolates. Host-adapted strains preferred to assimilate glucose polymers and pyruvate, which can be metabolized to generate N-acetylglucosamine polymers that comprise biofilm. MRSA undergoes substantial metabolic adaptation to the human airway to cause chronic pulmonary infection, and selected metabolites may be useful therapeutically to inhibit infection.
DOI 10.1165/rcmb.2018-0389OC
PubMed ID 30742488
PubMed Central ID PMC6670030
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