20.500.12556/DiRROS-27943 Genomic virulence markers are associated with severe outcomes in patients with Pseudomonas aeruginosa bloodstream infection Background: Pseudomonas aeruginosa (PA) bloodstream infection (BSI) is a common healthcare-associated complication linked to antimicrobial resistance and high mortality. Ongoing clinical trials are exploring novel anti-virulence agents, yet studies on how bacterial virulence affects PA infection outcomes is conflicting and data from real-world clinical populations is limited. Methods: We studied a multicentre cohort of 773 adult patients with PA BSI consecutively collected during 7-years from sites in Europe and Australia. Comprehensive clinical data and whole-genome sequencing of all bacterial strains were obtained. Results: Based on the virulence genotype, we identify several virulence clusters, each showing varying proportions of multidrug-resistant phenotypes. Genes tied to biofilm synthesis and epidemic clones ST175 and ST235 are associated with mortality, while the type III secretion system is associated with septic shock. Adding genomic biomarkers to machine learning models based on clinical data indicates improved prediction of severe outcomes in PA BSI patients. Conclusions: These findings suggest that virulence markers provide prognostic information with potential applications in guiding adjuvant sepsis treatments. Pseudomonas aeruginosa bloodstream infection virulence Pseudomonas aeruginosa okužbe krvni obtok virulenca true false true Angleški jezik Slovenski jezik Neznano 2026-02-27 14:14:44 2026-02-27 14:14:45 2026-03-01 03:40:29 0000-00-00 00:00:00 2024 0 0 Nasl. z nasl. zaslona; Opis vira z dne 26. 5. 2025; Št. članka: 264; str. 1-14 Vol. 4 2024 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.9 2730-664X 10.1038/s43856-024-00696-4 237177347 RAZ_Karlsson_Valik_John_2024.pdf RAZ_Karlsson_Valik_John_2024.pdf 1 333106D9C3A99EB29EBDDB62E676E6D4 6165e2421c223c7045d8bfffe67e3748f85896f7b511684901151e0edcedfa19 7115119a-13de-11f1-8c73-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=41159 https://www.nature.com/articles/s43856-024-00696-4 1 4c3d4e9f-13de-11f1-8c73-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=41158 Univerzitetni klinični center Ljubljana 0 0 0