Abstract

Pathogen-pathogen interactions in polymicrobial infections are known to directly impact, often to worsen, disease outcomes. For example, co-infection with Pseudomonas aeruginosa and Aspergillus fumigatus, respectively the most common bacterial and fungal pathogens isolated from cystic fibrosis (CF) airways, leads to a worsened prognosis. Recent studies of in vitro microbial cross-talk demonstrated that P. aeruginosa-derived volatile sulfur compounds (VSCs) can promote A. fumigatus growth in vitro. However, the mechanistic basis of such cross-talk and its physiological relevance during co-infection remains unknown. In this study we combine genetic approaches and GC-MS-mediated volatile analysis to show that A. fumigatus assimilates VSCs via cysteine (CysB)- or homocysteine (CysD)-synthase. This process is essential for utilization of VSCs as sulfur sources, since P. aeruginosa-derived VSCs trigger growth of A. fumigatus wild-type, but not of a ΔcysBΔcysD mutant, on sulfur-limiting media. P. aeruginosa produces VSCs when infecting Galleria mellonella and co-infection with A. fumigatus in this model results in a synergistic increase in mortality and of fungal and bacterial burdens. Interestingly, the increment in mortality is much greater with the A. fumigatus wild-type than with the ΔcysBΔcysD mutant. Therefore, A. fumigatus’ ability to assimilate P. aeruginosa derived VSCs significantly triggers a synergistic association that increases the pathobiology of infection. Finally, we show that P. aeruginosa can promote fungal growth when growing on substrates that resemble the lung environment, which suggests that this volatile based synergism is likely to occur during co-infection of the human respiratory airways.

Highlights

  • The filamentous fungus Aspergillus fumigatus and the bacterium Pseudomonas aeruginosa are common respiratory pathogens

  • P. aeruginosa could produce volatile sulfur compounds (VSCs) from mucins that triggered growth of the distally inoculated A. fumigatus wild-type strain. These results show that P. aeruginosa produces VSCs from mucins contained in Artificial Sputum Medium (ASM) that can stimulate A. fumigatus growth, suggesting that bacterial utilization of mucins may release an additional exploitable sulfur source for the fungus

  • A longitudinal study in adolescents with cystic fibrosis (CF) found that A. fumigatus was the only species associated with an increased risk for infection with P. aeruginosa (Hector et al, 2016) and another recent study showed that P. aeruginosa infection in CF patients was associated with higher incidence of subsequent Aspergillus infection (Granchelli et al, 2018)

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Summary

Introduction

The filamentous fungus Aspergillus fumigatus and the bacterium Pseudomonas aeruginosa are common respiratory pathogens. CF is the result of mutations in the CF transmembrane conductance regulator (CFTR) gene, which encodes a chloride channel. Co-infection with both pathogens is associated with a more rapid decline in CF pulmonary function and more respiratory exacerbations, all leading to a worse prognosis (Amin et al, 2010; Reece et al, 2017). Both pathogens should be considered and targeted in order to improve CF patient outcomes. To understand such cross effects and exploit them to the patients’ benefit a profound insight of the pathogen-pathogen interaction taking place during infection is required

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