Requirements for <i>Pseudomonas aeruginosa</i> Acute Burn and Chronic Surgical Wound Infection

<div><p>Opportunistic infections caused by <i>Pseudomonas aeruginosa</i> can be acute or chronic. While acute infections often spread rapidly and can cause tissue damage and sepsis with high mortality rates, chronic infections can persist for weeks, months, or years in the face of intensive clinical intervention. Remarkably, this diverse infectious capability is not accompanied by extensive variation in genomic content, suggesting that the genetic capacity to be an acute or a chronic pathogen is present in most <i>P. aeruginosa</i> strains. To investigate the genetic requirements for acute and chronic pathogenesis in <i>P. aeruginosa</i> infections, we combined high-throughput sequencing-mediated transcriptome profiling (RNA-seq) and genome-wide insertion mutant fitness profiling (Tn-seq) to characterize gene expression and fitness determinants in murine models of burn and non-diabetic chronic wound infection. Generally we discovered that expression of a gene <i>in vivo</i> is not correlated with its importance for fitness, with the exception of metabolic genes. By combining metabolic models generated from <i>in vivo</i> gene expression data with mutant fitness profiles, we determined the nutritional requirements for colonization and persistence in these infections. Specifically, we found that long-chain fatty acids represent a major carbon source in both chronic and acute wounds, and <i>P. aeruginosa</i> must biosynthesize purines, several amino acids, and most cofactors during infection. In addition, we determined that <i>P. aeruginosa</i> requires chemotactic flagellar motility for fitness and virulence in acute burn wound infections, but not in non-diabetic chronic wound infections. Our results provide novel insight into the genetic requirements for acute and chronic <i>P. aeruginosa</i> wound infections and demonstrate the power of using both gene expression and fitness profiling for probing bacterial virulence.</p>