Recurring acquisition of carbapenemase genes and global emergence of <i>Pseudomonas aeruginosa</i> ST-1047, a lineage shaped by geopolitical conflicts
Carbapenemase-producing <i>Pseudomonas aeruginosa</i> is a major cause of healthcare-associated infections worldwide and is associated with high mortality due to limited treatment options. In this study, we characterize the emergence and international spread of a previously underrecognized lineage of <i>P. aeruginosa</i> that has independently acquired and stabilized multiple resistance genes, including those encoding VIM, IMP, NDM, and Dutch imipenemase carbapenemases. Using genomic sequencing and evolutionary analyses, we show how this lineage emerged in the late 19th century and has since adapted by integrating resistance genes directly into its chromosome, promoting long-term stability and outbreak potential. Strikingly, we link its global expansion to population movements, soldier evacuations, and healthcare disruptions during armed conflicts in Afghanistan and Ukraine. This work reveals how political instability can drive the spread of multidrug-resistant bacteria and underscores the value of high-resolution surveillance to detect and contain emerging threats before they become dominant in clinical settings.
Authors
- Jason R. Smedberg
- Denis K. Byarugaba (ORCID: https://orcid.org/0000-0002-4175-5659)
- Ana Ong
- Brendan T. Jones (ORCID: https://orcid.org/0000-0001-5106-2795)
- Ting Luo (ORCID: https://orcid.org/0000-0002-9670-4031)
- Yoon I. Kwak (ORCID: https://orcid.org/0000-0002-1198-5437)
- Fred Wabwire-Mangeni
- Н. С. Фоміна (ORCID: https://orcid.org/0000-0003-3877-7563)
- Patrick McGann (ORCID: https://orcid.org/0000-0003-1548-9438)
- Frieder Fuchs (ORCID: https://orcid.org/0000-0001-7075-5378)
- Hannah Kibuuka (ORCID: https://orcid.org/0000-0002-2293-1944)
- Jason W. Bennett (ORCID: https://orcid.org/0000-0001-5879-2037)
- Antoni P. A. Hendrickx (ORCID: https://orcid.org/0000-0003-4431-9323)
- Viacheslav Kondratiuk (ORCID: https://orcid.org/0000-0002-2316-7941)
- François Lebreton (ORCID: https://orcid.org/0000-0002-7157-5026)
- Henry D. Dao
- Valentyn Kovalchuk
Institutions
- Landstuhl Regional Medical Center (DE)
- Makerere University Walter Reed Project (UG)
- National Institute for Public Health and the Environment (NL)
- Bundeswehrkrankenhaus (DE)
- National Medical and Surgical Center named after N.I. Pirogov (RU)
- National Pirogov Memorial Medical University, Vinnytsya (UA)
- Institute of Medical Microbiology and Hygiene (DE)
- University Hospital Cologne (DE)
- Bundeswehrzentralkrankenhaus Koblenz (DE)
- Walter Reed Army Institute of Research (US)
Publication Details
- Journal
- mBio
- Published
- 2025-10-08
- DOI
- https://doi.org/10.1128/mbio.02020-25
- Primary Topic
- Antibiotic Resistance in Bacteria
- Type
- article
- Field-Weighted Citation Impact
- 0.00