Beaume, MMBeaumeKöhler, TTKöhlerGreub, GGGreubManuel, OOManuelAubert, J-DJ-DAubertBaerlocher, LLBaerlocherFarinelli, LLFarinelliBuckling, AABucklingvan Delden, CCvan DeldenStirnimann, GuidoGuidoStirnimannBeldi, GuidoGuidoBeldi0000-0002-9914-3807Huynh-Do, UyenUyenHuynh-Do0000-0002-7276-032XSwiss Transplant, Cohort StudyCohort StudySwiss Transplant2024-10-242024-10-242017-01-17https://boris-portal.unibe.ch/handle/20.500.12422/149181In cystic fibrosis (CF) patients, chronic airway infection by Pseudomonas leads to progressive lung destruction ultimately requiring lung transplantation (LT). Following LT, CF-adapted Pseudomonas strains, potentially originating from the sinuses, may seed the allograft leading to infections and reduced allograft survival. We investigated whether CF-adapted Pseudomonas populations invade the donor microbiota and adapt to the non-CF allograft. We collected sequential Pseudomonas isolates and airway samples from a CF-lung transplant recipient during two years, and followed the dynamics of the microbiota and Pseudomonas populations. We show that Pseudomonas invaded the host microbiota within three days post-LT, in association with a reduction in richness and diversity. A dominant mucoid and hypermutator mutL lineage was replaced after 11 days by non-mucoid strains. Despite antibiotic therapy, Pseudomonas dominated the allograft microbiota until day 95. We observed positive selection of pre-LT variants and the appearance of novel mutations. Phenotypic adaptation resulted in increased biofilm formation and swimming motility capacities. Pseudomonas was replaced after 95 days by a microbiota dominated by Actinobacillus. In conclusion, mucoid Pseudomonas adapted to the CF-lung remained able to invade the allograft. Selection of both pre-existing non-mucoid subpopulations and of novel phenotypic traits suggests rapid adaptation of Pseudomonas to the non-CF allograft.en600 - Technology::610 - Medicine & healtharticle10.7892/boris.945022809432710.1038/srep40309