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Hedge, J.

Publications and source records attributed to Hedge, J..

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Evolutionary processes driving the rise and fall of Staphylococcus aureus ST239, a dominant hybrid pathogen

Staphylococcus aureus ST239 has been one of the most successful epidemic MRSA strains, and one of the leading causes of healthcare-associated MRSA infections. Here we investigate the evolution of ST239 using a combination of computational and experimental approaches. ST239 is thought to have emerged by a large scale chromosomal replacement event in which an ST8 clone acquired approximately 600 kb of DNA from an ST30 clone. Analysis of large-scale genomic data sets allowed us to confirm and refine the model of the origin of ST239. Importantly, we found that ST239 originated between the 1920s and 1945, implying that this MRSA lineage evolved at least 14 years before the clinical introduction of methicillin. Molecular evolution within ST239 has been dominated by purifying selection, although we found some evidence that the acquired region of the genome has evolved rapidly as a result of relaxed selective constraints. Crucially, we found that ST239 isolates have low competitive ability relative to both ST30 and ST8, demonstrating that this hybrid lineage is characterized by low fitness. We also found evidence of positive selection in a small number of genes involved in antibiotic resistance and virulence, suggesting that ST239 has evolved towards an increasingly pathogenic lifestyle. Collectively, these results support the view that low fitness has driven the recent decline of ST239, and highlight the challenge of using evolutionary approaches to understand the dynamics of pathogenic bacteria.

evolutionary biology

Rapid evolution drives the rise and fall of carbapenem resistance during an acute Pseudomonas aeruginosa infection

It is well established that antibiotic treatment selects for resistance in pathogenic bacteria. However, the evolutionary responses of pathogen populations to antibiotic treatment during infections remain poorly resolved, especially in acute infections. Here we map the evolutionary responses to treatment in high definition through genomic and phenotypic characterization of >100 isolates from a patient with P. aeruginosa pneumonia. Antibiotic therapy (meropenem, colistin) caused a rapid crash of the P. aeruginosa population in the lung, but this decline was followed by the spread of meropenem resistance mutations that restrict antibiotic uptake (oprD) or modify LPS biosynthesis (wbpM). Low fitness strains with high-level meropenem resistance (oprD) were then replaced by high fitness strains with anti-resistance mutations in the MexAB-OprM efflux pump, causing a rapid decline in resistance to both meropenem and a collateral loss of resistance to a broad spectrum of antibiotics. In contrast, we did not observe any evolutionary responses to antibiotic treatment in the intestinal population of P. aeruginosa. Carbapenem antibiotics are key to the treatment of infections caused by Gram negative pathogens, and our work highlights the ability of natural selection to drive both the rapid rise and fall of carbapenem resistance during acute infections.

evolutionary biology