Pseudomonas aeruginosa ST4936 with extensive antibacterial drug resistance and virulence determinants from ureteral stent biofilms: whole-genome insights.

Newly emerging Pseudomonas aeruginosa sequence types carrying diverse antibacterial resistance and virulence determinants pose serious clinical concerns. This study aimed to characterize the genomic features of P. aeruginosa isolates recovered from ureteral stent biofilms, focusing on antibacterial drug resistance genes, virulence determinants, and mobile genetic elements. P. aeruginosa isolates were confirmed phenotypically and underwent whole-genome sequencing. Multilocus sequence typing and phylogenomic, pangenomic analysis, and comprehensive bioinformatics tools were used to investigate the genomic determinants. All isolates belonged to ST4936 and clustered together phylogenetically, while exhibiting notable genomic variations. Resistome analysis identified acquired resistance genes, including blaIMP-34, blaOXA-10, aac(6')-Ib, aadA6, rmtF, sul1, dfrA15, and crpP, in addition to several intrinsic resistance genes. A total of 207 virulence-associated genes were detected, including type III secretion system (exoU, exoY, and exoT), alginate (algU, algW, mucA, mucD), flagellar genes (fliC, fliD, fleI, fleP), quorum sensing (lasI, lasR, rhlR), pyoverdine (pvdA, pvdE, pvdD, pvdS) and type IV pili (pilA, pilB). Four insertion sequences (ISPa6, ISPa7, ISPa32, and ISPa26) and multiple prophages were identified. Pangenomic analysis revealed extensive accessory gene content and genome rearrangements. To the best of our knowledge, this is the first genomic characterization of ST4936 P. aeruginosa isolated from ureteral stent biofilms in Pakistan. The combination of extensive antibacterial resistance determinants, numerous virulence factors, and mobile genetic elements suggests that ST4936 might have the potential to persist in ureteral stent-associated infections and limit antibacterial treatment options. However, multicenter surveillance studies are required to determine its epidemiological significance in Pakistan.