Biology subjects

Kostoulias, X.

Publications and source records attributed to Kostoulias, X..

6 recordsLinked to original sources

bioRxiv2026

Developing a sensitive indoor air surveillance approach for nosocomial pathogens and antimicrobial resistance

The role of bioaerosols in the transmission of pathogens and antimicrobial resistance (AMR) is of increasing clinical importance, particularly in settings housing vulnerable populations. Air filtration (e.g. HEPA filtration) and ventilation (e.g. minimum air changes per hour) measures are designed to restrict the airborne transmission of microorganisms. Despite these measures, airborne transmission remains a persistent issue in hospitals, workplaces, aged care, and schools, and is not typically assessed in routine surveillance for infection prevention. Here, we evaluated the efficacy of a high-volume air sampling approach to capture the indoor 'aerobiome', and investigated the potential for bioaerosols to mediate disease and AMR transmission in workplace and hospital settings. Our sampling approach demonstrates the benefits of simple decontamination procedures and personal protective equipment on the ability to distinguish genuine low biomass signals in air samples from blank controls, enabling reliable and sensitive microbial detection down to a limit of 69 bacterial cells/m3 of air. In a workplace bathroom setting, increased airborne biomass was strongly associated with human activity. This diminished significantly after a few hours of no activity, yet persisted in the indoor environment, with viable identical bacterial strains recovered from bioaerosols and bathroom surfaces across months of sampling. Applying our approach in a hospital ward, air samples from occupied patient rooms were not distinguishable from blank controls and contained negligible fungal and bacterial content, with only trace contributions from human occupancy. Our findings indicate that air filtration measures in this ward are effective at minimising airborne risks, but periodic testing of high-risk areas may be valuable in indoor settings with greater human traffic and may contribute key information to outbreak investigations.

microbiology↗

bioRxiv2025

Comparative analysis of shared and unique mechanisms important for diverse strains of Pasteurella multocida to cause systemic infection in mice

Pasteurella multocida is a Gram-negative bacterium that causes a range of distinct diseases in livestock animals. Different P. multocida diseases are associated with different capsule and lipopolysaccharide (LPS) types, but little else is known about what underpins this disease specificity. In this study, we utilised transposon-directed insertion site sequencing (TraDIS) to identify genes in two diverse P. multocida strains that are required for growth in rich media, and genes important for survival during systemic infections in BALB/c mice. Analysis of growth in heart infusion broth showed that the fowl cholera isolate VP161 (capsule type A and LPS type L1) and the bovine haemorrhagic septicaemia isolate M1404 (capsule type B and LPS type L2) shared 461 genes essential for growth in rich media, with 95% of these present in all publicly available closed P. multocida genomes. In vivo fitness analysis identified 63 and 94 genes important for VP161 and M1404 survival in BALB/c mice, respectively. Only 35 homologs were identified as important for survival in both strains, showing that conserved biological systems can be differentially important for different P. multocida strains. Investigation of proteins involved in the catabolite response showed that an active cyclic-adenosine monophosphate (cAMP) receptor protein (CRP) was required for maximal fitness in M1404. Furthermore, disrupting CRP or cAMP production also reduced capsule production in M1404, but increased capsule production in VP161, demonstrating that these P. multocida strains have different regulatory systems for crucial virulence factors. Author SummaryPasteurella multocida is an important livestock pathogen, causing several distinct severe diseases in many different livestock animals. P. multocida can spread rapidly throughout animal populations, with peracute infections causing death within 48 h, resulting in large outbreaks with high mortality. Host predilection and disease presentation often correlate with the capsule and lipopolysaccharide type produced by the causative strain. However, the processes that allow certain strains to cause a particular disease are not well understood. In this study, we have comprehensively identified genes required for two P. multocida strains to cause systemic infection in mice, showing that these diverse strains have differential requirements for survival during a systemic infection. This information is crucial for understanding P. multocida diseases and for the development of new strategies to combat infection.

microbiology↗

bioRxiv2025

Bacterial species and surface structures shape gene transfer and the transcriptional landscape during early conjugation

Conjugative plasmids drive bacterial evolution and niche adaptation, yet how their active acquisition reshapes host transcription remains poorly understood. Most studies focus on stable plasmid carriage, overlooking the dynamic transcriptional changes during conjugation itself. Here, we show that active RP4 conjugation triggers an immediate, host- and surface factor-dependent transcriptional response. This includes activation of non-SOS stress pathways, motility, exopolysaccharide production, anaerobic respiration, and metabolic adaptation. These responses do not inhibit conjugation, suggesting they serve to maintain host homeostasis. Capsule expression blocks these responses by preventing conjugation, and also inhibits RP4 activation by physically blocking donor-recipient contact. Unexpectedly, RP4 overcomes this barrier by exploiting single-cell variation in recipient capsule thickness, successfully conjugating with thin-capsulated recipients. These findings reveal a striking interplay between plasmid, host, and surface architecture in shaping the conjugation transcriptional landscape, with broad implications for plasmid dissemination and bacterial evolution.

microbiology↗

bioRxiv2024

Rational Design of Frontline Institutional Phage Cocktail for the Treatment of Nosocomial Enterobacter cloacae Complex Infections

Phage therapy is a promising strategy to treat antimicrobial-resistant infections. Currently, phage therapy applications span personalised treatments that are tailored for a given patients infection, through to the use of pre-established cocktails of virulent phages against clinically relevant pathogens. However, both approaches face challenges, with personalised phage therapy being time-consuming and requiring a phage match to a patients infection, while phage cocktails may not be effective against a patients specific strain. The Alfred Hospital in Melbourne, Australia has reported an ongoing outbreak of infections by the Enterobacter cloacae complex (ECC), a group of emerging multidrug-resistant pathogens responsible for considerable morbidity and mortality. Utilising the hospitals strain collection, built over the last decade, we established an initial three-phage product with 54% ECC coverage that effectively reduced bacterial loads (>99%) in septicaemic mice. We then iteratively improved this product by enhancing phage killing efficiency using phage training and expanded host range through targeted phage isolation against low-coverage ECC strains. This iterative optimisation led to the creation of the product Entelli-02, containing five well characterised virulent phages that target clinical ECC strains through distinct bacterial cell surface receptors. Importantly, Entelli-02 exhibits broad host coverage (99%) and efficacy (92%) against The Alfred Hospitals ECC strain collection (n = 156). We produced this as a therapeutic-grade product, verified and endotoxin unit compliant, ready for use. This approach integrated academic phage research with clinical insights to produce the phage product Entelli-02 as an institution-specific phage cocktail with frontline efficacy and on-demand availability. SUMMARYO_ST_ABSIn briefC_ST_ABSWe developed a phage product containing five phages with frontline potential to address infections caused by multidrug-resistant Enterobacter cloacae complex.

microbiology↗

bioRxiv2020

Bacteriophages targeting Acinetobacter baumannii capsule induce antimicrobial resensitization

Carbapenem-resistant Acinetobacter baumannii is responsible for frequent, hard-to-treat and often fatal healthcare-associated infections. Phage therapy, the use of viruses that infect and kill bacteria, is an approach gaining significant clinical interest to combat antibiotic-resistant infections. However, a major limitation is that bacteria can develop resistance against phages. Here, we isolated phages with activity against a panel of A. baumannii strains and focused on clinical isolates AB900 and A9844 and their phages for detailed characterization. As expected, coincubation of the phages with their hosts in vitro resulted in the emergence of phage-resistant bacterial mutants. Genome sequence analysis revealed that phage-resistant mutants harbored loss-of-function mutations in genes from the K locus, responsible for the biosynthesis of the bacterial capsule. Using molecular biology techniques, phage adsorption assays, and quantitative evaluation of capsule production, we established that the bacterial capsule serves as the primary receptor for these phages. As a collateral phenotype of impaired capsule production, the phage-resistant strains could not form biofilms, became fully sensitized to the human complement system, showed increased susceptibility to beta-lactam antibiotics, and became vulnerable to additional phages. Finally, in a murine model of bacteremia, the phage-resistant A. baumannii demonstrated a diminished capacity to colonize blood and solid tissues. This study demonstrates that phages can be used not only for their lytic activity but, if combined with a posteriori knowledge of their receptors and the mechanism of bacterial resistance, for their potential synergy with other antimicrobial agents, thus providing even broader clinical options for phage therapy.

microbiology↗

bioRxiv2017

Evolution of carbapenem resistance in Acinetobacter baumannii during a prolonged infection

Acinetobacter baumannii is a common causative agent of hospital-acquired infections and a leading cause of infection in burns patients. Carbapenem resistant A. baumannii is considered a major public health threat and has been identified by the World Health Organization as the top priority organism requiring new antimicrobials. The most common mechanism for carbapenem resistance in A. baumannii is via horizontal acquisition of carbapenemase genes. In this study, we sampled 20 A. baumannii isolates from a patient with extensive burns, and characterized the evolution of carbapenem resistance over a 45-day period via Illumina and Oxford Nanopore sequencing. All isolates were multi-drug resistant, carrying two genomic islands that harboured several antibiotic resistance genes. Most isolates were genetically identical and represent a single founder genotype. We identified three novel non-synonymous substitutions associated with meropenem resistance: F136L and G288S in AdeB (part of the AdeABC efflux pump) associated with an increase in meropenem MIC to [≥]8 g/mL; and A515V in FtsI (PBP3, a penicillin-binding protein) associated with a further increase in MIC to 32 g/mL. Structural modelling of AdeB and FtsI showed that these mutations affected their drug binding sites and revealed mechanisms for meropenem resistance. Notably, one of the adeB mutations arose prior to meropenem therapy but following ciprofloxacin therapy, suggesting exposure to one drug whose resistance is mediated by the efflux pump can induce collateral resistance to other drugs to which the bacteria has not yet been exposed.\n\nDATA SUMMARYO_LIAll raw genome sequences, including Illumina paired end short reads and Oxford Nanopore long reads, have been deposited in the SRA under project PRJNA396979. Individual accessions for each strain are provided in Table S1.\nC_LIO_LIThe annotated genome assembly for strain A2, the reference genome for the founder genotype, has been submitted to GenBank under accession CP024124 (chromosome) and CP024125 (plasmid).\nC_LIO_LIHybrid assemblies for strains A1, A3, A8, A13, A15, A17 and A20 are available in FigShare, doi: 10.4225/49/5987e14e9b530 (note they were not deposited in GenBank as they differ from A2 by only 1-4 SNPs as indicated).\nC_LI\n\nIMPACT STATEMENTSAcinetobacter baumannii is a highly drug resistant pathogen that is frequently found within intensive care units (ICUs) and especially impacts patients with severe burns. While several studies have examined the global population structure of A. baumannii, few have investigated within-host evolution of A. baumannii in direct response to antibiotic treatment in a single patient. Here, we analysed the genetic evolution of A. baumannii isolated from a patient with severe burns over the course of their stay in ICU. The A. baumannii population on this patient was highly drug resistant, carrying two distinct genomic islands encoding resistance to several antibiotics but not carbapenems. The bacterial population comprised four distinct subclades, two of which had evolved carbapenem resistance over the course of antibiotic treatment through novel mutations in genes associated with drug binding. One subclade was also transmitted to another patient on the ward. While carbapenem resistance is common in A. baumannii, this is generally attributed to horizontally transferred carbapenemase genes. These data provide evidence for carbapenem resistance arising in vivo via non-synonymous substitutions during a single infection episode, demonstrating carbapenem resistance can emerge in genetic isolation in response to exposure to carbapenems and other drugs.

genomics↗