Persistent Bacterial Coinfection of a COVID-19 Patient Caused by a Genetically Adapted Pseudomonas aeruginosa Chronic Colonizer

Pseudomonas aeruginosa is a biofilm-forming opportunistic pathogen which causes chronic infections in immunocompromised patients and leads to high mortality rate. It identified as common coinfecting COVID-19 causing exacerbation of illness. In our hospital, P. one the top bacteria among patients. We collected strong strain displaying small colony variant morphology from severe patient. Genomic transcriptomic sequencing analyses were performed with phenotypic validation investigate its adaptation SARS-CoV-2 infected environment. characterization predicted specific genomic islands highly associated virulence, transcriptional regulation, DNA restriction-modification systems. Epigenetic analysis revealed N 6 -methyl adenine (m A) methylating pattern including methylation alginate, flagellar quorum sensing genes. Differential gene expression indicated that this isolate formed excessive biofilm by reducing formation (7.4 1,624.1 folds) overproducing extracellular matrix components CdrA (4.4 folds), alginate (5.2 29.1 Pel (4.8–5.5 folds). summary, we demonstrated aeuginosa clinical isolates novel epigenetic markers could form biofilm, might enhance antibiotic resistance vivo colonization