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Chronic lung infection by  Pseudomonas aeruginosa  is the leading cause of morbidity and mortality in cystic fibrosis (CF) patients. This is associated with the conversion of the non-mucoid to the mucoid phenotype. However, there is little information about the occurrence of alginate-producing  P .  aeruginosa  in CF patients outside Europe and North America. The aim of the present study was to investigate mutations in the  algTmucABD  operon in mucoid and non-mucoid isolates from Brazilian CF patients. Twenty-seven mucoid and 37 non-mucoid isolates from 40 CF patients chronically infected by  P .  aeruginosa  attending a CF reference center in Brazil were evaluated by sequence analysis. Mutations in  mucA  were observed in 93% of the mucoid isolates and 54% of the non-mucoid isolates. Among these non-mucoid isolates, 55% were considered revertants, since they also had mutations in  algT  ( algU ). Most isolates associated with moderate alginate production presented point mutations in  mucB  and/or  mucD . We identified 30 mutations not previously described in the operon. In conclusion, mutations in  mucA  were the main mechanism of conversion to mucoidy, and most of the non-mucoid isolates were revertants, but the mechanism of revertance is not fully explained by changes in  algT .

plos one

Adaptation of Pseudomonas aeruginosa to the chronic phenotype by mutations in the algTmucABD operon in isolates from Brazilian cystic fibrosis patients