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Pathogen-pathogen interactions in polymicrobial infections are known to directly impact, often to worsen, disease outcomes. For example, co-infection with  Pseudomonas aeruginosa  and  Aspergillus fumigatus , respectively the most common bacterial and fungal pathogens isolated from cystic fibrosis (CF) airways, leads to a worsened prognosis. Recent studies of  in vitro  microbial cross-talk demonstrated that  P. aeruginosa -derived volatile sulfur compounds (VSCs) can promote  A. fumigatus  growth  in vitro . However, the mechanistic basis of such cross-talk and its physiological relevance during co-infection remains unknown. In this study we combine genetic approaches and GC-MS-mediated volatile analysis to show that  A. fumigatus  assimilates VSCs via cysteine (CysB)- or homocysteine (CysD)-synthase. This process is essential for utilization of VSCs as sulfur sources, since  P. aeruginosa -derived VSCs trigger growth of  A. fumigatus  wild-type, but not of a Δ cysB Δ cysD  mutant, on sulfur-limiting media.  P. aeruginosa  produces VSCs when infecting  Galleria mellonella  and co-infection with  A. fumigatus  in this model results in a synergistic increase in mortality and of fungal and bacterial burdens. Interestingly, the increment in mortality is much greater with the  A. fumigatus  wild-type than with the Δ cysB Δ cysD  mutant. Therefore,  A. fumigatus’  ability to assimilate  P. aeruginosa  derived VSCs significantly triggers a synergistic association that increases the pathobiology of infection. Finally, we show that  P. aeruginosa  can promote fungal growth when growing on substrates that resemble the lung environment, which suggests that this volatile based synergism is likely to occur during co-infection of the human respiratory airways.

frontiers in microbiology

Pseudomonas aeruginosa-Derived Volatile Sulfur Compounds Promote Distal Aspergillus fumigatus Growth and a Synergistic Pathogen-Pathogen Interaction That Increases Pathogenicity in Co-infection