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The emergence of strains with\n            <jats:italic>lasR<\/jats:italic>\n            loss-of-function alleles in chronic disease is well described and is thought to represent a specific adaptation to the host environment. However, the prevalence and virulence of these strains in acute infections remain unclear. This report describes observations revealing that\n            <jats:italic>lasR<\/jats:italic>\n            mutants were common among isolates from a large, multicenter clinical study of keratitis and were associated with worse clinical outcomes than LasR-intact strains despite reduced production of LasR-regulated factors. Additionally, these\n            <jats:italic>lasR<\/jats:italic>\n            mutants were closely related strains or clones, as determined by molecular analysis. Because bacterial keratitis is community acquired, these data indicate infection by endemic, LasR-deficient strains in the environment. These results suggest that the conventional paradigm regarding the role for LasR-mediated regulation of virulence is more complex than previously appreciated.\n          <\/jats:p>","DOI":"10.1128\/msphere.00140-16","type":"journal-article","created":{"date-parts":[[2016,9,8]],"date-time":"2016-09-08T02:18:58Z","timestamp":1473301138000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":53,"title":["Environmentally Endemic Pseudomonas aeruginosa Strains with Mutations in\n            <i>lasR<\/i>\n            Are Associated with Increased Disease Severity in Corneal Ulcers"],"prefix":"10.1128","volume":"1","author":[{"given":"John H.","family":"Hammond","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wesley 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