{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T03:18:11Z","timestamp":1781925491261,"version":"3.54.5"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p><jats:italic>Pseudomonas aeruginosa<\/jats:italic> is an opportunistic pathogen responsible for nosocomial infections in critically ill and immunocompromised patients. To elucidate genomic-phenotypic-clinical correlations in <jats:italic>P. aeruginosa<\/jats:italic> infections, this study integrates targeted next-generation sequencing (tNGS) with conventional diagnostics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was conducted between September, 2023 and December, 2024 at The Second Affiliated Hospital of Guangxi Medical University on patient specimens that were subjected to both conventional culture and tNGS testing. Only a single Gram-negative bacterium, <jats:italic>P. aeruginosa<\/jats:italic>, was detected by tNGS, and these isolates were subsequently analyzed in order to compare their genomic profiling (virulence\/resistance genes), antimicrobial susceptibility testing (AST), and clinical characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 105 samples were included in the study. Exoenzyme Y gene (<jats:italic>exoY<\/jats:italic>) and O-antigen polymerase gene (<jats:italic>wzy<\/jats:italic>) were detected in 77.1% and 12.4% of the samples, respectively. Meanwhile, aminoglycoside acetyltransferase gene (<jats:italic>aac(6\u2019)aac(3\u2019)<\/jats:italic>), aminoglycoside resistance methyltransferase gene (<jats:italic>armA<\/jats:italic>), and chloram phenicol resistance genes (<jats:italic>cmlA<\/jats:italic>) were detected in 6.7%, 4.8%, and 12.4% of the samples, respectively. <jats:italic>P. aeruginosa<\/jats:italic> isolates detected the <jats:italic>exoY<\/jats:italic> gene exhibit a higher level of drug resistance, particularly to cefepime (32.1% vs 4.2%, <jats:italic>p<\/jats:italic>&amp;lt;0.05) and piperacillin-tazobactam (33.3% vs 8.3%, <jats:italic>p<\/jats:italic>&amp;lt;0.05). <jats:italic>aac(6\u2019)aac(3\u2019)<\/jats:italic> and <jats:italic>armA<\/jats:italic> genes were statistically associated with tobramycin resistance (<jats:italic>p<\/jats:italic>&amp;lt;0.05). The use of antibiotics before hospitalization (within 90 days), hospital-acquired infections, ICU admission, as well as pre-<jats:italic>P. aeruginosa<\/jats:italic> detection interventions including invasive procedures, catheterization, mechanical ventilation, duration of antibiotic use time\u226514 days, and antibiotic use type \u22653 types (<jats:italic>p<\/jats:italic>&amp;lt;0.05) is associated with multidrug-resistant (MDR) and carbapenem-resistant <jats:italic>P. aeruginosa<\/jats:italic> (CRPA) infections (<jats:italic>p<\/jats:italic>&amp;lt;0.05). Furthermore, the detection of MDR and CRPA strains appears to lead to an increase in the duration and variety of antibiotic use, as well as prolonged of hospital stay (<jats:italic>p<\/jats:italic>&amp;lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study highlights the importance of integrating tNGS results, which provide insights into pathogen identification, resistance, and virulence genes, with phenotypic and clinical data in order to enhance the accuracy of diagnosis and guide treatment strategies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2025.1563741","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T05:17:35Z","timestamp":1748236655000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The relationship between virulence and drug resistance genes in Pseudomonas aeruginosa and antibiotic resistance: a targeted next-generation sequencing approach"],"prefix":"10.3389","volume":"15","author":[{"given":"Huanhuan","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyong","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijuan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyi","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyi","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoning","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3500","DOI":"10.1099\/mic.0.031443-0","article-title":"Pseudomonas aeruginosa recognizes and responds aggressively to the presence of polymorphonuclear leukocytes","volume":"155","author":"Alhede","year":"2009","journal-title":"Microbiol. 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