{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T01:43:14Z","timestamp":1772502194434,"version":"3.50.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"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. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Whole genome sequencing (WGS) was performed on 10 extensively drug-resistant (XDR)\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      ST235 isolates to investigate potential healthcare-associated transmission of XDR P. aeruginosa ST235 within a U.S. military treatment facility (MTF), assess its environmental persistence, and determine its genomic relatedness to global strains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patient samples were collected and processed using standard clinical protocols. To assess potential environmental contamination, ICU sink drains from rooms previously occupied by study patients were swabbed, cultured in BHI and BAP media, and screened by PCR targeting 16S rRNA and\n                      <jats:italic>P. aeruginosa ecfX<\/jats:italic>\n                      . Isolates included 2 from the index patient with prior hospitalization in the Philippines, 4 from a secondary patient in the same ICU, and 4 from the index patient\u2019s room sink collected 9 months later. Genetic relatedness was evaluated using core genome multilocus sequence typing (cgMLST) and single nucleotide polymorphism (SNP) analysis. Antimicrobial resistance genes were identified with AMRFinderPlus, and global phylogenetic comparisons were performed using publicly available genomes from NCBI and the MRSN database.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 6 clinical isolates differed by only 0\u20134 SNPs, indicating high genetic relatedness. The 4 environmental isolates differed from the clinical isolates by just 1 allele in cgMLST and 0\u20134 SNPs. Global phylogenetic analysis showed close clustering with ST235 strains from the Philippines, with the closest match being a 2018 Manila isolate (1\u201312 allele differences). The isolates carried the blaVIM-2 carbapenemase gene and exhibited resistance to all tested antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>WGS surveillance revealed an undetected intra-hospital transmission of XDR P. aeruginosa ST235 and its persistence in the environment for at least nine months. The findings underscore the importance of genomic surveillance in identifying AMR outbreaks, especially among patients returning from high-risk regions, and proactive infection control measures to prevent the spread of high-risk AMR clones in healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2025.1741917","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T10:29:17Z","timestamp":1768300157000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unveiling a hidden threat: whole genome sequencing exposes the cross-hospital spread of extensively drug-resistant Pseudomonas aeruginosa"],"prefix":"10.3389","volume":"16","author":[{"given":"Edwin","family":"Kamau","sequence":"first","affiliation":[{"name":"Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"Jones","sequence":"additional","affiliation":[{"name":"Multidrug Resistant Organism Repository and Surveillance Network, Bacterial Diseases Branch, CIDR, Walter Reed Army Institute of Research","place":["Silver Spring, MD, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatdanai","family":"Kitjawat","sequence":"additional","affiliation":[{"name":"Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han Ha","family":"Youn","sequence":"additional","affiliation":[{"name":"Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Schweikert","sequence":"additional","affiliation":[{"name":"Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Caldwell","sequence":"additional","affiliation":[{"name":"Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Harens","sequence":"additional","affiliation":[{"name":"Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick T.","family":"Kiernan","sequence":"additional","affiliation":[{"name":"Naval Medical Center San Diego","place":["San Diego, CA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Mark","family":"Velasco","sequence":"additional","affiliation":[{"name":"Walter Reed Army Institute of Research \u2013 Armed Forces Research Institute of Medical Sciences","place":["Quezon City, Philippines"]},{"name":"National Institutes of Health, University of the Philippines Manila, Ermita","place":["Manila, Philippines"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francois","family":"Lebreton","sequence":"additional","affiliation":[{"name":"Multidrug Resistant Organism Repository and Surveillance Network, Bacterial Diseases Branch, CIDR, Walter Reed Army Institute of Research","place":["Silver Spring, MD, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathanial K.","family":"Copeland","sequence":"additional","affiliation":[{"name":"Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"47","DOI":"10.3201\/eid3014.240152","article-title":"Molecular surveillance of multidrug-resistant bacteria among refugees from afghanistan in 2 us military hospitals during operation allies refuge, 2021.","volume":"30","author":"Anderson","year":"2024","journal-title":"Emerg. 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