Coculture of Staphylococcus aureus with Pseudomonas aeruginosa Drives S. aureus towards Fermentative Metabolism and Reduced Viability in a Cystic Fibrosis Model
ABSTRACTThe airways of patients with cystic fibrosis are colonized with diverse bacterial communities that change dynamically during pediatric years and early adulthood.Staphylococcus aureusis the most prevalent pathogen during early childhood, but during late teens and early adulthood, a shift in microbial composition occurs leading toPseudomonas aeruginosacommunity predominance in ∼50% of adults. We developed a robust dual-bacterialin vitrococulture system ofP. aeruginosaandS. aureuson monolayers of human bronchial epithelial cells homozygous for the ΔF508 cystic fibrosis transmembrane conductance regulator (CFTR) mutation to better model the mechanisms of this interaction. We show thatP. aeruginosadrives theS. aureusexpression profile from that of aerobic respiration to fermentation. This shift is dependent on the production of both 2-heptyl-4-hydroxyquinolineN-oxide (HQNO) and siderophores byP. aeruginosa. Furthermore,S. aureus-produced lactate is a carbon source thatP. aeruginosapreferentially consumes over medium-supplied glucose. We find that initiallyS. aureusandP. aeruginosacoexist; however, over extended cocultureP. aeruginosareducesS. aureusviability, also in an HQNO- andP. aeruginosasiderophore-dependent manner. Interestingly,S. aureussmall-colony-variant (SCV) genetic mutant strains, which have defects in their electron transport chain, experience reduced killing byP. aeruginosacompared to their wild-type parent strains; thus, SCVs may provide a mechanism for persistence ofS. aureusin the presence ofP. aeruginosa. We propose that the mechanism ofP. aeruginosa-mediated killing ofS. aureusis multifactorial, requiring HQNO andP. aeruginosasiderophores as well as additional genetic, environmental, and nutritional factors.IMPORTANCEIn individuals with cystic fibrosis,Staphylococcus aureusis the primary respiratory pathogen during childhood. During adulthood,Pseudomonas aeruginosapredominates and correlates with worse patient outcome. The mechanism(s) by whichP. aeruginosaoutcompetes or killsS. aureusis not well understood. We describe anin vitrodual-bacterial species coculture system on cystic fibrosis-derived airway cells, which models interactions relevant to patients with cystic fibrosis. Further, we show that molecules produced byP. aeruginosaadditively induce a transition ofS. aureusmetabolism from aerobic respiration to fermentation and eventually lead to loss ofS. aureusviability. Elucidating the molecular mechanisms ofP. aeruginosacommunity predominance can provide new therapeutic targets and approaches to impede this microbial community transition and subsequent patient worsening.