Distribution of MGEs across the ESKAPE pathogens. (A) Maximum likelihood tree representing the ESKAPE genomes. Tree nodes are coloured according to the ESKAPE pathogen. Three bar charts with aligned fields are shown outside the tree: the innermost bar chart shows the density of ICEs/IMEs, while the density of prophages and plasmids across the genomes are shown in the middle and outermost bar charts, respectively. (B) Total number of MGEs and of considered masked genomes per ESKAPE pathogen. Size of the circles is proportional to the number of identified elements. (C) Proportion of genomes carrying at least one plasmid, ICE/IME or prophage. (D) Total number of RGPs and ICEs/IMEs per ESKAPE. The size of the green bars is proportional to the total number of ICEs/IMEs identified per ESKAPE pathogen, and the relative number of ICEs/IMEs per RGPs is shown in percentage next to the green bars. Bars are sorted according to the relative number of ICEs/IMEs per RGPs. Ab, A. baumannii; Ef, E. faecium; En, Enterobacter sp.; Kp, K. pneumoniae; Pa, P. aeruginosa; Sa, S. aureus.

Distribution of MGEs across the ESKAPE pathogens. (A) Maximum likelihood tree representing the ESKAPE genomes. Tree nodes are coloured according to the ESKAPE pathogen. Three bar charts with aligned fields are shown outside the tree: the innermost bar chart shows the density of ICEs/IMEs, while the density of prophages and plasmids across the genomes are shown in the middle and outermost bar charts, respectively. (B) Total number of MGEs and of considered masked genomes per ESKAPE pathogen. Size of the circles is proportional to the number of identified elements. (C) Proportion of genomes carrying at least one plasmid, ICE/IME or prophage. (D) Total number of RGPs and ICEs/IMEs per ESKAPE. The size of the green bars is proportional to the total number of ICEs/IMEs identified per ESKAPE pathogen, and the relative number of ICEs/IMEs per RGPs is shown in percentage next to the green bars. Bars are sorted according to the relative number of ICEs/IMEs per RGPs. Ab, A. baumannii; Ef, E. faecium; En, Enterobacter sp.; Kp, K. pneumoniae; Pa, P. aeruginosa; Sa, S. aureus.

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Mobile genetic elements (MGEs) mediate the shuffling of genes among organisms. They contribute to the spread of virulence and antibiotic resistance (AMR) genes in human pathogens, such as the particularly problematic group of ESKAPE pathogens. Here, we performed the first systematic analysis of MGEs, including plasmids, prophages, and integrative a...

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... this parameter is only applied for species delineation, we also built a phylogenomic tree with Enterobacter sp. genomes and type strains belonging to the Enterobacteriaceae family (Supplementary Figure S1). Our curated dataset included 1746 complete genomes which belong to 451 different MLST profiles (Supplementary Table S2). ...
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... curated dataset included 1746 complete genomes which belong to 451 different MLST profiles (Supplementary Table S2). We found a total of 21 478 MGEs, including 16 153 prophages, 2685 ICEs/IMEs and 2640 plasmids ( Figure 1A and B). The density of these MGEs (i.e. the cumulative length of each MGE type per genome length) shows a patchy distribution across the ESKAPE phylogeny ( Figure 1A and Supplementary Figure S2). ...
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... found a total of 21 478 MGEs, including 16 153 prophages, 2685 ICEs/IMEs and 2640 plasmids ( Figure 1A and B). The density of these MGEs (i.e. the cumulative length of each MGE type per genome length) shows a patchy distribution across the ESKAPE phylogeny ( Figure 1A and Supplementary Figure S2). S. aureus genomes are densely populated by prophages, while ICEs/IMEs are prevalent in P. aeruginosa. ...
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... pneumoniae and Enterobacter are populated by plasmids and prophages. In fact, plasmids were prevalent in every ESKAPE except P. aeruginosa and S. aureus Figures 1A and C). The majority of plasmids carried a relaxase (62.5%, 1651/2640), and were classified as mobilizable (either self-conjugative or not) (64). ...
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... majority of plasmids carried a relaxase (62.5%, 1651/2640), and were classified as mobilizable (either self-conjugative or not) (64). Curiously, E. faecium genomes have high densities of both prophages, plasmids and ICEs/IMEs ( Figure 1A). ...
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... look for RGPs exclusively integrated in the chromosome, we used the 1746 chromosomal replicons to generate plasmid-free pangenomes for each ESKAPE taxon. We identified a total of 50482 plasmid-free RGPs in chromosomal replicons ( Figure 1D). Of these, 2685 were classified as ICEs/IMEs due to the presence of relaxase and integrase domains ( Figure 1B and D). ...
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... identified a total of 50482 plasmid-free RGPs in chromosomal replicons ( Figure 1D). Of these, 2685 were classified as ICEs/IMEs due to the presence of relaxase and integrase domains ( Figure 1B and D). At least one ICE/IME was detected in >50% of genomes for all ESKAPE pathogens and was abundant in E. faecium and P. aeruginosa (∼3 elements/genome) ( Figure 1B and C). ...
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... these, 2685 were classified as ICEs/IMEs due to the presence of relaxase and integrase domains ( Figure 1B and D). At least one ICE/IME was detected in >50% of genomes for all ESKAPE pathogens and was abundant in E. faecium and P. aeruginosa (∼3 elements/genome) ( Figure 1B and C). After masking the ICEs/IMEs identified in the ESKAPE chromosomes, we performed a search for prophages. ...
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... observed that AMR genes are broadly distributed in plasmids across the ESKAPE pathogens. Even though the total number of prophages far outnumber that of plasmids in our collection (Figure 1), the absolute count of AMR genes in plasmids is greater than that observed in prophages (6068 versus 1845, respectively) (Supplementary Figure S9). Interestingly, most AMR genes in plasmids and prophages are found in K. pneumoniae, whereas P. aeruginosa carries the majority of these genes within ICEs/IMEs (Supplementary Table S4). ...
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... most AMR genes in plasmids and prophages are found in K. pneumoniae, whereas P. aeruginosa carries the majority of these genes within ICEs/IMEs (Supplementary Table S4). All ESKAPE pathogens have a large proportion of AMR-carrying plasmids (>35% of plasmids across the different ESKAPE carry at least one AMR gene), while a high proportion of AMR-harbouring ICEs (>25%) was only observed for S. aureus and P. aeruginosa (Supplementary Figures S10A and B). As previously reported (72), we observed that AMR genes are rarely found in prophages (<12% of prophages across the different ES-KAPE carry at least one AMR gene) ( Supplementary Fig- ure S10C). ...
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... ESKAPE pathogens have a large proportion of AMR-carrying plasmids (>35% of plasmids across the different ESKAPE carry at least one AMR gene), while a high proportion of AMR-harbouring ICEs (>25%) was only observed for S. aureus and P. aeruginosa (Supplementary Figures S10A and B). As previously reported (72), we observed that AMR genes are rarely found in prophages (<12% of prophages across the different ES-KAPE carry at least one AMR gene) ( Supplementary Fig- ure S10C). As expected from the vast repertoire of MGEs present in K. pneumoniae ( Figure 1A), this species presented a wider selection of different AMR genes. ...
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... previously reported (72), we observed that AMR genes are rarely found in prophages (<12% of prophages across the different ES-KAPE carry at least one AMR gene) ( Supplementary Fig- ure S10C). As expected from the vast repertoire of MGEs present in K. pneumoniae ( Figure 1A), this species presented a wider selection of different AMR genes. Some AMR genes were restricted to specific ESKAPE pathogens, while others were more promiscuous. ...
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... next assessed the distribution of virulence genes. These genes are broadly distributed in prophages and ICEs/IMEs across the ESKAPE pathogens (Supplementary Figure S11 and Table S5). In fact, we identified no virulence genes in E. faecium plasmids, and only 0.6% of A. baumannii plasmids carry these genes. ...
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... fact, we identified no virulence genes in E. faecium plasmids, and only 0.6% of A. baumannii plasmids carry these genes. More than 25% ICEs/IMEs in S. aureus, K. pneumoniae, and E. faecium carried at least one virulence gene (Supplementary Figures S10C and D). P. aeruginosa is the ESKAPE pathogen carrying a wider variety of virulence genes in these MGEs, mostly on prophages. ...
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... pneumoniae and Enterobacter sp.). These virulence loci were mostly present in ICEs/IMEs, as previously reported (74), but we also found these genes on plasmids and prophages (Supplementary Figure S11 and Table S5). Interestingly, S. aureus was the ESKAPE pathogen with a higher proportion of both plasmids and ICEs/IMEs carrying at least one AMR or virulence genes (Supplementary Figure S10). ...
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... virulence loci were mostly present in ICEs/IMEs, as previously reported (74), but we also found these genes on plasmids and prophages (Supplementary Figure S11 and Table S5). Interestingly, S. aureus was the ESKAPE pathogen with a higher proportion of both plasmids and ICEs/IMEs carrying at least one AMR or virulence genes (Supplementary Figure S10). ...
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... the low prevalence of CRISPR-Cas systems in S. aureus, this species was also excluded, and we focused exclusively on P. aeruginosa, K. pneumoniae, and A. baumannii. Interestingly, some sequence types (ST) consisted entirely of either CRISPR-Cas positive or negative genomes (Supplementary Figure S12 and Table S2). For example, the most frequent MLST profile in A. baumannii from our dataset was ST2 (n = 101), which only included strains with no CRISPR-Cas systems. ...
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... contrast, ST233 and ST1971 (n = 8 for both) consisted exclusively of strains carrying the I-F CRISPR-Cas system on masked genomes (Supple- mentary Table S2). These findings suggest that the presence or absence of CRISPR-Cas systems across the ESKAPE pathogens is related to sequence type and thus most likely due to phylogenetic history of the strains (Supplementary Figure S12). ...
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... looking into the influence of GC content and sequence length in pairs of conspecific ESKAPE pathogens with and without CRISPR-Cas systems, we would expect to observe smaller and GC richer strains on those carrying these systems. Size expectations could only be met for P. aeruginosa, for which CRISPR-Cas positive genomes were significantly smaller than their counterparts (Supplementary Figure S13A, P-value 0.0028), as observed before (76-78). Surprisingly in K. pneumoniae, genomes with CRISPRCas systems were significantly larger than CRISPR-Cas negative genomes (Supplementary Figure S13A, P-value 0.0023). ...
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... expectations could only be met for P. aeruginosa, for which CRISPR-Cas positive genomes were significantly smaller than their counterparts (Supplementary Figure S13A, P-value 0.0028), as observed before (76-78). Surprisingly in K. pneumoniae, genomes with CRISPRCas systems were significantly larger than CRISPR-Cas negative genomes (Supplementary Figure S13A, P-value 0.0023). The non-significant differences observed for A. baumannii, Enterobacter sp. and S. aureus could in part be explained by the low sample size of CRISPR-Cas positive genomes ( Figure 6A). ...
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... the GC content, we observed significant differences in A. baumannii, K. pneumoniae, and P. aeruginosa. CRISPR-Cas positive genomes were GC richer in A. baumannii and P. aeruginosa (Supplementary Figure S13B, P-values 0.0013 and 0.046, respectively). Curiously, we noticed that CRISPR-Cas positive genomes in K. pneumoniae were GC poorer (Supplementary Figure S13B, P-value 5.7e−09). ...
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... positive genomes were GC richer in A. baumannii and P. aeruginosa (Supplementary Figure S13B, P-values 0.0013 and 0.046, respectively). Curiously, we noticed that CRISPR-Cas positive genomes in K. pneumoniae were GC poorer (Supplementary Figure S13B, P-value 5.7e−09). Given the known association between GC content and genome size (67), these GC differences in CRISPR-Cas positive and negative P. aeruginosa genomes may be a spurious correlation driven by small size of CRISPR-Cas positive genomes. ...
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... the known association between GC content and genome size (67), these GC differences in CRISPR-Cas positive and negative P. aeruginosa genomes may be a spurious correlation driven by small size of CRISPR-Cas positive genomes. So, we corrected the GC content for variation in genome size, and we observed that the association was maintained (Supplementary Figure S14A, P-value 0.0035), in accordance to a previous study (77). ...
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... virulence genes are overrepresented in the chromosome (Figure 5), we assessed the distribution of these genes in pairs of conspecific ESKAPE pathogens with and without CRISPR-Cas systems. Virulence genes were significantly less abundant in CRISPR-Cas positive genomes from P. aeruginosa and A. baumannii ( Supplementary Fig- ure S13C, P-values 4.1e−06 and 0.0016, respectively). Given that P. aeruginosa genomes positive for these systems are significantly smaller than their CRISPR-Cas negative counterparts (Supplementary Figure S13A), the lower prevalence of these genes in CRISPR-Cas positive P. aeruginosa genomes may again be driven by a spurious correlation. ...
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... genes were significantly less abundant in CRISPR-Cas positive genomes from P. aeruginosa and A. baumannii ( Supplementary Fig- ure S13C, P-values 4.1e−06 and 0.0016, respectively). Given that P. aeruginosa genomes positive for these systems are significantly smaller than their CRISPR-Cas negative counterparts (Supplementary Figure S13A), the lower prevalence of these genes in CRISPR-Cas positive P. aeruginosa genomes may again be driven by a spurious correlation. As so, we corrected the number of virulence genes for variation in genome size, and we observed that indeed the difference was no longer significant ( Supplementary Fig- ure S14B, P-value 0.74), confirming our prediction that the genome size was a confounding variable obscuring the effect of CRISPR-Cas systems on the prevalence of virulence genes in P. aeruginosa. ...
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... that P. aeruginosa genomes positive for these systems are significantly smaller than their CRISPR-Cas negative counterparts (Supplementary Figure S13A), the lower prevalence of these genes in CRISPR-Cas positive P. aeruginosa genomes may again be driven by a spurious correlation. As so, we corrected the number of virulence genes for variation in genome size, and we observed that indeed the difference was no longer significant ( Supplementary Fig- ure S14B, P-value 0.74), confirming our prediction that the genome size was a confounding variable obscuring the effect of CRISPR-Cas systems on the prevalence of virulence genes in P. aeruginosa. ...
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... this trend was only observed Nucleic Acids Research, 2023 11 in K. pneumoniae (Figure 7). The variation in the number of MGEs in genomes either with or without CRISPRCas systems still holds when correcting for genome size (Supplementary Figure S15). Finally, we focused on AMR and virulence genes carried exclusively by plasmids and ICEs/IMEs, as these were the most important vectors (Supplementary Figure S10). ...
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... variation in the number of MGEs in genomes either with or without CRISPRCas systems still holds when correcting for genome size (Supplementary Figure S15). Finally, we focused on AMR and virulence genes carried exclusively by plasmids and ICEs/IMEs, as these were the most important vectors (Supplementary Figure S10). For most MGE/ESKAPE pairs, we observed no significant difference between pairs of conspecific genomes with and without CRISPR-Cas systems. ...
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... most MGE/ESKAPE pairs, we observed no significant difference between pairs of conspecific genomes with and without CRISPR-Cas systems. When it comes to AMR genes, we only observed significant differences in MGEs from P. aeruginosa (Supplementary Figure S16A, P-values 0.037). Indeed, AMR genes were more prevalent on ICEs/IMEs from P. aeruginosa genomes with CRISPR-Cas systems (Supplementary Table S7). ...
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... the less prevalent I-C CRISPR-Cas subtype, which was exclusively identified in P. aeruginosa and mostly on ICEs/IMEs (Supplementary Table S6), was recently found to be positively correlated with certain AMR genes (76). Regarding virulence genes, we observed significant differences in MGEs from K. pneumoniae, where CRISPRCas-carrying elements were associated with more virulence genes than their CRISPR-Cas negative counterparts (Supplementary Figure S16B, P-values 0.0054). Taken together, we observed species-specific trends shaping the number of MGEs, AMR and virulence genes across pairs of conspecific ESKAPE genomes with and without CRISPR-Cas systems. ...
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... total of 1087 spacers was found across all MGEs (n = 554 on plasmids, n = 343 on ICEs/IMEs and n = 190 on prophages). Given the large number of MGEs and CRISPR-Cas-encoding plasmids in K. pneumoniae (Figures 1 and 6B), it was no surprise to observe that more than half of the spacers were found in this species (577/1087). The large majority of plasmid spacers were identified on mobilizable plasmids (99.4%, 551/554). ...
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... then corrected the total length of CRISPR spacers found on each MGE by the size of the corresponding MGE. Interestingly, we found that the density of CRISPR arrays is significantly higher across prophages than that of plasmids and ICEs/IMEs (P-value 3.7e−07, Supplementary Figure S17). ...
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... A. baumannii; En, Enterobacter sp.; Kp, K. pneumoniae; Pa, P. aeruginosa; Sa, S. aureus. of CRISPR-Cas systems in the E. faecium strains from our dataset, no spacers were identified in masked genomes from this species. The number of CRISPR spacers per genome varied considerably between the masked genomes of the ESKAPE pathogens (Supplementary Figure S18), reaching as high as 189 in A. baumannii. In fact, only strains from this species carried >100 spacers per masked genome. ...

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Pseudomonas aeruginosa is a ubiquitous, opportunistic human pathogen. Since it often expresses multidrug resistance, new treatment options are urgently required. Such new treatments are usually assessed with one of the canonical laboratory strains, PAO1 or PA14. However, these two strains are unlikely representative of the strains infecting patients, because they have adapted to laboratory conditions and do not capture the enormous genomic diversity of the species. Here, we characterized the major P. aeruginosa clone type (mPact) panel. This panel consists of 20 strains, which reflect the species’ genomic diversity, cover all major clone types, and have both patient and environmental origins. We found significant strain variation in distinct responses toward antibiotics and general growth characteristics. Only few of the measured traits are related, suggesting independent trait optimization across strains. High resistance levels were only identified for clinical mPact isolates and could be linked to known antimicrobial resistance (AMR) genes. One strain, H01, produced highly unstable AMR combined with reduced growth under drug-free conditions, indicating an evolutionary cost to resistance. The expression of microcolonies was common among strains, especially for strain H15, which also showed reduced growth, possibly indicating another type of evolutionary trade-off. By linking isolation source, growth, and virulence to life history traits, we further identified specific adaptive strategies for individual mPact strains toward either host processes or degradation pathways. Overall, the mPact panel provides a reasonably sized set of distinct strains, enabling in-depth analysis of new treatment designs or evolutionary dynamics in consideration of the species’ genomic diversity. IMPORTANCE New treatment strategies are urgently needed for high-risk pathogens such as the opportunistic and often multidrug-resistant pathogen Pseudomonas aeruginosa . Here, we characterize the major P. aeruginosa clone type (mPact) panel. It consists of 20 strains with different origins that cover the major clone types of the species as well as its genomic diversity. This mPact panel shows significant variation in (i) resistance against distinct antibiotics, including several last resort antibiotics; (ii) related traits associated with the response to antibiotics; and (iii) general growth characteristics. We further developed a novel approach that integrates information on resistance, growth, virulence, and life-history characteristics, allowing us to demonstrate the presence of distinct adaptive strategies of the strains that focus either on host interaction or resource processing. In conclusion, the mPact panel provides a manageable number of representative strains for this important pathogen for further in-depth analyses of treatment options and evolutionary dynamics.