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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Journal of microbiology, epidemiology and immunobiology</journal-id><journal-title-group><journal-title xml:lang="en">Journal of microbiology, epidemiology and immunobiology</journal-title><trans-title-group xml:lang="ru"><trans-title>Журнал микробиологии, эпидемиологии и иммунобиологии</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0372-9311</issn><issn publication-format="electronic">2686-7613</issn><publisher><publisher-name xml:lang="en">Central Research Institute for Epidemiology</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">18485</article-id><article-id pub-id-type="doi">10.36233/0372-9311-417</article-id><article-id pub-id-type="edn">uvszan</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Molecular-genetic portrait of virulence of Stenotrophomonas maltophilia</article-title><trans-title-group xml:lang="ru"><trans-title>Молекулярно-генетический портрет вирулентности Stenotrophomonas maltophilia</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4894-1304</contrib-id><name-alternatives><name xml:lang="en"><surname>Mikhailovich</surname><given-names>Vladimir M.</given-names></name><name xml:lang="ru"><surname>Михайлович</surname><given-names>Владимир Михайлович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>D. Sci. (Biol.), senior researcher, Deputy Head, Laboratory of biological microchips, Engelhardt Institute of Molecular Biology</p></bio><bio xml:lang="ru"><p>д.б.н., с.н.с., зам. зав. лаб. биологических микрочипов Института молекулярной биологии им. В.А. Энгельгардта</p></bio><email>nizarnn@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4971-2629</contrib-id><name-alternatives><name xml:lang="en"><surname>Geydarov</surname><given-names>Rustam N.</given-names></name><name xml:lang="ru"><surname>Гейдаров</surname><given-names>Рустам Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>senior laboratory assistant, Laboratory of biological microchips, Engelhardt Institute of Molecular Biology</p></bio><bio xml:lang="ru"><p>старший лаборант лаб. биологических микрочипов Института молекулярной биологии им. В.А. Энгельгардта</p></bio><email>nizarnn@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0197-0255</contrib-id><name-alternatives><name xml:lang="en"><surname>Bocharova</surname><given-names>Julia A.</given-names></name><name xml:lang="ru"><surname>Бочарова</surname><given-names>Юлия Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Cand. Sci. (Med.), senior researcher, Laboratory of molecular microbiology, Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>к.м.н., в.н.с. лаб. молекулярной микробиологии РНИМУ им. Н.И. Пирогова</p></bio><email>nizarnn@yandex.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6691-2171</contrib-id><name-alternatives><name xml:lang="en"><surname>Chebotar</surname><given-names>Igor V.</given-names></name><name xml:lang="ru"><surname>Чеботарь</surname><given-names>Игорь Викторович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>D. Sci. (Med.), Head, Laboratory of molecular microbiology, Pirogov Russian National Research Medical University</p></bio><bio xml:lang="ru"><p>д.м.н., зав. лаб. молекулярной микробиологии РНИМУ им. Н.И. Пирогова</p></bio><email>nizarnn@yandex.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Engelhardt Institute of Molecular Biology</institution></aff><aff><institution xml:lang="ru">Институт молекулярной биологии им. В.А. Энгельгардта</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Pirogov Russian National Research Medical University</institution></aff><aff><institution xml:lang="ru">Российский национальный исследовательский медицинский университет имени Н.И. Пирогова</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2023-11-22" publication-format="electronic"><day>22</day><month>11</month><year>2023</year></pub-date><volume>100</volume><issue>5</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>380</fpage><lpage>390</lpage><history><date date-type="received" iso-8601-date="2023-11-21"><day>21</day><month>11</month><year>2023</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2023, Mikhailovich V.M., Geydarov R.N., Bocharova J.A., Chebotar I.V.</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2023, Михайлович В.М., Гейдаров Р.Н., Бочарова Ю.А., Чеботарь И.В.</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="en">Mikhailovich V.M., Geydarov R.N., Bocharova J.A., Chebotar I.V.</copyright-holder><copyright-holder xml:lang="ru">Михайлович В.М., Гейдаров Р.Н., Бочарова Ю.А., Чеботарь И.В.</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://microbiol.crie.ru/jour/article/view/18485">https://microbiol.crie.ru/jour/article/view/18485</self-uri><abstract xml:lang="en"><p><bold>Introduction.</bold> <italic>Stenotrophomonas maltophilia</italic> is an opportunistic pathogen that is intrinsically resistant to a wide range of antibiotics. The bacterium is associated with a number of serious diseases and makes a significant contribution to the pathogenesis of polymicrobial infections. <italic>S. maltophilia</italic> has a wide range of virulence factors, information about which is currently presented in the form of scattered and unconsolidated data.</p> <p><bold>Purposes and objectives:</bold> critically analyze and summarize current data regarding the molecular-genetic aspects of <italic>S. maltophilia</italic> virulence for better understanding of the pathogenesis of infections associated with this pathogen.</p> <p><bold>Materials and methods.</bold> An analysis of information from 80 modern literary sources devoted to the study of the virulent properties of <italic>S. maltophilia</italic> at the molecular-genetic level has been carried out. The analysis focuses on the mechanisms of production of virulence factors and their genetic determinants.</p> <p><bold><italic>Results.</italic></bold>The molecular mechanisms of virulence that determine the infectious process caused by <italic>S. maltophilia </italic>have been analyzed and summarized, including the adhesive function of the surface structures of the bacterial cell (lipopolysaccharides, pili/fimbriae, flagella), the production of extracellular enzymes, the ability to form biofilms on abiotic surfaces and on the tissues of the macroorganism, the functioning of efflux pumps, secretion of small molecules into the external environment by the intercellular information exchange system Quorum Sensing, as well as the influence of iron metabolism on the virulence properties of <italic>S. maltophilia</italic>.</p> <p><bold>Conclusion.</bold> The adaptation mechanisms that allow <italic>S. maltophilia</italic> to adapt to new habitat niches and survive in the human body and unfavorable environmental conditions have been poorly studied. An analytical review summarizing current information on the molecular-genetic aspects of <italic>S. maltophilia</italic> virulence will be of interest to clinicians and researchers studying the fundamental mechanisms of virulence.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Введение.</bold> <italic>Stenotrophomonas maltophilia</italic> является условно-патогенным микроорганизмом, обладающим природной устойчивостью к широкому спектру антибиотиков. Бактерия ассоциирована с рядом серьёзных заболеваний и вносит значимый вклад в патогенез полимикробных инфекций. <italic>S. maltophilia</italic> обладает широким набором факторов вирулентности, информация о которых к настоящему времени представлена в виде разрозненных и необобщённых данных.</p> <p><bold>Цели и задачи: </bold>критически проанализировать и обобщить актуальные данные, затрагивающие молекулярно-генетические аспекты вирулентности <italic>S. maltophilia</italic>, для более глубокого понимания патогенеза инфекций, связанных с этим возбудителем.</p> <p><bold>Материалы и методы.</bold> Выполнен анализ информации из 80 современных литературных источников, посвящённых изучению вирулентных свойств <italic>S. maltophilia</italic> на молекулярно-генетическом уровне. Анализ сфокусирован на механизмах продукции факторов вирулентности и определяющих их генетических детерминантах.</p> <p><bold>Результаты. </bold>Проанализированы и обобщены молекулярные механизмы вирулентности, детерминирующие вызванный <italic>S. maltophilia</italic> инфекционный процесс, включая адгезивную функцию поверхностных структур бактериальной клетки (липополисахариды, пили/фимбрии, флагеллы), продукцию внеклеточных энзимов, способность формировать биоплёнки на абиотических поверхностях и на тканях макроорганизма, фукционирование эффлюкс-помп, секрецию во внешнюю среду малых молекул системой межклеточного обмена информацией Quorum Sensing, а также влияние метаболизма железа на вирулентные свойства <italic>S. maltophilia</italic>.</p> <p><bold>Заключение. </bold>Адаптационные механизмы, позволяющие <italic>S. maltophilia</italic> приспосабливаться к новым нишам обитания, выживать в организме человека и неблагоприятных условиях окружающей среды, изучены недостаточно. Аналитический обзор, обобщающий актуальные сведения о молекулярно-генетических аспектах вирулентности <italic>S. maltophilia</italic>, будет интересен клиническим специалистам и исследователям, изучающим фундаментальные механизмы вирулентности.</p></trans-abstract><kwd-group xml:lang="en"><kwd>Stenotrophomonas maltophilia</kwd><kwd>virulence factors</kwd><kwd>adhesins</kwd><kwd>biofilms</kwd><kwd>Quorum Sensing</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>Stenotrophomonas maltophilia</kwd><kwd>факторы вирулентности</kwd><kwd>адгезины</kwd><kwd>биоплёнки</kwd><kwd>Quorum Sensing</kwd></kwd-group><funding-group><funding-statement xml:lang="en">The work has been carried out with financial support from the Ministry of Health of the Russian Federation under the State Assignment “Molecular-genetic mechanisms of the emergence and loss of antibiotic bacterial resistance in current opportunistic pathogens” (Number in the Integrated state information system for recording research, development and technological work for civil purposes (EGISU NIOKTR No.) 121060200152-8).</funding-statement><funding-statement xml:lang="ru">Работа выполнена при финансовой поддержке Министерства здравоохранения Российской Федерации по Государственному заданию «Молекулярно-генетические механизмы возникновения и утраты антибиотикорезистентности у актуальных оппортунистических патогенов» (ЕГИСУ НИОКТР № 121060200152-8).</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Gröschel M.I., Meehan C.J., Barilar I., et al. The phylogenetic landscape and nosocomial spread of the multidrug-resistant opportunist Stenotrophomonas maltophilia. Nat. Commun. 2020;11(1): 2044. DOI: https://doi.org/10.1038/s41467-020-15123-0</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Ryan R.P., Monchy S., Cardinale M., et al. The versatility and adaptation of bacteria from the genus Stenotrophomonas. Nat. Rev. Microbiol. 2009;7(7):514–25. DOI: https://doi.org/10.1038/nrmicro2163</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Turrientes M.C., Baquero M.R., Sánchez M.B., et al. Polymorphic mutation frequencies of clinical and environmental Stenotrophomonas maltophilia populations. Appl. Environ. Microbiol. 2010;76(6):1746–58. DOI: https://doi.org/10.1128/AEM.02817-09</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Pompilio A., Crocetta V., Ghosh D., et al. Stenotrophomonas maltophilia phenotypic and genotypic diversity during a 10-year colonization in the lungs of a cystic fibrosis patient. Front. Microbiol. 2016;7:1551. DOI: https://doi.org/10.3389/fmicb.2016.01551</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Pompilio A., Pomponio S., Crocetta V., et al. Phenotypic and genotypic characterization of Stenotrophomonas maltophilia isolates from patients with cystic fibrosis: Genome diversity, biofilm formation, and virulence. BMC Microbiol. 2011;11:159. DOI: https://doi.org/10.1186/1471-2180-11-159</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Trifonova A., Strateva T. Stenotrophomonas maltophilia — a low-grade pathogen with numerous virulence factors. Infect. Dis. (Lond.). 2019;51(3):168–78. DOI: https://doi.org/10.1080/23744235.2018.1531145</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Brooke J.S. Stenotrophomonas maltophilia: an emerging global opportunistic pathogen. Clin. Microbiol. Rev. 2012;25(1):2–41. DOI: https://doi.org/10.1128/CMR.00019-11</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Goss C.H., Mayer-Hamblett N., Aitken M.L., et al. Association between Stenotrophomonas maltophilia and lung function in cystic fibrosis. Thorax. 2004;59(11):955–9. DOI: https://doi.org/10.1136/thx.2003.017707</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Coutinho H., Falcão-Silva V.S., Gonçalves G. Pulmonary bacterial pathogens in cystic fibrosis patients and antibiotic therapy: a tool for the health workers. Int. Arch. Med. 2008;1(1):24. DOI: https://doi.org/10.1186/1755-7682-1-24</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Looney W.J. Role of Stenotrophomonas maltophilia in hospital-acquired infection. Br. J. Biomed. Sci. 2005;62(3):145–54. DOI: https://doi.org/10.1080/09674845.2005.11732702</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Brooke J. Advances in the microbiology of Stenotrophomonas maltophilia. Clin. Microbiol. Rev. 2021;34(3):e0003019. DOI: https://doi.org/10.1128/cmr.00030-19</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Neal D.J., Wilkinson S.G. Lipopolysaccharides from Pseudomonas maltophilia structural studies of the side‐chain, core, and lipid‐a regions of the lipopolysaccharide from strain NCTC 10257. Eur. J. Biochem. 1982;128(1):143–9. DOI: https://doi.org/10.1111/j.1432-1033.1982.tb06944.x</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>McKay G.A., Woods D.E., MacDonald K.L., Poole K. Role of phosphoglucomutase of Stenotrophomonas maltophilia in lipopolysaccharide biosynthesis, virulence, and antibiotic resistance. Infect. Immun. 2003;71(6):3068–75. DOI: https://doi.org/10.1128/IAI.71.6.3068-3075.2003</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Waters V.J., Gómez M.I., Soong G., et al. Immunostimulatory properties of the emerging pathogen Stenotrophomonas maltophilia. Infect. Immun. 2007;75(4):1698–703. DOI: https://doi.org/10.1128/IAI.01469-06</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Goldberg J.B., Coyne M.J., Neely A.N., Holder I.A. Avirulence of a Pseudomonas aeruginosa algC mutant in a burned-mouse model of infection. Infect. Immun. 1995;63(10):4166–9. DOI: https://doi.org/10.1128/iai.63.10.4166-4169.1995</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>West N.P., Jungnitz H., Fitter J.T., et al. Role of phosphoglucomutase of Bordetella bronchiseptica in lipopolysaccharide biosynthesis and virulence. Infect. Immun. 2000;68(8): 4673–80. DOI: https://doi.org/10.1128/IAI.68.8.4673-4680.2000</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>DeShazer D., Brett P.J., Woods D.E. The type II O-antigenic polysaccharide moiety of Burkholderia pseudomallei lipopolysaccharide is required for serum resistance and virulence. Mol. Microbiol. 1998;30(5):1081–100. DOI: https://doi.org/10.1046/j.1365-2958.1998.01139.x</mixed-citation></ref><ref id="B18"><label>18.</label><citation-alternatives><mixed-citation xml:lang="en">Ugalde J.E., Czibener C., Feldman M.F., Ugalde R.A. Identification and characterization of the Brucella abortus phosphoglucomutase gene: role of lipopolysaccharide in virulence and intracellular multiplication. Infect. Immun. 2000;68(10):5716–23. DOI: https://doi.org/10.1128/IAI.68.10.5716-5723.2000</mixed-citation><mixed-citation xml:lang="ru">Ugalde J.E., Czibener C., Feldman M.F., Ugalde R.A. Identification and characterization of the Brucella abortus phosphoglucomutase gene: role of lipopolysaccharide in virulence and intracellular multiplication. Infect. Immun. 2000;68(10): 5716–23. DOI: https://doi.org/10.1128/IAI.68.10.5716-5723.2000</mixed-citation></citation-alternatives></ref><ref id="B19"><label>19.</label><mixed-citation>Winn A.M., Wilkinson S.G. Structures of the O4 and O18 antigens of Stenotrophomonas maltophilia: a case of enantiomeric repeating units. Carbohydr. Res. 2001;330(2):215–21. DOI: https://doi.org/10.1016/S0008-6215(00)00287-1</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Flores-Treviño S., Bocanegra-Ibarias P., Camacho-Ortiz A., et al. Stenotrophomonas maltophilia biofilm: its role in infectious diseases. Expert. Rev. Anti Infect. Ther. 2019;17(11):877–93. DOI: https://doi.org/10.1080/14787210.2019.1685875</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Huang T.P., Somers E.B., Wong A.C.L. Differential biofilm formation and motility associated with lipopolysaccharide/exopolysaccharide-coupled biosynthetic genes in Stenotrophomonas maltophilia. J. Bacteriol. 2006;188(8):3116–20. DOI: https://doi.org/10.1128/JB.188.8.3116-3120.2006</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>de Oliveira-Garcia D., Dall’Agnol M., Rosales M., et al. Characterization of flagella produced by clinical strains of Stenotrophomonas maltophilia. Emerg. Infect. Dis. 2002;8(9):918–23. DOI: https://doi.org/10.3201/eid0809.010535</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Zgair A.K., Chhibber S. Adhesion of Stenotrophomonas maltophilia to mouse tracheal mucus is mediated through flagella. J. Med. Microbiol. 2011;60(7):1032–7. DOI: https://doi.org/10.1099/jmm.0.026377-0</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Zgair A.K., Chhibber S. Stenotrophomonas maltophilia flagellin restricts bacterial colonization in BALB/c mouse lung in vivo. FEMS Immunol. Med. Microbiol. 2012;66(2):191–200. DOI: https://doi.org/10.1111/j.1574-695X.2012.00999.x</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Pompilio A., Crocetta V., Di Bonaventura G. Stenotrophomonas maltophilia mutant lacking flagella remains virulent in DBA/2N mice but is less efficient in stimulating TNF-α expression. FEMS Microbiol. Lett. 2018;365(19). DOI: https://doi.org/10.1093/femsle/fny205</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Mahenthiralingam E., Campbell M.E., Speert D.P. Nonmotility and phagocytic resistance of Pseudomonas aeruginosa isolates from chronically colonized patients with cystic fibrosis. Infect. Immun. 1994;62(2):596–605. DOI: https://doi.org/10.1128/iai.62.2.596-605.1994</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Pompilio A., Crocetta V., Confalone P., et al. Adhesion to and biofilm formation on IB3-1 bronchial cells by Stenotrophomonas maltophilia isolates from cystic fibrosis patients. BMC Microbiol. 2010;10(1):102. DOI: https://doi.org/10.1186/1471-2180-10-102</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Ross P., Weinhouse H., Aloni Y., et al. Regulation of cellulose synthesis in Acetobacter xylinum by cyclic diguanylic acid. Nature. 1987325(6101):279–81. DOI: https://doi.org/10.1038/325279a0</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Cheng S.T., Wang F.F., Qian W. Cyclic-di-GMP binds to histidine kinase RavS to control RavS-RavR phosphotransfer and regulates the bacterial lifestyle transition between virulence and swimming. PLOS Pathog. 2019;15(8):e1007952. DOI: https://doi.org/10.1371/journal.ppat.1007952</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Chan C., Paul R., Samoray D., et al. Structural basis of activity and allosteric control of diguanylate cyclase. Proc. Natl. Acad. Sci. USA. 2004;101(49):17084–9. DOI: https://doi.org/10.1073/pnas.0406134101</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>Christen M., Christen B., Folcher M., et al. Identification and characterization of a cyclic di-GMP-specific phosphodiesterase and its allosteric control by GTP. J. Biol. Chem. 2005;280(35):30829–37. DOI: https://doi.org/10.1074/jbc.M504429200</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Caly D., Bellini D., Walsh M., et al. Targeting cyclic di-GMP signalling: a strategy to control biofilm formation? Curr. Pharm. Des. 2014;21(1):12–24. DOI: https://doi.org/10.2174/1381612820666140905124701</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Arora S.K., Ritchings B.W., Almira E.C., et al. A transcriptional activator, FleQ, regulates mucin adhesion and flagellar gene expression in Pseudomonas aeruginosa in a cascade manner. J. Bacteriol. 1997;179(17):5574–81. DOI: https://doi.org/10.1128/jb.179.17.5574-5581.1997</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Hickman J.W., Harwood C.S. Identification of FleQ from Pseudomonas aeruginosa as a c-di-GMP-responsive transcription factor. Mol. Microbiol. 2008;69(2):376–89. DOI: https://doi.org/10.1111/j.1365-2958.2008.06281.x</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Klose K.E., Mekalanos J.J. Distinct roles of an alternative sigma factor during both free‐swimming and colonizing phases of the Vibrio cholerae pathogenic cycle. Mol. Microbiol. 1998;28(3):501–20. DOI: https://doi.org/10.1046/j.1365-2958.1998.00809.x</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>Stewart B.J., McCarter L.L. Vibrio parahaemolyticus FlaJ, a homologue of FliS, is required for production of a flagellin. Mol. Microbiol. 1996;20(1):137–49. DOI: https://doi.org/10.1111/j.1365-2958.1996.tb02496.x</mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation>Yang J.G., Shih M.S., Kuo W.T., et al. Crystallization of the N-terminal regulatory domain of the enhancer-binding protein FleQ from Stenotrophomonas maltophilia. Acta Crystallogr. F. Struct. Biol. Commun. 2014;70(Pt. 3):326–30. DOI: https://doi.org/10.1107/S2053230X14001514</mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation>Liu W., Tian X.Q., Wei J.W., et al. BsmR degrades c-di-GMP to modulate biofilm formation of nosocomial pathogen Stenotrophomonas maltophilia. Sci. Rep. 2017;7(1):4665. DOI: https://doi.org/10.1038/s41598-017-04763-w</mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation>Kang X.M., Wang F.F., Zhang H., et al. Genome-wide identification of genes necessary for biofilm formation by nosocomial pathogen Stenotrophomonas maltophilia reveals that orphan response regulator FsnR is a critical modulator. Appl. Environ. Microbiol. 2015;81(4):1200–9. DOI: https://doi.org/10.1128/AEM.03408-14</mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation>Zheng L., Wang F.F., Ren B.Z., et al. Systematic mutational analysis of histidine kinase genes in the nosocomial pathogen Stenotrophomonas maltophilia identifies BfmAK system control of biofilm development. Appl. Environ. Microbiol. 2016;82(8):2444–56. DOI: https://doi.org/10.1128/AEM.03951-15</mixed-citation></ref><ref id="B41"><label>41.</label><mixed-citation>Zhang X., Wang Y., Wu Y., et al. Dual regulatory role exerted by cyclic dimeric GMP To control FsnR-mediated bacterial swimming. MBio. 2022;13(5):e0141422. DOI: https://doi.org/10.1128/mbio.01414-22</mixed-citation></ref><ref id="B42"><label>42.</label><mixed-citation>de Oliveira-Garcia D., Dall’Agnol M., Rosales M., et al. Fimbriae and adherence of Stenotrophomonas maltophilia to epithelial cells and to abiotic surfaces. Cell Microbiol. 2003;5(9):625–36. DOI: https://doi.org/10.1046/j.1462-5822.2003.00306.x</mixed-citation></ref><ref id="B43"><label>43.</label><mixed-citation>Zgair A.K., Al-Adressi A.M.H. Stenotrophomonas maltophilia fimbrin stimulates mouse bladder innate immune response. Eur. J. Clin. Microbiol. Infect. Dis. 2013;32(1):139–46. DOI: https://doi.org/10.1007/s10096-012-1729-0</mixed-citation></ref><ref id="B44"><label>44.</label><mixed-citation>Nicoletti M., Iacobino A., Prosseda G., et al. Stenotrophomonas maltophilia strains from cystic fibrosis patients: Genomic variability and molecular characterization of some virulence determinants. Int. J. Med. Microbiol. 2011;301(1):34–43. DOI: https://doi.org/10.1016/j.ijmm.2010.07.003</mixed-citation></ref><ref id="B45"><label>45.</label><mixed-citation>Crossman L.C., Gould V.C., Dow J.M., et al. The complete genome, comparative and functional analysis of Stenotrophomonas maltophilia reveals an organism heavily shielded by drug resistance determinants. Genome Biol. 2008;9(4):R74. DOI: https://doi.org/10.1186/gb-2008-9-4-r74</mixed-citation></ref><ref id="B46"><label>46.</label><mixed-citation>Giltner C.L., Nguyen Y., Burrows L.L. Type IV pilin proteins: versatile molecular modules. Microbiol. Mol. Biol. Rev. 2012;76(4):740–72. DOI: https://doi.org/10.1128/MMBR.00035-12</mixed-citation></ref><ref id="B47"><label>47.</label><mixed-citation>Travassos L.H., Pinheiro M.N., Coelho F.S., et al. Phenotypic properties, drug susceptibility and genetic relatedness of Stenotrophomonas maltophilia clinical strains from seven hospitals in Rio de Janeiro, Brazil. J. Appl. Microbiol. 2004;96(5):1143–50. DOI: https://doi.org/10.1111/j.1365-2672.2004.02248.x</mixed-citation></ref><ref id="B48"><label>48.</label><mixed-citation>Trifonova A., Strateva T. Stenotrophomonas maltophilia — a low-grade pathogen with numerous virulence factors. Infect. Dis. 2019;51(3):168–78. DOI: https://doi.org/10.1080/23744235.2018.1531145</mixed-citation></ref><ref id="B49"><label>49.</label><mixed-citation>Adamek M., Linke B., Schwartz T. Virulence genes in clinical and environmental Stenotrophomas maltophilia isolates: a genome sequencing and gene expression approach. Microb. Pathog. 2014;67-68:20–30. DOI: https://doi.org/10.1016/j.micpath.2014.02.001</mixed-citation></ref><ref id="B50"><label>50.</label><mixed-citation>Alavi P., Starcher M.R., Thallinger G.G., et al. Stenotrophomonas comparative genomics reveals genes and functions that differentiate beneficial and pathogenic bacteria. BMC Genomics. 2014;15(1):482. DOI: https://doi.org/10.1186/1471-2164-15-482</mixed-citation></ref><ref id="B51"><label>51.</label><mixed-citation>DuMont A.L., Karaba S.M., Cianciotto N.P. Type II secretion-dependent degradative and cytotoxic activities mediated by Stenotrophomonas maltophilia serine proteases StmPr1 and StmPr2. Infect. Immun. 2015;83(10):3825–37. DOI: https://doi.org/10.1128/IAI.00672-15</mixed-citation></ref><ref id="B52"><label>52.</label><mixed-citation>DuMont A.L., Cianciotto N.P. Stenotrophomonas maltophilia serine protease StmPr1 induces matrilysis, anoikis, and protease-activated receptor 2 Activation in human lung epithelial cells. Infect. Immun. 2017;85(12):e00544-17. DOI: https://doi.org/10.1128/IAI.00544-17</mixed-citation></ref><ref id="B53"><label>53.</label><mixed-citation>Windhorst S., Frank E., Georgieva D.N., et al. The major extracellular protease of the nosocomial pathogen Stenotrophomonas maltophilia. J. Biol. Chem. 2002;277(13):11042–9. DOI: https://doi.org/10.1074/jbc.M109525200</mixed-citation></ref><ref id="B54"><label>54.</label><mixed-citation>Ribitsch D., Heumann S., Karl W., et al. Extracellular serine proteases from Stenotrophomonas maltophilia: screening, isolation and heterologous expression in E. coli. J. Biotechnol. 2012; 157(1):140–7. DOI: https://doi.org/10.1016/j.jbiotec.2011.09.025</mixed-citation></ref><ref id="B55"><label>55.</label><mixed-citation>Nas M.Y., Gabell J., Cianciotto N.P. Effectors of the Stenotrophomonas maltophilia Type IV secretion system mediate killing of clinical isolates of Pseudomonas aeruginosa. MBio. 2021; 12(3):e0150221. DOI: https://doi.org/10.1128/mBio.01502-21</mixed-citation></ref><ref id="B56"><label>56.</label><mixed-citation>Nas M.Y., White R.C., DuMont A.L., et al. Stenotrophomonas maltophilia encodes a VirB/VirD4 type IV secretion system that modulates apoptosis in human cells and promotes competition against heterologous bacteria, including Pseudomonas aeruginosa. Infect. Immun. 2019;87(9). DOI: https://doi.org/10.1128/IAI.00457-19</mixed-citation></ref><ref id="B57"><label>57.</label><mixed-citation>Ramos-Hegazy L., Chakravarty S., Anderson G.G. Phosphoglycerate mutase affects Stenotrophomonas maltophilia attachment to biotic and abiotic surfaces. Microbes Infect. 2020;22(1): 60–4. DOI: https://doi.org/10.1016/j.micinf.2019.08.001</mixed-citation></ref><ref id="B58"><label>58.</label><mixed-citation>Di Bonaventura G., Picciani C., Lupetti V., Pompilio A. Comparative proteomic analysis of protein patterns of Stenotrophomonas maltophilia in biofilm and planktonic lifestyles. Microorganisms. 2023;11(2):442. DOI: https://doi.org/10.3390/microorganisms11020442</mixed-citation></ref><ref id="B59"><label>59.</label><mixed-citation>Pompilio A., Savini V., Fiscarelli E., et al. Clonal diversity, biofilm formation, and antimicrobial resistance among Stenotrophomonas maltophilia strains from cystic fibrosis and non-cystic fibrosis patients. Antibiotics (Basel). 2020;9(1):15. DOI: https://doi.org/10.3390/antibiotics9010015</mixed-citation></ref><ref id="B60"><label>60.</label><mixed-citation>Alio I., Gudzuhn M., Pérez García P., et al. Phenotypic and transcriptomic analyses of seven clinical Stenotrophomonas maltophilia isolates identify a small set of shared and commonly regulated genes involved in the biofilm lifestyle. Appl. Environ. Microbiol. 2020;86(24):e02038-20. DOI: https://doi.org/10.1128/AEM.02038-20</mixed-citation></ref><ref id="B61"><label>61.</label><mixed-citation>Lin Y.T., Huang Y.W., Liou R.S., et al. MacABCsm, an ABC-type tripartite efflux pump of Stenotrophomonas maltophilia involved in drug resistance, oxidative and envelope stress tolerances and biofilm formation. J. Antimicrob. Chemother. 2014;69(12):3221–6. DOI: https://doi.org/10.1093/jac/dku317</mixed-citation></ref><ref id="B62"><label>62.</label><mixed-citation>Huang Y.W., Hu R.M., Chu F.Y., et al. Characterization of a major facilitator superfamily (MFS) tripartite efflux pump EmrCABsm from Stenotrophomonas maltophilia. J. Antimicrob. Chemother. 2013;68(11):2498–505. DOI: https://doi.org/10.1093/jac/dkt250</mixed-citation></ref><ref id="B63"><label>63.</label><mixed-citation>Hu R.M., Liao S.T., Huang C.C., et al. An inducible fusaric acid tripartite efflux pump contributes to the fusaric acid resistance in Stenotrophomonas maltophilia. PLoS One. 2012;7(12):e51053. DOI: https://doi.org/10.1371/journal.pone.0051053</mixed-citation></ref><ref id="B64"><label>64.</label><mixed-citation>Gil-Gil T., Martínez J.L., Blanco P. Mechanisms of antimicrobial resistance in Stenotrophomonas maltophilia: a review of current knowledge. Expert. Rev. Anti Infect. Ther. 2020;18(4):335–47. DOI: https://doi.org/10.1080/14787210.2020.1730178</mixed-citation></ref><ref id="B65"><label>65.</label><mixed-citation>Wu C.J., Chen Y., Li L.H., et al. Efflux systems in iron homeostasis of Stenotrophomonas maltophilia. Microbiol. Spectr. 2022;10(3):e0244821. DOI: https://doi.org/10.1128/spectrum.02448-21</mixed-citation></ref><ref id="B66"><label>66.</label><mixed-citation>Hirakata Y., Srikumar R., Poole K., et al. Multidrug efflux systems play an important role in the invasiveness of Pseudomonas aeruginosa. J. Exp. Med. 2002;196(1):109–18. DOI: https://doi.org/10.1084/jem.20020005</mixed-citation></ref><ref id="B67"><label>67.</label><mixed-citation>Brunson D.N., Maldosevic E., Velez A., et al. Porin loss in Klebsiella pneumoniae clinical isolates impacts production of virulence factors and survival within macrophages. Int. J. Med. Microbiol. 2019;309(3-4):213–24. DOI: https://doi.org/10.1016/j.ijmm.2019.04.001</mixed-citation></ref><ref id="B68"><label>68.</label><mixed-citation>Jurado R.L. Iron, infections, and anemia of inflammation. Clin. Infect. Dis. 1997;25(4):888–95. DOI: https://doi.org/10.1086/515549</mixed-citation></ref><ref id="B69"><label>69.</label><mixed-citation>Kalidasan V., Joseph N., Kumar S., et al. Iron and virulence in Stenotrophomonas maltophilia: all we know so far. Front. Cell Infect. Microbiol. 2018;8:401. DOI: https://doi.org/10.3389/fcimb.2018.00401</mixed-citation></ref><ref id="B70"><label>70.</label><mixed-citation>Nairz M., Schroll A., Sonnweber T., Weiss G. The struggle for iron — a metal at the host-pathogen interface. Cell Microbiol. 2010;12(12):1691–702. DOI: https://doi.org/10.1111/j.1462-5822.2010.01529.x</mixed-citation></ref><ref id="B71"><label>71.</label><mixed-citation>García C.A., Alcaraz E.S., Franco M.A., Passerini de Rossi B.N. Iron is a signal for Stenotrophomonas maltophilia biofilm formation, oxidative stress response, OMPs expression, and virulence. Front. Microbiol. 2015;6:926. DOI: https://doi.org/10.3389/fmicb.2015.00926</mixed-citation></ref><ref id="B72"><label>72.</label><mixed-citation>Huang T.P., Lee Wong A.C. A cyclic AMP receptor protein-regulated cell-cell communication system mediates expression of a FecA homologue in Stenotrophomonas maltophilia. Appl. Environ. Microbiol. 2007;73(15):5034–40. DOI: https://doi.org/10.1128/AEM.00366-07</mixed-citation></ref><ref id="B73"><label>73.</label><mixed-citation>Papenfort K., Bassler B.L. Quorum sensing signal-response systems in Gram-negative bacteria. Nat. Rev. Microbiol. 2016;14(9):576–88. DOI: https://doi.org/10.1038/nrmicro.2016.89</mixed-citation></ref><ref id="B74"><label>74.</label><citation-alternatives><mixed-citation xml:lang="en">Huedo P., Yero D., Martínez-Servat S., et al. Two different rpf clusters distributed among a population of Stenotrophomonas maltophilia clinical strains display differential diffusible signal factor production and virulence regulation. J. Bacteriol. 2014; 196(13):2431–42. DOI: https://doi.org/10.1128/JB.01540-14</mixed-citation><mixed-citation xml:lang="ru">Huedo P., Yero D., Martínez-Servat S., et al. Two different rpf clusters distributed among a population of Stenotrophomonas maltophilia clinical strains display differential diffusible signal factor production and virulence regulation. J. Bacteriol. 2014;196(13):2431–42. DOI: https://doi.org/10.1128/JB.01540-14</mixed-citation></citation-alternatives></ref><ref id="B75"><label>75.</label><mixed-citation>Huedo P., Kumar V.P., Horgan C., et al. Sulfonamide-based diffusible signal factor analogs interfere with quorum sensing in Stenotrophomonas maltophilia and Burkholderia cepacia. Future Med. Chem. 2019;11(13):1565–82. DOI: https://doi.org/10.4155/fmc-2019-0015</mixed-citation></ref><ref id="B76"><label>76.</label><mixed-citation>Huedo P., Yero D., Martinez-Servat S., et al. Decoding the genetic and functional diversity of the DSF quorum-sensing system in Stenotrophomonas maltophilia. Front. Microbiol. 2015;6:761. DOI: https://doi.org/10.3389/fmicb.2015.00761</mixed-citation></ref><ref id="B77"><label>77.</label><mixed-citation>Yero D., Huedo P., Conchillo-Solé O., et al. Genetic variants of the DSF quorum sensing system in Stenotrophomonas maltophilia influence virulence and resistance phenotypes among genotypically diverse clinical isolates. Front. Microbiol. 2020;11:1160. DOI: https://doi.org/10.3389/fmicb.2020.01160</mixed-citation></ref><ref id="B78"><label>78.</label><mixed-citation>Martínez P., Huedo P., Martinez-Servat S., et al. Stenotrophomonas maltophilia responds to exogenous AHL signals through the LuxR solo SmoR (Smlt1839). Front. Cell Infect. Microbiol. 2015;5:41. DOI: https://doi.org/10.3389/fcimb.2015.00041</mixed-citation></ref><ref id="B79"><label>79.</label><mixed-citation>McCarthy Y., Dow J.M., Ryan R.P. The Ax21 protein is a cell-cell signal that regulates virulence in the nosocomial pathogen Stenotrophomonas maltophilia. J. Bacteriol. 2011;193(22):6375–8. DOI: https://doi.org/10.1128/JB.05949-11</mixed-citation></ref><ref id="B80"><label>80.</label><mixed-citation>Devos S., Van Oudenhove L., Stremersch S., et al. The effect of imipenem and diffusible signaling factors on the secretion of outer membrane vesicles and associated Ax21 proteins in Stenotrophomonas maltophilia. Front. Microbiol. 2015;6:298. DOI: https://doi.org/10.3389/fmicb.2015.00298</mixed-citation></ref><ref id="B81"><label>81.</label><mixed-citation>Park H.J., Lee S.W., Han S.W. Proteomic and functional analyses of a novel porin-like protein in Xanthomonas oryzae pv. oryzae. J. Microbiol. 2014;52(12):1030–5. DOI: https://doi.org/10.1007/s12275-014-4442-0.</mixed-citation></ref></ref-list></back></article>
