Fig. 6: Bacterial barcoding reveals two patterns of lung dissemination during early K. pneumoniae bacteremia.

Bacterial barcoding and STAMPR analysis revealed infection dynamics that are unresolved with quantitative culture and CFU values alone. In direct dissemination, replication is not necessary prior to translocation from the initial site. This pattern may arise due to defects in the host barrier integrity during infection. In metastatic dissemination, clonal replication in the lung leads to the presence of dominant clones in secondary sites. It is likely that bacterial factors influencing replication ability at the initial site also influence the ability for metastatic dissemination to occur. Metastatic dissemination is influenced by time, where clones which have more time to replicate are more likely to translocate and be identified at a secondary site. While two patterns of dissemination are described here, these modes likely represent a spectrum of translocation dynamics.