Pseudomonas aeruginosa balances cytotoxicity and motility to counter phagocytosis by macrophages

Abstract During chronic lung infections, Pseudomonas aeruginosa diversifies under selection from antibiotics, metabolic constraints, and host defenses. Macrophages are key sentinels of the innate immune system and play a central role in clearing airway pathogens. Yet, how they process heterogeneous bacterial populations remains poorly understood. Here, we investigate how P. aeruginosa evades phagocytosis under conditions that mimic chronic infection. We use an attenuated mutant lacking a functional type III secretion system (T3SS), which reduces macrophage killing, allowing us to isolate determinants of bacterial susceptibility to phagocytosis. Using transposon insertion sequencing (Tn-seq), we identify bacterial fitness factors under phagocytic selection. Our screen reveals that disruption of genes involved in swimming and twitching motility reduces uptake by macrophages. We find that motility defects interfere with the physical interactions between bacteria and macrophages. Live-cell imaging shows that motility-deficient bacteria exhibit reduced surface exploration and unstable attachment to macrophages, limiting their internalization. Clinical isolates with reduced swimming or twitching motility display similarly impaired uptake. Restoring T3SS activity in these motility mutants rescues cytotoxicity toward macrophages, with one notable exception: flagellum-less, hyper-piliated P. aeruginosa remains avirulent and resistant to phagocytosis due to their lack of engagement with macrophages. Together, these results support two distinct immune evasion strategies: during chronic infection, reduced motility promotes a “freeze”-like state that limits detection and engulfment, whereas during acute infection, P. aeruginosa adopts a “fight”-like strategy by activating its T3SS to eliminate macrophages. Summary How immune cells recognize and eliminate bacteria is typically explained by molecular signaling, yet the role of physical interactions remains unclear. We show that bacterial motility is a key determinant of phagocytosis by macrophages. Using functional genomics and live imaging, we find that swimming and twitching motility promote bacterial uptake by enabling effective surface exploration and stable physical engagement with macrophages. Loss of motility commonly observed in chronic P. aeruginosa infections reduces these interactions and allows bacteria to evade engulfment. In contrast, during acute infection, bacteria rely on T3SS-mediated killing of macrophages, independently of motility. These findings reveal that phagocytosis is governed not only by immune recognition but also by bacterial mechanical behavior, and identify a shift in host-pathogen interactions associated with chronic versus acute infection. More broadly, this work establishes mechanics as an important dimension of immune evasion.