Reversible adhesion by type IV pili leads to formation of irreversible localized clusters

Despite the fact a fundamental first step in the physiopathology of many disease-causing bacteria is the formation of long-lived, localized, multicellular clusters, the spatio-temporal dynamics of the cluster formation process, particularly on host tissues, remains poorly understood. Experiments on abiotic surfaces suggest that the colonization of a surface by swimming bacteria requires i) irreversible adhesion to the surface, ii) cell proliferation, and iii) a phenotypic transition from an initial planktonic state. Here, we investigate how Pseudomonas aeruginosa (PA) infects a polarized MDCK epithelium and show that contrary to what has been reported on the colonization of abiotic surfaces, PA forms irreversible bacterial clusters on apoptotic epithelial cells without requiring irreversible adhesion, cell proliferation, or phenotypic transition. By combining experiments and a mathematical model, we reveal that the cluster formation process is regulated by type IV pili (T4P). Furthermore, we unveil how T4P quantitatively operate during adhesion on the biotic surface, finding that it is a stochastic process that involves an activation time, requires the retraction of pili, and results in reversible adhesion with a characteristic attachment time. Using a simple kinetic model, we explain how such reversible adhesion process leads to the formation of irreversible bacterial clusters and quantify the cluster growth dynamics.