Southern hybridization analysis of the mecA deletion from methicillin-resistant Staphylococcus aureus

Genomic organization of methicillin-resistant Staphylococcus aureus strains and their methicillin-susceptible subclones were analyzed by pulsed-field gel electrophoresis and Southern hybridization with DNA fragments of methicillin-resistance gene mecA and an insertion element IS431 as probes. The entire mecA gene was deleted in all the seven methicillin-susceptible subclones studied, and the size of the deletion varied from 20 to 100 kilobases depending on each subclone. In six of the seven subclones, however, the downstream deletion end points were confined within a 2.0 kilobase HindIII-HindIII fragment containing a part of IS431 which was located 2.6 kilobase downstream of mecA gene. The results indicated that the intramolecular transposition of IS431 is responsible for the mecA deletion in methicillin-resistant Staphylococcus aureus.

Genetic characterisation of resistance to metal ions in methicillin-resistant Staphylococcus aureus: elimination of resistance to cadmium, mercury and tetracycline with loss of methicillin resistance

Susceptibility to six metal ions--cadmium (Cd), mercury (Hg), arsenate (Asa), arsenite (Asi), antimony (Sb) and zinc (Zn)--was tested in 23 independent isolates of methicillin-resistant Staphylococcus aureus (MRSA) obtained from Guy's Hospital (GH) during 1984-1986, which included 10 isolates of the UK epidemic EMRSA-1 strain. Strains were also tested for resistance to antibiotics and the nucleic-acid-binding compounds propamidine isethionate and ethidium bromide. A further 19 methicillin-resistant isolates, including 10 EMRSA-1 were obtained from other sources. Ten methicillin-sensitive, antibiotic sensitive isolates were from Guy's Hospital. Resistance to Hg was associated with methicillin resistance in 19 of the 20 EMRSA-1 isolates, all of which were resistant to Cd. Resistance to Cd and Hg was found in 13 out of 22 other MRSA isolates. Hg resistance was not present in the methicillin-sensitive isolates which were often (13 out of 19) moderately resistant to Cd. Multiple resistance to metal ions, including resistance to Hg, Asa, Asi and Sb, was uncommon. Resistance to Cd (MIC greater than 32 mg/L or 8-16 mg/L) was associated with increased resistance to Zn. In 11 of the consecutive MRSA isolates from Guy's Hospital seven distinct strains were recognised by phage type. Methicillin resistance in these strains varied from 16 to 1024 mg/L at 30 degrees C with a 2-8-fold lower minimum inhibitory concentration at 37 degrees C indicating some degree of heterogeneity. Representatives of the EMRSA-1 strain had the higher levels of resistance. Loss of methicillin resistance occurred in 0.2-5.0% of colonies tested after storage at room temperature in 10 of these isolates.(ABSTRACT TRUNCATED AT 250 WORDS)

Multiple mechanisms of methicillin resistance and improved methods for detection in clinical isolates of Staphylococcus aureus

The mec gene of a number of clinical methicillin-resistant Staphylococcus aureus isolates exhibiting a variety of heterogeneous expression modes was selectively inactivated by allelic replacement mutagenesis. While the resistance level of each of the transformants was reduced, the methicillin MIC for these transformants was well above the MIC for susceptible laboratory strains of S. aureus and was similar to the methicillin MIC for many contemporary clinical isolates which did not react with the mec-specific DNA probe but which showed a low or borderline level of resistance to methicillin. A number of those strains had no detectable beta-lactamase, and for about half of the isolates that did carry plasmid-borne beta-lactamase, elimination of the plasmid caused only partial reduction of the methicillin MIC or no reduction at all. The findings suggest that many contemporary strains of staphylococci harbor a combination of at least three distinct beta-lactam resistance mechanisms: (i) the mechanism related to the acquisition of the foreign mec gene and (ii) a beta-lactamase-dependent and (iii) a beta-lactamase-independent mechanism, each one of which can provide a certain degree of resistance against penicillinase-resistant beta-lactam antibiotics.

Nonradioactive DNA probe for detection of gene for methicillin resistance in Staphylococcus aureus

A DNA probe was developed by inserting, in the SmaI site of pBluescript sK, a 528-bp fragment of the gene responsible for intrinsic resistance to beta-lactam antibiotics in Staphylococcus aureus (mec determinant). The mec probe provided a useful tool for the rapid identification of the intrinsic resistance trait and for establishing guidelines for testing the in vitro susceptibility of S. aureus to beta-lactams.

Suppression of autolysis and cell wall turnover in heterogeneous Tn551 mutants of a methicillin-resistant Staphylococcus aureus strain

Isogenic Tn551 mutants of a highly and uniformly methicillin-resistant strain of Staphylococcus aureus were tested for their rates of autolysis and cell wall degradation in buffer and for cell wall turnover during growth. The normal (relatively fast) autolysis and turnover rates of the parent strain were retained in a Tn551 mutant in which the insert was located within the mec gene and which produced undetectable levels of penicillin-binding protein 2A. On the other hand, autolysis and cell wall turnover rates were greatly reduced in auxiliary mutants, i.e., mutants in which the transposon caused conversion of the high-level and uniform resistance of the parent strain to a variety of distinct heterogeneous expression types and greatly decreased resistance levels. All of these mutants contained an intact mec gene and produced normal amounts of penicillin-binding protein 2A, and one of the mutations was located in the femA region of the staphylococcal chromosome (B. Berger-Bachi, L. Barberis-Maino, A. Strassle, and F. H. Kayser, Mol. Gen. Genet. 219:263-269, 1989). Autolysis rates were related to the degree of residual methicillin resistance and to the sites of Tn551 insertion. Fast cell wall turnover may help expression of high-level methicillin resistance by providing a mechanism for the excision of abnormal (and potentially lethal) structural elements of the cell wall synthesized by the bacteria in the presence of methicillin.

Stable classes of phenotypic expression in methicillin-resistant clinical isolates of staphylococci

A collection of coagulase-positive and -negative clinical strains of staphylococci, all of which gave a positive reaction with a mec-specific DNA probe, was analyzed for the mode of phenotypic expression of methicillin resistance by using population analysis on agar plates containing different concentrations of the antibiotic. Strains could be divided into four arbitrary expression classes. Cultures of class 4 strains were composed of uniformly and highly resistant bacteria (MIC greater than or equal to 800 micrograms/ml). In contrast, cultures of strains belonging to classes 1, 2, and 3 were heterogeneous: they were composed of two or more subpopulations of cells that differed from one another in MICs and frequencies. In cultures of strains belonging to expression class 1, most of the cells had methicillin MICs of 1.5 to 3 micrograms/ml, i.e., only two to three times higher than those for truly susceptible strains. In cultures of strains belonging to expression classes 2 and 3, the methicillin MICs for the majority of bacteria ranged from 6 to 12 and up to 50 to 200 micrograms/ml, respectively. While the definition of the expression classes was arbitrary, the modes of phenotypic expression were specific and reproducible: randomly picked colonies of a given strain produced identical population profiles. The strain-specific mode of expression was also retained after numerous single-colony picks and sequential passages in antibiotic-free medium. We suggest that these classes represent stages in an evolutionary sequence leading to progressively improved phenotypic expression of methicillin resistance in staphylococci.

Identification of a methicillin-resistant strain of Staphylococcus caprae from a human clinical specimen

The analysis of gel banding patterns of penicillin-binding proteins was used to identify two clinical isolates of a coagulase-negative Staphylococcus species as Staphylococcus caprae, a species originally isolated from goat's milk. One of the isolates was further shown to carry mecA, the structural gene for methicillin resistance.

Cloning and nucleotide sequence of a chromosomally encoded tetracycline resistance determinant, tetA(M), from a pathogenic, methicillin-resistant strain of Staphylococcus aureus

This report describes the cloning and sequencing of a chromosomally encoded tetracycline resistance determinant from a clinical isolate of methicillin-resistant Staphylococcus aureus. On the basis of the sequence, the gene is in the tet(M) class, and it was shown that the S. aureus tetA(M) gene is induced at the level of transcription.

Insertional inactivation of the mec gene in a transposon mutant of a methicillin-resistant clinical isolate of Staphylococcus aureus

All clinical strains of methicillin-resistant Staphylococcus aureus (MRSA) examined so far contain the mec gene and its product, the penicillin-binding protein (PBP) 2A. Yet the same strains show tremendous variation in the phenotypic expression of antibiotic resistance (MIC), which is under the control of a set of additional, auxiliary genes. Thus, the quantitative contribution of the mec gene to the resistance phenotype of MRSA is not known, and no mutants with the lesion located within the mec gene have been described. We subjected a highly resistant MRSA strain to transposon mutagenesis with the erythromycin resistance transposon Tn551, and a mutant expressing greatly decreased methicillin resistance (RUSA4) was selected to characterize the transposon insertion site. The results indicate that the Tn551 insertion site in mutant RUSA4 is between base pairs 1000 and 1400 of the sequence encoding PBP 2A. Thus, the uniform and greater than 200-fold drop in the methicillin MIC (4 micrograms/ml) for this mutant relative to that for the parent strain (MIC greater than or equal to 800 micrograms/ml) must be related to the inactivation of the PBP 2A gene. The results provide the first unequivocal evidence for the importance of PBP 2A as a quantitative contributor to the MIC for MRSA.

Detection of methicillin resistance in staphylococci by using a DNA probe

A DNA probe derived from the PBP 2a gene of the methicillin-resistant Staphylococcus aureus COL was compared with phenotypic microbiologic tests for its ability to identify methicillin-resistant and -susceptible staphylococci. Lysates were applied to nitrocellulose with a dot blot apparatus. Isolates tested were both S. aureus and coagulase-negative staphylococci that had been recovered from a variety of geographic and clinical sources. When compared with a spread plate phenotypic test, the DNA probe gave sensitivity, specificity, and predictive values for both positive and negative tests of 100% for 204 S. aureus isolates (103 positive, 101 negative) and 99, 95, 99, and 95%, respectively, for 249 coagulase-negative staphylococci (210 positive, 39 negative). The probe was more sensitive than broth microdilution and more specific than agar dilution in identifying methicillin-resistant and -susceptible coagulase-negative staphylococci; all tests were equally accurate in identifying the methicillin susceptibility of S. aureus. DNA probe analysis for determining the methicillin susceptibility of staphylococci was rapid, easily interpretable, and equally accurate with radioactive and nonradioactive probes, and it gave results equivalent to the most sensitive microbiologic test for all staphylococcus species studied.

Evidence of a novel staphylococcal mec-encoded element (mecR) controlling expression of penicillin-binding protein 2'

A region was identified on the methicillin resistance determinant (mec) isolated from Staphylococcus epidermidis and cloned into Staphylococcus carnosus which was responsible for a novel downregulation of the expression of methicillin resistance. The presence of this region reduced the overall expression of methicillin resistance and the synthesis of the mec-encoded penicillin-binding protein 2' (PBP 2') in S. carnosus. This region was located by Bal31 deletion mutagenesis upstream of the structural gene for PBP 2'. Deletions within this region resulted in higher levels of expression of methicillin resistance and increased levels of PBP 2' synthesis. We tentatively called this region mecR. Analysis of selected Mcr strains of Staphylococcus aureus and S. epidermidis by Southern hybridization suggested that the natural occurrence of two types of mec resistance determinants differ by the presence or absence of mecR-specific sequences.

Use of a ribosomal RNA gene probe for the epidemiological study of methicillin and ciprofloxacin resistant Staphylococcus aureus

Conventional bacteriophage typing was combined with ribotyping in the analysis of methicillin and ciprofloxacin resistant Staphylococcus aureus strains isolated in increasing frequency since the introduction of the new 4-quinolones as therapeutic agents in the Tel-Aviv Medical Center. Whole-cell DNA was digested with EcoRI and HindIII restriction endonucleases. Agarose gel electrophoresis, Southern blotting, and hybridization by biotinylated probe DNA coding for ribosomal RNA revealed 7 to 14 bands. Analysis of the patterns established a single DNA type in EcoRI as well as in HindIII digests for all strains except one. Control strains from other sources differed in their band patterns. Bacteriophage typing confirmed the results of DNA typing. Thus, the frequent occurrence of staphylococcal isolates resistant to 4-quinolones in the hospital was not due to mutational development of resistance in many strains, but to the spread of a resistant strain.

Characterization of a small cryptic plasmid isolated from a methicillin-resistant strain of Staphylococcus aureus

The nucleotide sequence of a small (1613 bp) plasmid, pOX2000, isolated from a methicillin-resistant strain of Staphylococcus aureus has been determined. The sequence contains only one large ORF and the predicted amino acid sequence shows homology to the REP proteins of some other small staphylococcal plasmids. In addition there are two palindromic sequences, palA and palJ, that are similar to but not identical with the palindromes known from other staphylococcal plasmids to be involved in lagging strand initiation and possibly leading strand termination, respectively. Preliminary functional analysis of pOX2000 has been carried out by assessing the effect of interrupting the sequence at three unique restriction endonuclease sites. The plasmid pOX2000, and its relationship to other small staphylococcal plasmids, is discussed.

Presence of an additional penicillin-binding protein in methicillin-resistant Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, and Staphylococcus simulans with a low affinity for methicillin, cephalothin, and cefamandole

The presence of an additional penicillin-binding protein (PBP) was demonstrated in methicillin-resistant strains of Staphylococcus epidermidis, S. haemolyticus, S. hominis, and S. simulans. In these four species, the apparent molecular mass of this protein was analogous to that of PBP 2' of methicillin-resistant S. aureus SR 1550-9. It exhibited a low affinity for methicillin, cephalothin, and cefamandole; and its synthesis was methicillin inducible. Peptide mapping of this PBP from the four species yielded identical results that were analogous to those obtained with S. aureus SR 1550-9. These results suggest that this protein is similar to, if not the same as, PBP 2' of S. aureus and that it is involved in methicillin resistance in the four species studied.

A probe for the detection of methicillin-resistant Staphylococcus aureus

An approximately 300 base pair DNA fragment for use as a probe was isolated from methicillin-resistant Staphylococcus aureus DNA partially digested with Sau3AI. This probe hybridized with 25 methicillin-resistant clinical isolates of Staphylococcus aureus belonging to 18 different phage types, but not with 41 clinical isolates susceptible to methicillin.