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Satishkumar N, Lai LY, Mukkayyan N, Vogel BE, Chatterjee SS. A Nonclassical Mechanism of β-Lactam Resistance in Methicillin-Resistant Staphylococcus aureus and Its Effect on Virulence. Microbiol Spectr 2022; 10:e0228422. [PMID: 36314912 PMCID: PMC9769611 DOI: 10.1128/spectrum.02284-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a group of pathogenic bacteria that are infamously resistant to β-lactam antibiotics, a property attributed to the mecA gene. Recent studies have reported that mutations associated with the promoter region of pbp4 demonstrated high levels of β-lactam resistance, suggesting the role of PBP4 as an important non-mecA mediator of β-lactam resistance. The pbp4-promoter-associated mutations have been detected in strains with or without mecA. Our previous studies that were carried out in strains devoid of mecA described that pbp4-promoter-associated mutations lead to PBP4 overexpression and β-lactam resistance. In this study, by introducing various pbp4-promoter-associated mutations in the genome of a MRSA strain, we demonstrate that PBP4 overexpression can supplement mecA-associated resistance in S. aureus and can lead to increased β-lactam resistance. The promoter and regulatory region of pbp4 is shared with a divergently transcribed gene, abcA, which encodes a multidrug exporter. We demonstrate that the promoter mutations caused an upregulation of pbp4 and downregulation of abcA, confirming that the resistant phenotype is associated with PBP4 overexpression. PBP4 has also been associated with staphylococcal pathogenesis, however, its exact role remains unclear. Using a Caenorhabditis elegans model, we demonstrate that strains having increased PBP4 expression are less virulent than wild-type strains, suggesting that β-lactam resistance mediated via PBP4 likely comes at the cost of virulence. IMPORTANCE Our study demonstrates the ability of PBP4 to be an important mediator of β-lactam resistance in not only methicillin-susceptible Staphylococcus aureus (MSSA) background strains as previously demonstrated but also in MRSA strains. When present together, PBP2a and PBP4 overexpression can produce increased levels of β-lactam resistance, causing complications in treatment. Thus, this study suggests the importance of monitoring PBP4-associated resistance in clinical settings, as well as understanding the mechanistic basis of associated resistance, so that treatments targeting PBP4 may be developed. This study also demonstrates that S. aureus strains with increased PBP4 expression are less pathogenic, providing important hints about the role of PBP4 in S. aureus resistance and pathogenesis.
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Affiliation(s)
- Nidhi Satishkumar
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
- Institute of Marine and Environmental Technology (IMET), Baltimore, Maryland, USA
| | - Li-Yin Lai
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
- Institute of Marine and Environmental Technology (IMET), Baltimore, Maryland, USA
| | - Nagaraja Mukkayyan
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
- Institute of Marine and Environmental Technology (IMET), Baltimore, Maryland, USA
| | - Bruce E. Vogel
- Center for Biomedical Engineering and Technology, University of Maryland School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Som S. Chatterjee
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
- Institute of Marine and Environmental Technology (IMET), Baltimore, Maryland, USA
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2
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Mukkayyan N, Poon R, Sander PN, Lai LY, Zubair-Nizami Z, Hammond MC, Chatterjee SS. In Vivo Detection of Cyclic-di-AMP in Staphylococcus aureus. ACS OMEGA 2022; 7:32749-32753. [PMID: 36120079 PMCID: PMC9476191 DOI: 10.1021/acsomega.2c04538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
Cyclic-di-AMP (CDA) is a signaling molecule that controls various cellular functions including antibiotic tolerance and osmoregulation in Staphylococcus aureus (S. aureus). In this study, we developed a novel biosensor (bsuO P6-4) for in vivo detection of CDA in S. aureus. The fluorescent biosensor is based on a natural CDA riboswitch from Bacillus subtilis connected at its P6 stem to the dye-binding aptamer Spinach. Our study showed that bsuO P6-4 could detect a wide concentration range of CDA in both laboratory and clinical strains, making it suitable for use in both basic and clinical research applications.
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Affiliation(s)
- Nagaraja Mukkayyan
- Department
of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland 21202, United States
- Institute
of Marine and Environmental Technology, Baltimore, Maryland 21202, United States
| | - Raymond Poon
- Department
of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland 21202, United States
- Institute
of Marine and Environmental Technology, Baltimore, Maryland 21202, United States
| | - Philipp N. Sander
- Department
of Chemistry, University of California, Berkeley, California 94720, United States
| | - Li-Yin Lai
- Department
of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland 21202, United States
- Institute
of Marine and Environmental Technology, Baltimore, Maryland 21202, United States
| | - Zahra Zubair-Nizami
- Department
of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland 21202, United States
- Institute
of Marine and Environmental Technology, Baltimore, Maryland 21202, United States
| | - Ming C. Hammond
- Department
of Chemistry, University of California, Berkeley, California 94720, United States
- Department
of Chemistry and Henry Eyring Center for Cell and Genome Sciences, University of Utah, Salt Lake City, Utah 84112, United States
| | - Som S. Chatterjee
- Department
of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, Maryland 21202, United States
- Institute
of Marine and Environmental Technology, Baltimore, Maryland 21202, United States
- University
of Maryland Center for Environmental Science, Baltimore, Maryland 21202, United States
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3
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Loss of GdpP function in Staphylococcus aureus leads to β-lactam tolerance and enhanced evolution of β-lactam resistance. Antimicrob Agents Chemother 2021; 66:e0143121. [PMID: 34843389 DOI: 10.1128/aac.01431-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Infections caused by Staphylococcus aureus are a leading cause of mortality. Treating infections caused by S. aureus is difficult due to resistance against most traditional antibiotics, including β-lactams. We previously reported the presence of mutations in gdpP among S. aureus strains that were obtained by serial passaging in β-lactam drugs. Similar mutations have recently been reported in natural S. aureus isolates that are either non-susceptible or resistant to β-lactam antibiotics. gdpP codes for a phosphodiesterase that cleaves cyclic-di-AMP (CDA), a newly discovered second messenger. In this study, we sought to identify the role of gdpP in β-lactam resistance in S. aureus. Our results showed that gdpP associated mutations caused loss of phosphodiesterase function, leading to increased CDA accumulation in the bacterial cytosol. Deletion of gdpP led to an enhanced ability of the bacteria to withstand a β-lactam challenge (two to three log increase in bacterial colony forming units) by promoting tolerance without enhancing MICs of β-lactam antibiotics. Our results demonstrated that increased drug tolerance due to loss of GdpP function can provide a selective advantage in acquisition of high-level β-lactam resistance. Loss of GdpP function thus increases tolerance to β-lactams that can lead to its therapy failure and can permit β-lactam resistance to occur more readily.
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4
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Abdizadeh N, Haeili M, Kafil HS, Ahmadi A, Feizabadi MM. Evaluation of in vitro activity of ceftaroline on methicillin resistant Staphylococcus aureus blood isolates from Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2021; 13:442-448. [PMID: 34557271 PMCID: PMC8421581 DOI: 10.18502/ijm.v13i4.6967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Ceftaroline (CPT) is a novel cephalosporin with potent activity against methicillin-resistant Staphylococcus aureus (MRSA). Despite its recent introduction, CPT resistance in MRSA has been described worldwide. We aimed in the current study to evaluate the in vitro activity of CPT against 91 clinical MRSA and 3 MSSA isolates. Materials and Methods: Susceptibility of isolates to CPT was tested using E-test and disk diffusion (DD) method. The nucleotide sequence of the mecA gene and molecular types of isolates with reduced susceptibility to CPT were further studied to identify resistance conferring mutations in PBP2a and the genetic relatedness of the isolates respectively. Results: Overall, 92.5% of isolates were found to be CPT susceptible (MICs≤1mg/l) and 7 MRSA isolates were characterized with MIC=2mg/l and categorized as susceptible dose dependent. Compared to E-test, DD revealed a categorical agreement rate of 93.6% and the obtained rates for minor, major /very major error were found to be 6.3% and 0% respectively. The MRSA isolates with increased CPT MICs (n=7), belonged to spa types t030 (n=6) and t13927 (n=1) and all carried N146K substitution in PBP2a allosteric domain, except for one isolate which harbored a wild-type PBP2a. Conclusion: While resistance to CPT was not detected we found increased CPT MICs in 7.69% of MRSA isolates. Reduced susceptibility to CPT in the absence of mecA mutations is indicative of contribution of secondary chromosomal mutations in resistance development.
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Affiliation(s)
- Negin Abdizadeh
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Mehri Haeili
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Ahmadi
- Pharmaceutical Nanotechnology Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Thoracic Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Morroni G, Fioriti S, Salari F, Brenciani A, Brescini L, Mingoia M, Giovanetti E, Pocognoli A, Giacometti A, Molinelli E, Offidani A, Simonetti O, Cirioni O. Characterization and Clonal Diffusion of Ceftaroline Non-Susceptible MRSA in Two Hospitals in Central Italy. Antibiotics (Basel) 2021; 10:antibiotics10081026. [PMID: 34439075 PMCID: PMC8388857 DOI: 10.3390/antibiotics10081026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/13/2021] [Accepted: 08/21/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Ceftaroline represents a novel fifth-generation cephalosporin to treat infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Methods: Ceftaroline susceptibility of 239 MRSA isolates was assessed by disk diffusion and a MIC test strip following both EUCAST and CLSI guidelines. Non-susceptible isolates were epidemiologically characterized by pulsed-field gel electrophoresis, spa typing, and multilocus sequence typing, and further investigated by PCR and whole genome sequencing to detect penicillin-binding protein (PBP) mutations as well as antibiotic resistance and virulence genes. Results: Fourteen isolates out of two hundred and thirty-nine (5.8%) were non-susceptible to ceftaroline (MIC > 1 mg/L), with differences between the EUCAST and CLSI interpretations. The characterized isolates belonged to seven different pulsotypes and three different clones (ST228/CC5-t041-SCCmecI, ST22/CC22-t18014-SCCmecIV, and ST22/CC22-t022-SCCmecIV), confirming a clonal diffusion of ceftaroline non-susceptible strains. Mutations in PBPs involved PBP2a for ST228-t041-SCCmecI strains and all the other PBPs for ST22-t18014-SCCmecIV and ST22-t022-SCCmecIV clones. All isolates harbored antibiotic resistance and virulence genes with a clonal distribution. Conclusion: Our study demonstrated that ceftaroline non-susceptibile isolates belonged not only to ST228 strains (the most widespread clone in Italy) but also to ST22, confirming the increasing role of these clones in hospital infections.
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Affiliation(s)
- Gianluca Morroni
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Simona Fioriti
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Federica Salari
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Andrea Brenciani
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Lucia Brescini
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Marina Mingoia
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Eleonora Giovanetti
- Department of Life and Environmental Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
| | | | - Andrea Giacometti
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Elisa Molinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy; (E.M.); (A.O.)
| | - Annamaria Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy; (E.M.); (A.O.)
| | - Oriana Simonetti
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy; (E.M.); (A.O.)
- Correspondence: ; Tel.: +39-0715963494
| | - Oscar Cirioni
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
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6
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Satishkumar N, Alexander JAN, Poon R, Buggeln E, Argudín MA, Strynadka NCJ, Chatterjee SS. PBP4-mediated β-lactam resistance among clinical strains of Staphylococcus aureus. J Antimicrob Chemother 2021; 76:2268-2272. [PMID: 34151961 DOI: 10.1093/jac/dkab201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/24/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND PBP4, a low-molecular-weight PBP in Staphylococcus aureus, is not considered to be a classical mediator of β-lactam resistance. Previous studies carried out by our group with laboratory strains of S. aureus demonstrated the ability of PBP4 to produce β-lactam resistance through mutations associated with the pbp4 promoter and/or gene. Recent studies of β-lactam-resistant clinical isolates of S. aureus have reported similar mutations associated with pbp4. OBJECTIVES To determine if pbp4-associated mutations reported among clinical strains of S. aureus mediate β-lactam resistance. METHODS The pbp4 promoters and genes bearing mutations from clinical isolates were cloned into a heterologous host. Reporter, growth and Bocillin assays were performed to assess their role in β-lactam resistance. X-ray crystallography was used to obtain acyl-enzyme intermediate structures of the WT and mutant PBP4 with nafcillin and cefoxitin. RESULTS Of the five strains that contained pbp4 promoter mutations, three strains exhibited enhanced expression of PBP4. The R200L mutation in pbp4 resulted in increased survival in the presence of the β-lactams nafcillin and cefoxitin. Further, introduction of either a promoter or a gene mutation into the genome of a WT host increased the ability of the strains to resist the action of β-lactams. The four high-resolution X-ray structures presented demonstrate the binding pose of the β-lactams tested and provide hints for further drug development. CONCLUSIONS Mutations associated with the pbp4 promoter and pbp4 gene altered protein activity and mediated β-lactam resistance among the clinically isolated strains that were studied.
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Affiliation(s)
- Nidhi Satishkumar
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD, USA.,Institute of Marine and Environmental Technology, Baltimore, MD, USA
| | - J Andrew N Alexander
- Department of Biochemistry and Molecular Biology and Centre for Blood Research, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Raymond Poon
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD, USA.,Institute of Marine and Environmental Technology, Baltimore, MD, USA
| | - Emma Buggeln
- Division of HIV/AIDS, Infectious Diseases and Global Health, Department of Medicine, University of California, San Francisco, San Francisco General Hospital, San Francisco, CA, USA
| | - Maria A Argudín
- National Reference Centre for Staphylococcus aureus, Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles, Brussels, Belgium
| | - Natalie C J Strynadka
- Department of Biochemistry and Molecular Biology and Centre for Blood Research, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Som S Chatterjee
- Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD, USA.,Institute of Marine and Environmental Technology, Baltimore, MD, USA
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Sasaki H, Ishikawa H, Itoh T, Arano M, Hirata K, Ueshiba H. Penicillin-Binding Proteins and Associated Protein Mutations Confer Oxacillin/Cefoxitin Tolerance in Borderline Oxacillin-Resistant Staphylococcus aureus. Microb Drug Resist 2020; 27:590-595. [DOI: 10.1089/mdr.2020.0191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Hiraku Sasaki
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Hiroki Ishikawa
- Department of Microbiology and Immunology, Showa University School of Medicine, Shinagawa-ku, Japan
| | - Taisuke Itoh
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Makoto Arano
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Koya Hirata
- Department of Health Science, Faculty of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Hidehiro Ueshiba
- Department of Microbiology and Immunology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Japan
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Susceptibility of Methicillin-Resistant Staphylococcus aureus to Five Quinazolinone Antibacterials. Antimicrob Agents Chemother 2019; 64:AAC.01344-19. [PMID: 31611358 PMCID: PMC7187613 DOI: 10.1128/aac.01344-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/08/2019] [Indexed: 11/22/2022] Open
Abstract
The in vitro activities of five quinazolinone antibacterials, compounds Q1 to Q5, were tested against 210 strains of methicillin-resistant Staphylococcus aureus (MRSA). The MIC50/MIC90 values (in μg/ml) were as follows: Q1, 0.5/2; Q2, 1/4; Q3, 2/4; Q4, 0.06/0.25; and Q5, 0.125/0.5. The in vitro activities of five quinazolinone antibacterials, compounds Q1 to Q5, were tested against 210 strains of methicillin-resistant Staphylococcus aureus (MRSA). The MIC50/MIC90 values (in μg/ml) were as follows: Q1, 0.5/2; Q2, 1/4; Q3, 2/4; Q4, 0.06/0.25; and Q5, 0.125/0.5. Several strains with high MIC values (from 8 to >32 μg/ml) for some of these compounds exhibited amino acid changes in the penicillin-binding proteins, which are targeted by these antibacterials.
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Gostev V, Sopova J, Kalinogorskaya O, Tsvetkova I, Lobzin Y, Klotchenko S, Sidorenko S. In Vitro Ceftaroline Resistance Selection of Methicillin-Resistant Staphylococcus aureus Involves Different Genetic Pathways. Microb Drug Resist 2019; 25:1401-1409. [PMID: 31329022 DOI: 10.1089/mdr.2019.0130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The pathways in the development of ceftaroline resistance of methicillin-resistant Staphylococcus aureus (MRSA) isolates belonging to the ST8, ST239, and ST228 were evaluated. Ceftaroline-resistant derivatives were isolated through selection during 40 passages. Ceftaroline MIC measurements and whole-genome sequencing were performed after 5, 20, and 40 passages. In two ST8 derivative isolates, ceftaroline MIC increased up to 128 mg/L. Mutations were acquired in gdpP and graS in one isolate after 20 passages and in gdpP in another after 40 passages. MIC for two ST239 derivatives increased to 128 mg/L. Substitutions in Pbp4 and polymorphisms in the upstream region of pbp4 were identified in both derivatives after 40 passages. In one isolate, additional mutation in gdpP and deletion in graR were detected. In an ST228 derivative, MIC increased to 32 mg/L with one mutation in penicillin-binding protein 2a (Y446N) detected after five passages and a second (E447K) after 20 passages. Three pathways in the development of ceftaroline resistance were identified. For ST8 and ST239 derivatives mutations were detected in gdpP and pbp4, respectively, whereas in ST228 - in mecA. Most derivatives harbored additional mutations whose potential role in the development of resistance has not been determined.
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Affiliation(s)
- Vladimir Gostev
- Department of Medical Microbiology and Molecular Epidemiology, Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russia
- Department of Medical Microbiology, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia
| | - Julia Sopova
- Laboratory of Genetic Models of Human Diseases, Saint Petersburg Branch of Vavilov Institute of General Genetics, Saint Petersburg, Russia
- Department of Genetics and Biotechnology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Olga Kalinogorskaya
- Department of Medical Microbiology and Molecular Epidemiology, Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russia
| | - Irina Tsvetkova
- Department of Medical Microbiology and Molecular Epidemiology, Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russia
| | - Yuri Lobzin
- Department of Medical Microbiology and Molecular Epidemiology, Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russia
- Department of Medical Microbiology, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia
| | - Sergey Klotchenko
- Division of Viral Molecular Biology, Smorodintsev Research Institute of Influenza, Saint Petersburg, Russia
| | - Sergey Sidorenko
- Department of Medical Microbiology and Molecular Epidemiology, Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg, Russia
- Department of Medical Microbiology, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia
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10
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Bongiorno D, Mongelli G, Stefani S, Campanile F. Genotypic analysis of Italian MRSA strains exhibiting low-level ceftaroline and ceftobiprole resistance. Diagn Microbiol Infect Dis 2019; 95:114852. [PMID: 31288948 DOI: 10.1016/j.diagmicrobio.2019.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/29/2019] [Accepted: 06/06/2019] [Indexed: 11/19/2022]
Abstract
The aim of this study was to address the involvement of PBP mutations in the bactericidal activity to novel cephalosporins, alone and in combination with daptomycin, in not-related multidrug-resistant methicillin-resistant Staphylococcus aureus strains isolated during a nationwide Italian survey. MICs determination and time-killing assays were performed and mecA, pbp1, pbp2, pbp3, pbp4, and gdpP genes were sequenced. Ten strains showed low-level resistance to ceftaroline and ceftobiprole. PBP2a sequence analysis identified four different mutations (N146K; N204K; T235I; E239K) uniquely present in the non-penicillin-binding domain (nPBD). Epidemiologically, this resistance was associated with the most widespread MDR Italian clone ST228-SCCmecI-t001/t041, confirming its proclivity to accumulate mutations, and it is also associated to substitutions in the GdpP signaling protein, involved in the maintenance of di-AMP balance, recently associated with resistance to beta-lactams. Despite these mutations, both drugs retained their potent in vitro bactericidal activity and showed a synergistic effect towards difficult-to-treat isolates.
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Affiliation(s)
- Dafne Bongiorno
- Department of Biomedical and Biotechnological Sciences (BIOMETEC) - Medical Molecular Microbiology and Antibiotic Resistance laboratory (MMARLab), - University of Catania, Italy
| | - Gino Mongelli
- Department of Biomedical and Biotechnological Sciences (BIOMETEC) - Medical Molecular Microbiology and Antibiotic Resistance laboratory (MMARLab), - University of Catania, Italy
| | - Stefania Stefani
- Department of Biomedical and Biotechnological Sciences (BIOMETEC) - Medical Molecular Microbiology and Antibiotic Resistance laboratory (MMARLab), - University of Catania, Italy
| | - Floriana Campanile
- Department of Biomedical and Biotechnological Sciences (BIOMETEC) - Medical Molecular Microbiology and Antibiotic Resistance laboratory (MMARLab), - University of Catania, Italy.
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11
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Basuino L, Jousselin A, Alexander JAN, Strynadka NCJ, Pinho MG, Chambers HF, Chatterjee SS. PBP4 activity and its overexpression are necessary for PBP4-mediated high-level β-lactam resistance. J Antimicrob Chemother 2019; 73:1177-1180. [PMID: 29360990 DOI: 10.1093/jac/dkx531] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/15/2017] [Indexed: 11/13/2022] Open
Abstract
Background PBP4 is typically considered unimportant for conferring high-level β-lactam resistance in Staphylococcus aureus. Mutations in PBP4 have been associated with β-lactam non-susceptibility among natural strains of S. aureus. We have previously shown that PBP4 can mediate high-level β-lactam resistance in laboratory-generated strains passaged in β-lactam antibiotics. Mutations in the pbp4 promoter that up-regulate its expression and missense mutations that surround PBP4's active site were detected in high frequencies among passaged strains, suggesting PBP4 plays a key role in resistance. How these mutations participate in PBP4's ability to provide high-level β-lactam resistance is unknown. Objectives To determine whether enzymatic activity of PBP4 is required for high-level β-lactam resistance and to investigate how the pbp4-associated mutations provide β-lactam resistance. Methods The catalytic activity of PBP4 was disabled through introduction of a serine to alanine point mutation in its active site (Ser-75→Ala) in a representative and well-studied passaged strain, CRB. pbp4 promoter and missense mutations detected in CRB were reconstituted in a WT strain individually and in combination. β-Lactam resistance of the resultant strains was evaluated by population analysis. Bacterial peptidoglycan composition of the pbp4 mutants was evaluated with and without antibiotic treatment using LC. Results PBP4 inactivation imparted complete β-lactam susceptibility of CRB. Reconstitution of PBP4 missense mutations alone did not impart β-lactam resistance, but did so in synergism with pbp4 promoter mutation. A similar synergistic interaction of pbp4 mutations was observed in enhanced peptidoglycan cross-linking upon antibiotic treatment. Conclusions PBP4's activity and overexpression both contribute to high-level β-lactam resistance.
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Affiliation(s)
- Li Basuino
- Division of HIV/AIDS, Infectious Diseases and Global Health, Department of Medicine, University of California, San Francisco, CA, USA
| | - Ambre Jousselin
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal
| | - J Andrew N Alexander
- Department of Biochemistry and Molecular Biology and the Center for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Natalie C J Strynadka
- Department of Biochemistry and Molecular Biology and the Center for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mariana G Pinho
- Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Henry F Chambers
- Division of HIV/AIDS, Infectious Diseases and Global Health, Department of Medicine, University of California, San Francisco, CA, USA
| | - Som S Chatterjee
- Division of HIV/AIDS, Infectious Diseases and Global Health, Department of Medicine, University of California, San Francisco, CA, USA
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Latour K, Huang TD, Jans B, Berhin C, Bogaerts P, Noel A, Nonhoff C, Dodémont M, Denis O, Ieven M, Loens K, Schoevaerdts D, Catry B, Glupczynski Y. Prevalence of multidrug-resistant organisms in nursing homes in Belgium in 2015. PLoS One 2019; 14:e0214327. [PMID: 30921364 PMCID: PMC6438666 DOI: 10.1371/journal.pone.0214327] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 03/11/2019] [Indexed: 12/29/2022] Open
Abstract
Objectives Following two studies conducted in 2005 and 2011, a third prevalence survey of multidrug-resistant microorganisms (MDRO) was organised in Belgian nursing homes (NHs) using a similar methodology. The aim was to measure the prevalence of carriage of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum β-lactamase producing Enterobacteriaceae (ESBLE) and carbapenemase-producing Enterobacteriaceae (CPE) in NH residents. Risk factors for MDRO carriage were also explored. Methods Up to 51 randomly selected residents per NH were screened for MDRO carriage by trained local nurses between June and October 2015. Rectal swabs were cultured for ESBLE, CPE and VRE, while pooled samples of nose, throat and perineum and chronic wound swabs were obtained for culture of MRSA. Antimicrobial susceptibility testing, molecular detection of resistance genes and strain genotyping were performed. Significant risk factors for MDRO colonization MDRO was determined by univariate and multivariable analysis. Results Overall, 1447 residents from 29 NHs were enrolled. The mean weighted prevalence of ESBLE and MRSA colonization was 11.3% and 9.0%, respectively. Co-colonization occurred in 1.8% of the residents. VRE and CPE carriage were identified in only one resident each. Impaired mobility and recent treatment with fluoroquinolones or with combinations of sulphonamides and trimethoprim were identified as risk factors for ESBLE carriage, while for MRSA these were previous MRSA carriage/infection, a stay in several different hospital wards during the past year, and a recent treatment with nitrofuran derivatives. Current antacid use was a predictor for both ESBL and MRSA carriage. Conclusions In line with the evolution of MRSA and ESBL colonization/infection in hospitals, a decline in MRSA carriage and an increase in ESBLE prevalence was seen in Belgian NHs between 2005 and 2015. These results show that a systemic approach, including surveillance and enhancement of infection control and antimicrobial stewardship programs is needed in both acute and chronic care facilities.
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Affiliation(s)
- Katrien Latour
- Operational Directorate Epidemiology & Public Health, Sciensano, Brussels, Belgium
- Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
- * E-mail:
| | - Te-Din Huang
- National Reference Centre for antibiotic resistant Gram-negative bacilli, Laboratory of Clinical Microbiology, Centre hospitalier universitaire de Namur, Université catholique de Louvain, Yvoir, Belgium
| | - Béatrice Jans
- Operational Directorate Epidemiology & Public Health, Sciensano, Brussels, Belgium
| | - Catherine Berhin
- National Reference Centre for antibiotic resistant Gram-negative bacilli, Laboratory of Clinical Microbiology, Centre hospitalier universitaire de Namur, Université catholique de Louvain, Yvoir, Belgium
| | - Pierre Bogaerts
- National Reference Centre for antibiotic resistant Gram-negative bacilli, Laboratory of Clinical Microbiology, Centre hospitalier universitaire de Namur, Université catholique de Louvain, Yvoir, Belgium
| | - Audrey Noel
- National Reference Centre for antibiotic resistant Gram-negative bacilli, Laboratory of Clinical Microbiology, Centre hospitalier universitaire de Namur, Université catholique de Louvain, Yvoir, Belgium
| | - Claire Nonhoff
- National Reference Centre for methicillin-resistant Staphylococcus aureus and staphylococci, Department of Clinical Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Magali Dodémont
- National Reference Centre for methicillin-resistant Staphylococcus aureus and staphylococci, Department of Clinical Microbiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Denis
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Margareta Ieven
- National Reference Centre for vancomycin-resistant enterococci, Department of Clinical Microbiology, University Hospital of Antwerp, Edegem, Belgium
| | - Katherine Loens
- National Reference Centre for vancomycin-resistant enterococci, Department of Clinical Microbiology, University Hospital of Antwerp, Edegem, Belgium
| | - Didier Schoevaerdts
- Department of Geriatric Medicine, Centre hospitalier universitaire de Namur, Université catholique de Louvain, Mont-Godinne, Belgium
- Institute of Health and Society, Ecole de Santé Publique, Université catholique de Louvain, Brussels, Belgium
| | - Boudewijn Catry
- Operational Directorate Epidemiology & Public Health, Sciensano, Brussels, Belgium
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Youri Glupczynski
- National Reference Centre for antibiotic resistant Gram-negative bacilli, Laboratory of Clinical Microbiology, Centre hospitalier universitaire de Namur, Université catholique de Louvain, Yvoir, Belgium
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High Rate of Ceftobiprole Resistance among Clinical Methicillin-Resistant Staphylococcus aureus Isolates from a Hospital in Central Italy. Antimicrob Agents Chemother 2018; 62:AAC.01663-18. [PMID: 30275082 DOI: 10.1128/aac.01663-18] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/15/2018] [Indexed: 11/20/2022] Open
Abstract
Ceftobiprole is a fifth-generation cephalosporin with activity against methicillin-resistant Staphylococcus aureus (MRSA). One-year surveillance at the Regional Hospital of Ancona (Italy) disclosed a 12% ceftobiprole resistance rate (12/102 isolates; MIC, ≥4 mg/liter). Epidemiological characterization demonstrated that the resistant isolates all belonged to different clones. Penicillin-binding protein (PBP) analysis showed substitutions in all PBPs and a novel insertion in PBP2a. The mecB and mecC genes were not detected. Ceftobiprole susceptibility screening is essential to avoid therapeutic failure and the spread of ceftobiprole-resistant strains.
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Ceballos S, Kim C, Ding D, Mobashery S, Chang M, Torres C. Activities of Oxadiazole Antibacterials against Staphylococcus aureus and Other Gram-Positive Bacteria. Antimicrob Agents Chemother 2018; 62:e00453-18. [PMID: 29866865 PMCID: PMC6105842 DOI: 10.1128/aac.00453-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/26/2018] [Indexed: 12/13/2022] Open
Abstract
The activities of four oxadiazoles were investigated with 210 methicillin-resistant Staphylococcus aureus (MRSA) strains. MIC50 and MIC90 values of 1 to 2 and 4 μg/ml, respectively, were observed. We also evaluated the activity of oxadiazole ND-421 against other staphylococci and enterococci and in the presence of oxacillin for selected MRSA strains. The MIC for ND-421 is lowered severalfold in combination with oxacillin, as they synergize. The MIC90 of ND-421 against vancomycin-resistant enterococci is ≤1 μg/ml.
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Affiliation(s)
- Sara Ceballos
- Area of Biochemistry and Molecular Biology, University of La Rioja, Logroño, Spain
| | - Choon Kim
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana, USA
| | - Derong Ding
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana, USA
| | - Shahriar Mobashery
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana, USA
| | - Mayland Chang
- Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, Indiana, USA
| | - Carmen Torres
- Area of Biochemistry and Molecular Biology, University of La Rioja, Logroño, Spain
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Genetic Diversity among Staphylococcus aureus Isolates Showing Oxacillin and/or Cefoxitin Resistance Not Linked to the Presence of mec Genes. Antimicrob Agents Chemother 2018; 62:AAC.00091-18. [PMID: 29661881 DOI: 10.1128/aac.00091-18] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/12/2018] [Indexed: 01/30/2023] Open
Abstract
Methicillin-resistant Staphylococcus aureus isolates lacking mec genes (n = 32), collected from Belgian hospitals, were characterized for their β-lactamase production and the presence of mutations in pbp genes, the pbp4 promoter, and genes involved in penicillin-binding protein 4 overproduction (gdpP and yjbH). Twelve isolates were β-lactamase hyperproducers (BHPs), while 12 non-BHP isolates might produce an incomplete GdpP protein. Most isolates showed nucleotide missense mutations in pbp genes. A few isolates also showed mutations in the pbp4 promoter.
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PBP4: A New Perspective on Staphylococcus aureus β-Lactam Resistance. Microorganisms 2018; 6:microorganisms6030057. [PMID: 29932109 PMCID: PMC6164785 DOI: 10.3390/microorganisms6030057] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/19/2018] [Accepted: 06/20/2018] [Indexed: 12/14/2022] Open
Abstract
β-lactam antibiotics are excellent drugs for treatment of staphylococcal infections, due to their superior efficacy and safety compared to other drugs. Effectiveness of β-lactams is severely compromised due to resistance, which is widespread among clinical strains of Staphylococcus aureus. β-lactams inhibit bacterial cells by binding to penicillin binding proteins (PBPs), which perform the penultimate steps of bacterial cell wall synthesis. Among PBPs of S. aureus, PBP2a has received the most attention for the past several decades due to its preeminent role in conferring both high-level and broad-spectrum resistance to the entire class of β-lactam drugs. Studies on PBP2a have thus unraveled incredible details of its mechanism of action. We have recently identified that an uncanonical, low molecular weight PBP of S. aureus, PBP4, can also provide high-level and broad-spectrum resistance to the entire class of β-lactam drugs at a level similar to that of PBP2a. The role of PBP4 has typically been considered not so important for β-lactam resistance of S. aureus, and as a result its mode of action remains largely unknown. In this article, we review our current knowledge of PBP4 mediating β-lactam resistance in S. aureus.
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PBP4 Mediates β-Lactam Resistance by Altered Function. Antimicrob Agents Chemother 2017; 61:AAC.00932-17. [PMID: 28807923 DOI: 10.1128/aac.00932-17] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/08/2017] [Indexed: 11/20/2022] Open
Abstract
Penicillin binding protein 4 (PBP4) can provide high-level β-lactam resistance in Staphylococcus aureus A series of missense and promoter mutations associated with pbp4 were detected in strains that displayed high-level resistance. We show here that the missense mutations facilitate the β-lactam resistance mediated by PBP4 and the promoter mutations lead to overexpression of pbp4 Our results also suggest a cooperative interplay among PBPs for β-lactam resistance.
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