Dispersal in Campylobacter spp. of aphA-3, a kanamycin resistance determinant from gram-positive cocci

Characterization of plasmid-mediated aphA-3 kanamycin resistance in Campylobacter jejuni

A total of 254 isolates of Campylobacter jejuni and three isolates of Campylobacter coli, isolated from Sweden, Canada, and Egypt, were screened for kanamycin resistance. Eight strains of C. jejuni contained large plasmids that carried the aphA-3 kanamycin-resistance marker. In six plasmids, the aphA-3 gene was located downstream of an apparent insertion sequence, designated IS607*, which showed a considerable similarity to IS607, characterized on the chromosome of some Helicobacter pylori strains. In contrast, the other plasmids carried the aphA-3 gene as a part of a resistance cluster. This included three resistance markers encoding 6'-adenylyltransferase (aadE), streptothricin acetyltransferase (sat), and 3'-aminoglycoside phosphotransferase type III (aphA-3). The genetic organization of this resistance cluster suggests that it has been acquired by C. jejuni from a Gram-positive organism. The IS607* element was also observed in kanamycin-susceptible strains of C. jejuni on plasmids mediating tetracycline resistance. The kanamycin-resistance phenotype transferred along with tetracycline resistance by conjugation from four representative C. jejuni strains to a recipient strain of C. jejuni. The kanamycin-resistance determinant (aphA-3) was stably transferred from one of the four C. jejuni strains to a recipient strain of Escherichia coli. However, the C. jejuni plasmid, which also carries the tetO gene, was not maintained in E. coli. Pulsed-field gel electrophoresis revealed the integration of approximately 50 kb of the plasmid into the chromosome of the E. coli recipient.

Versatility of aminoglycosides and prospects for their future

Aminoglycoside antibiotics have had a major impact on our ability to treat bacterial infections for the past half century. Whereas the interest in these versatile antibiotics continues to be high, their clinical utility has been compromised by widespread instances of resistance. The multitude of mechanisms of resistance is disconcerting but also illuminates how nature can manifest resistance when bacteria are confronted by antibiotics. This article reviews the most recent knowledge about the mechanisms of aminoglycoside action and the mechanisms of resistance to these antibiotics.

Epidemiological survey of genes encoding aminoglycoside phosphotransferases APH (3') I and APH (3') II using DNA probes

The epidemiological survey of APH (3') I and APH (3') II genes, at a time when the specific antibiotic pressure was very low, was carried out by DNA-DNA hybridization. The sample included 334 aminoglycoside resistant Gram-negative bacteria collected from patients of a General Hospital. Of these, 251 hybridized with the APH (3') I-probe and 19 with the APH (3') II-probe but only 190 strains showed high resistance levels (CIM greater than 64 micrograms/ml) for kanamycin, neomycin and paromomycin. These strains were isolated both from inpatients and outpatients with different infectious diseases. The APH (3') I-gene was dispersed among all the bacterial species and clinical specimens tested but the APH (3') II-gene was not found in Pseudomonas spp, Escherichia coli, Citrobacter freundii and Enterobacter cloacae, nor in infected catheters. Several plasmids of different sizes carrying APH (3') genes were detected among different bacteria. Plasmids along with transposable elements (the probes used in this work were developed from Tn906 and Tn5) and the high consumption of other antibiotics whose resistance is carried by these bacteria might be playing an important role in the maintenance and dispersion of APH (3') genes.

Characterization of two plasmids from Campylobacter jejuni isolates that carry the aphA-7 kanamycin resistance determinant

Two small plasmids of 11.5 and 9.5 kb, each carrying an aphA-7 kanamycin phosphotransferase gene, were studied. The MICs of kanamycin for the two human Campylobacter jejuni isolates harboring the plasmids were 10,000 and 5,000 micrograms/ml, while the MICs of amikacin were 32 and 8 micrograms/ml, respectively. The MICs of gentamicin and tobramycin were less than or equal to 2 micrograms/ml for both isolates. The restriction endonuclease maps of the plasmids were similar, with the larger plasmid showing two discrete regions of additional DNA. When the aphA-7 gene from each plasmid was cloned into pBR322, the aphA-7 gene expressed the kanamycin resistance phenotype in Escherichia coli. For transformants containing the cloned aphA-7 gene, kanamycin MICs were greater than or equal to 128 micrograms/ml. The aphA-7 gene was also subcloned from the plasmid pFKT4420 into the E. coli-Streptococcus shuttle vector pDL278 and was transformed into Streptococcus gordonii Challis. For streptococcal transformants containing the novel plasmid, kanamycin MICs were 4,000 micrograms/ml. In the presence of a tetracycline resistance plasmid, both small plasmids could be mobilized during conjugal matings to Campylobacter coli recipients.

Novel and emerging mechanisms of antimicrobial resistance in nosocomial pathogens

Nosocomial pathogens frequently are resistant to antimicrobial agents. Although methicillin-resistant strains of Staphylococcus aureus continue to be a major problem in many hospitals, several new types of resistance determinants have been noted among organisms causing hospital-acquired infections. The mechanisms include extended spectrum beta-lactamases in gram-negative bacilli; resistance to beta-lactams, glycopeptides, and high levels of aminoglycosides among enterococci; quinolone resistance in isolates of methicillin-resistant S. aureus; and the spread of multiple resistance genes simultaneously in gram-negative organisms via Tn21-related genetic elements. These novel mechanisms of resistance complicate the treatment of nosocomial infections by limiting the number of effective antimicrobial agents available to the clinician. It is important for infection control practitioners and microbiologists to work together to detect and control the spread of resistant pathogens in the hospital setting.

Emergence of aminoglycoside resistance genes aadA and aadE in the genus Campylobacter

Resistance to streptomycin or spectinomycin or both in five Campylobacter coli strains, two Campylobacter jejuni strains, and a Campylobacter-like strain was studied by enzymatic assays and dot blot hybridization. Resistance was due to 6- or 3",9-aminoglycoside adenylyltransferases and to new types of phospho- and adenylyltransferases.

Genetic characterization of kanamycin resistance in Campylobacter coli

The restriction map of plasmid pIP1433 from Campylobacter coli BM2509, isolated in France, was constructed and the location of the kanamycin (Km) and tetracycline (Tc) resistance markers determined using probes for aphA-3 and tetO genes, respectively. These DNA probes were used to study a second Km- and Tc-resistant strain C. coli UA696, isolated in Canada. In this strain, the Km resistance determinant was located in the chromosome. Like pIP1433, the Km resistance determinant in C. coli UA696 specified a 3'-aminoglycoside phosphotransferase of type III whereas the tetO gene was located on a non-transmissible plasmid.