Nature of the deoxyribonucleic acid-chloroquine complex

A Biohistorical Perspective of Typhoid and Antimicrobial Resistance

We combine methodology from history and genetics to reconstruct the biosocial history of antimicrobial resistance (AMR) in the bacterium Salmonella enterica serovar Typhi (S. Typhi). We show how evolutionary divergence in S. Typhi was driven by rising global antibiotic use and by the neglect of typhoid outside of high-income countries. Although high-income countries pioneered 1960s precautionary antibiotic regulations to prevent selection for multidrug resistance, new antibiotic classes, typhoid's cultural status as a supposedly ancient disease of "undeveloped" countries, limited international funding, and narrow biosecurity agendas helped fragment effective global collective action for typhoid control. Antibiotic-intensive compensation for weak water and healthcare systems subsequently fueled AMR selection in low- and middle-income countries but often remained invisible due to lacking surveillance capabilities. The recent rise of extensively drug-resistant typhoid bears the biosocial footprint of more than half a century of antibiotic-intensive international neglect.

Plasmids carrying antimicrobial resistance genes in Enterobacteriaceae

Bacterial antimicrobial resistance (AMR) is constantly evolving and horizontal gene transfer through plasmids plays a major role. The identification of plasmid characteristics and their association with different bacterial hosts provides crucial knowledge that is essential to understand the contribution of plasmids to the transmission of AMR determinants. Molecular identification of plasmid and strain genotypes elicits a distinction between spread of AMR genes by plasmids and dissemination of these genes by spread of bacterial clones. For this reason several methods are used to type the plasmids, e.g. PCR-based replicon typing (PBRT) or relaxase typing. Currently, there are 28 known plasmid types in Enterobacteriaceae distinguished by PBRT. Frequently reported plasmids [IncF, IncI, IncA/C, IncL (previously designated IncL/M), IncN and IncH] are the ones that bear the greatest variety of resistance genes. The purpose of this review is to provide an overview of all known AMR-related plasmid families in Enterobacteriaceae, the resistance genes they carry and their geographical distribution.

Incidence, clinical presentation, and antimicrobial resistance trends in Salmonella and Shigella infections from children in Yucatan, Mexico

BACKGROUND

Salmonella and Shigella cause significant morbidity and mortality among children worldwide. Increased antimicrobial resistance results in greater burden of disease.

MATERIALS AND METHODS

From 2005 to 2011, Salmonella and Shigella isolates collected from ill children at a major hospital in Yucatan, Mexico, were subjected to serotyping and antimicrobial susceptibility testing by disk diffusion and agar dilution. The identification of bla CTX, bla CMY, bla SHV, bla TEM, and bla OXA and qnr resistance genes was conducted by PCR and sequencing.

RESULTS

Among 2344 children with acute gastroenteritis, salmonellosis decreased from 17.7% in 2005 to 11.2% in 2011 (p < 0.001). In contrast, shigellosis increased from 8.3% in 2010 to 12.1% in 2011. Compared to children with Salmonella, those with Shigella had significantly more bloody stools (59 vs 36%, p < 0.001), dehydration (27 vs 15%, p = 0.031), and seizures (11 vs 3%, p = 0.03). In Salmonella (n = 365), there was a significant decrease in resistance to ampicillin (43 to 16%, p < 0.001), trimethoprim-sulfamethoxazole (44 to 26%, p = 0.014), and extended-spectrum cephalosporins (27 to 10%, p = 0.009). Reduced susceptibility to ciprofloxacin in Salmonella rose from 30 to 41% (p < 0.001). All ceftriaxone-resistant isolates harbored the bla CMY-2 gene. qnr genes were found in 42 (36%) of the 117 Salmonella isolates with a ciprofloxacin MIC ≥ 0.125 μg/ml. Four were qnrA1 and 38 were qnrB19. Resistance to ampicillin (40%) and trimethoprim-sulfamethoxazole (58%) was common in Shigella (n = 218), but isolates remained fully susceptible to ceftriaxone and ciprofloxacin.

CONCLUSION

Illness from Salmonella has decreased while severe Shigella infections have increased among children with gastroenteritis in the Yucatan Peninsula. While Shigella resistance to clinically important antibiotics remained unchanged, resistance to most of these, except ciprofloxacin, declined in Salmonella. bla CMY-2 and qnr genes are common in Salmonella isolates.

The emergence of antibiotic resistance in typhoid fever

Typhoid fever, caused by Salmonella typhi, causes over 20 million cases annually, with at least 700,000 deaths. The main burden of disease is in developing countries, particularly the Indian Subcontinent and South East Asia. However, cases in returning travellers, immigrants and refugees in developed countries are not uncommon. Drug resistance is fast becoming a major problem in the management of this infection. Chloramphenicol resistance became established globally in the S.Typhi population after 1972 on plasmids of incompatibility group IncH. Multi-drug resistance defined as resistance to the three first-line agents used to treat typhoid fever, namely chloramphenicol, ampicillin and co-trimoxazole, and acquired on the same plasmid type, has been endemic in most of South East Asia and the Indian Subcontinent for many years. Resistance data from many endemic areas are sparse and with the increasing problem of reduced sensitivity to the fluoroquinolone antibiotics, empirical choice of antibiotics may be difficult. We review the historical aspects of the development of resistance and the current data available on the epidemiology of antibiotic resistance in S.Typhi.

Underexpression of ap from R-plasmids in fast-growing Rhizobium species

The presence of the plasmid RP1 in the cells of Rhizobium leguminosarum strains Rld1, 300, and 248, R. phaseoli 1233, R. trifolii strains T1 and 6661, and R. meliloti 4013 was found to appreciably increase bacterial resistance toward kanamycin and tetracycline but not toward ampicillin. The presence of 16 other R-plasmids in R. leguminosarum was also found to either not increase or only marginally increase bacterial resistance toward ampicillin. It appears now that underexpression of the plasmid-specified ampicillin function is common to most fast- and slow-growing rhizobia.

Interaction between the co-inherited TraG coupling protein and the TraJ membrane-associated protein of the H-plasmid conjugative DNA transfer system resembles chromosomal DNA translocases

Bacterial conjugation is a DNA transfer event that requires three plasmid-encoded multi-protein complexes: the membrane-spanning mating pair formation (Mpf) complex, the cytoplasmic nucleoprotein relaxosome complex, and a homo-multimeric coupling protein that links the Mpf and relaxosome at the cytoplasmic membrane. Bacterial two-hybrid (BTH) technology and immunoprecipitation were used to demonstrate an interaction between the IncH plasmid-encoded transfer protein TraJ and the coupling protein TraG. TraJ is essential for conjugative transfer but is not required for the formation of the conjugative pilus, and is therefore not regarded as an Mpf component. Fractionation studies indicated that TraJ shared a similar cellular domain to that of TraG at the cellular membrane. Protein blast analyses have previously identified TraJ homologues encoded in a multitude of plasmid and chromosomal genomes that were also found to encode an adjacent TraG homologue, thus indicating co-inheritance. BTH analysis of these TraJ and cognate TraG homologues demonstrated conservation of the TraJ-TraG interaction. Additional occurrences of the traJ-traG module were also detected in genomic sequence data throughout the Proteobacteria, and phylogenetic comparison of these IncH-like TraG proteins with the coupling proteins encoded by other conjugative transfer systems (including IncP, IncW and IncF) that lack TraJ homologues indicated that the H-like coupling proteins were distinct. Accordingly, the IncP, IncW and IncF coupling proteins were unable to interact with TraJ, but were able to interact with IncH plasmid-encoded TrhB, an Mpf component known to complex with its cognate coupling protein TraG. The divergence of the IncH-type coupling proteins may partly be due to the requirement of TraJ interaction, and notably, TraG and TraJ cumulatively represent the domain architecture of the known translocase family FtsK/SpoIIIE. It is proposed that TraJ is a functional part of the IncH-type coupling protein complex required for translocation of DNA through the cytoplasmic membrane.

The emergence of multidrug resistance to antimicrobial agents for the treatment of typhoid fever

Resistance to chloramphenicol was reported in Salmonella Typhi in 1950 but it was not until 22 years later that the first outbreaks of chloramphenicol-resistant typhoid fever occurred. Multidrug-resistant (MDR) Salmonella Typhi emerged in the 1980s and today has an almost worldwide distribution. Genome analysis of Salmonella Typhi strain CT18, an MDR isolate from a patient admitted to The Centre for Tropical Diseases, Ho Chi Minh City, Viet Nam, in December 1993 revealed that the resistance plasmid pHCM1 is very closely related to plasmid R27 which was first isolated in 1961. There is a core region shared by the two plasmids with five regions of variation. Two of these regions contain the genes encoding resistance. The largest region is 34.955 kbp in length, is bordered by two almost identical IS10 elements and contains several integron-like structures including a truncated Tn10 element. The second region is 14.75I kbp and encodes a trimethoprim-resistance gene, dfrA14, associated with a class one integrase. Restriction enzyme analysis has shown that the variation in Salmonella Typhi plasmids, collected during the emergence of resistant Salmonella Typhi in Viet Nam, maps to five variable regions. These regions appear to be hot spots for DNA acquisition in IncHI1 plasmids.

Antibiotic-resistant Salmonella typhi from two outbreaks: few ribotypes and IS200 types harbor Inc HI1 plasmids

To investigate factors that could be involved in the emergence of antibiotic resistant S. typhi, we characterized R plasmids and antibiotic resistant S. typhi strains from two outbreaks of typhoid in Peru and Chile. Differences in the Inc HI1 plasmids of Peruvian and Chilean strains were identified by conjugation and incompatibility studies and plasmid DNA characterization. Antibiotic-resistant S. typhi harboring Inc HI1 plasmids belonged to a reduced number of Pst1 and Cla1 ribotypes and IS200 types, in contrast to the high genetic diversity found among epidemic antibiotic-susceptible S. typhi. The low diversity of antibiotic-resistant S. typhi suggests that they may express properties that are related to both their ability to harbor Inc HI1 R plasmids and to disseminate.

Epidemiological study of Salmonella enteritidis strains of animal origin in Belgium

Since 1987, the number of cases of salmonellosis caused by Salmonella enteritidis has considerably increased in Western Europe. Comparison of endemic animal strains isolated in Belgium from 1976-84 with strains isolated from 1987 on shows that the strains which cause the current epidemic have no features distinguishing them from the previously-isolated strains and that furthermore, they do not constitute a bacterial clone. They belong to 13 different lysotypes and in most cases remain sensitive to antibiotics. Nevertheless, the lysotype 33 (which belongs to the phage type 4 has increased significantly. It encompasses 37% of the animal strains isolated in Belgium from 1987-9, but only 7% of the strains isolated from 1976-84. It is worth noting that the endemic as well as the epidemic strains contain a virulence plasmid sharing sequence similarities with the FIB and FIIA plasmid replicons and with the VirA and VirB virulence regions of the S. typhimurium virulent plasmid: pIP1350.

Restriction endonuclease characterization of resistant plasmids in Enterobacteriaceae isolated from children in the Sudan

The investigation of plasmid similarity is an important component in the surveillance of antimicrobial resistance and in the detection of epidemic plasmids. The use of restriction endonucleases in the classification of transferable, multiply-resistant plasmids from faecal Enterobacteriaceae isolated at the Children's Emergency Hospital, Khartoum was investigated. Twenty-four transconjugant plasmids, coding for 11 different resistance patterns, each of molecular weight 62 MDa, were studied using four restriction enzymes; Pst I, EcoR I, Hind III and Ava II. Fifteen different digest profiles were obtained. Restriction profiles discriminated between plasmids with differing resistance patterns and demonstrated homology of plasmids with common resistance patterns. Restriction endonuclease digest patterns provide a potentially rapid and reproducible method of plasmid classification, that could contribute towards surveillance systems in tropical countries with a high prevalence of antimicrobial resistance.

Molecular analysis and nucleotide sequence of finQ, a transcriptional inhibitor of the F plasmid transfer genes

We report the cloning of finQ, a gene coding for fertility inhibition of the F plasmid, from the IncI R factor R820a. The finQ gene was mapped precisely within a 1.24 kb region by ptac-transposase + min-kan mutagenesis and its product, FinQp, identified as a single polypeptide by means of SDS-polyacrylamide gel electrophoresis. Nucleotide sequencing of the finQ region allowed elucidation of the FinQp amino acid sequence and determination of its precise molecular weight as 39,895 Da. Analysis of the predicted amino acid sequence indicated that FinQp is a positively charged protein possessing a helix-turn-helix DNA binding motif. We propose a possible model for the mechanism by which FinQp terminates transcription within the F plasmid tra region. DNA-DNA hybridization established that all FinQ+ R factors examined have an homologous finQ gene.

A gene encoding an SOS inhibitor is present in different conjugative plasmids

In 9 of 20 conjugative plasmids of different incompatibility groups, including F and R100 (or R6-5), coexist two sequences which are homologous, respectively, to the gene psiB, which encodes an inhibitor of SOS induction, and to the gene ssb, which encodes a single-stranded-DNA-binding protein.

Elimination of plasmids by new 4-quinolones

Nalidixic acid and six of the new 4-quinolones eliminated F'lac and various native R plasmids from Escherichia coli at one half or one quarter the MIC. Four of eight plasmids tested were cured by all derivatives, with frequencies from 10 to 98%. Quinolones did not eliminate all plasmids that were cured by novobiocin, and vice versa.

Variability of IncHI1 plasmids from Salmonella typhi with special reference to Peruvian plasmids encoding resistance to trimethoprim and other antibiotics

In spite of extensive DNA homology among IncHI1 plasmids, ApaI and XbaI restriction digests of plasmids from Peruvian Salmonella typhi varied considerably from other IncHI1 plasmids isolated previously. IncHI1 plasmids appear to be undergoing a process of modular evolution, probably by sequential acquisition of resistance determinants.

Plasmid-mediated drug resistance of shigellae in Kuwait

Of 153 clinical isolates of shigellae examined, 64.7% belonged to Shigella flexneri, 18.9% to Sh. sonnei, 11.8% to Sh. boydii and 4.6% to Sh. dysenteriae. Part of these isolates were resistant to sulfamethoxazole and streptomycin (88.2% each), ampicillin (66.7%), tetracycline (63.4%) and co-trimoxazole (43.1%), with levels of resistance (MIC50 and MIC90) being invariably high. Resistance to three or more drugs (multidrug resistance) was seen in 77.8% of the isolates. All the 25 strains examined for transfer of resistance contained R-plasmids, both autotransferable and non-autotransferable (mobilized by transfer factor X). The frequency of transfer of different r-determinants varied from 2.7 X 10(-8) to 1.4 X 10(-3).

Some mercurial resistance plasmids from different incompatibility groups specify merR regulatory functions that both repress and induce the mer operon of plasmid R100

Transcription of the mer genes of plasmid R100 is regulated by the product of the merR gene. The merR gene negatively regulates its own expression and also controls the transcription of the merTCA operon both negatively (in the absence of inducer) and positively (in the presence of inducer). We used transcriptional mer-lac fusions of R100-1 in complementation tests to measure the ability of the merR products of different mercury-resistant transposons and plasmids to functionally interact with R100-1. Plasmids from incompatibility groups C, B, S, L, and P, as well as the Pseudomonas transposons Tn501 and Tn3401, regulated the expression of the R100 mer genes in a similar fashion to the R100-1 merR product itself, suggesting that these elements are closely related. Only plasmid R391 (IncJ) did not complement.

R plasmids conferring multiple drug resistance from shigella isolated in Korea

The majority (85%) of shigella isolated in 1980 and 1981 in Korea were Shigella flexneri, the others were Sh. sonnei (14%) with only a small number of Sh. dysenteriae. Only 14 of the 459 strains of shigella isolated were susceptible to all 12 drugs tested, and 445 were resistant to three or more drugs. Strains multiply resistant to the six drugs, chloramphenicol (Cm), tetracycline (Tc), streptomycin (Sm), sulfisomidine (Su), ampicillin (Ap) and trimethoprim (Tp) were most frequently encountered, followed by those resistant to Cm, Tc, Sm, Su and Tp. The complete patterns of resistance to drugs except nalidixic acid and rifampin in approximately 73% of drug-resistant strains were co-transferred to Escherichia coli by conjugation, indicating that the resistance was R plasmid-mediated. Randomly selected R plasmids conferring various patterns of resistance markers were tested for the incompatibility groups, and almost all of them were classified into Inc FII. Two of three R plasmids conferring resistance to Cm, Tc, Sm and Su were classified into Inc B and one to Inc FII. Two R types with resistance markers of Cm, Tc, Sm and Ap were not classified with our standard plasmids used.

Regulation of the F conjugation genes studied by hybridization and tra-lacZ fusion

Hybridization experiments and tra-lacZ fusions were used to obtain further insight into the complex series of control systems that affect F conjugation. We confirmed that the regular IncF FinOP control system represses transcription of traJ, and found that the traJ product is required for transcription of traM as well as of the traY-Z operon. The chromosomal sfrA gene product may be required to prevent premature termination of traJ transcription, while the sfrB gene product prevents premature termination at two sites within the traY-Z operon. The FinQ inhibition system determined by several IncI plasmids caused termination at three different sites in the operon, and that of JR66a at one further site. JR66a and R485 strongly inhibit F transfer, but have weak, or no (respectively) effects on transcription: they may inhibit function of one or more transfer gene products.

Thermoactivation of a periplasmic heat-stable enterotoxin of Escherichia coli

Strains of Escherichia coli that host a plasmid that codes for the heat-stable (ST) enterotoxin showed 160 times more extracellular enterotoxin than intracellular activity. However, when washed bacteria were sonicated and incubated at between 50 and 85 degrees C, an activity similar to that of the ST enterotoxin was detected. No such effect was present in strains lacking the plasmid, in a plasmid ST- mutant, or in chromosomal mutants that lack a cyclic AMP-linked positive regulatory system which previously were shown to yield an ST- phenotype. The thermoactivation was inhibited by iodoacetamide and N-ethylmaleimide; chloramphenicol did not affect the phenomenon. The heat-activated ST-like enterotoxin was localized in the periplasmic space. The results are discussed in relation to the export of the toxin from the periplasm to the outside of the cell.

Comparison of DNA sequences required for the function of citrate utilization among different citrate utilization plasmids

The relatedness of DNA sequences encoding citrate utilization was examined by hybridization with a cloned DNA fragment from a citrate utilization (Cit) plasmid, pOH30221, and DNA of other Cit plasmids. This revealed that there are at least two groups of Cit plasmids: the Inc W Cit plasmids, which show homology with the probe, and the Inc H1 plasmids, which do not.

Shigella species from Addis Ababa: frequency of isolation and in vitro drug sensitivity

One hundred and five shigella isolates from Addis Ababa were studied to determine serogroup frequency and in vitro antibacterial drug sensitivity. About 70% of the isolates were Shigella flexneri followed by Sh. dysenteriae (15%), Sh. boydii (10%) and Sh. sonnei (5%). All or most of the strains were susceptible to cephalothin, gentamicin, kanamycin, polymyxin B and trimethoprim-sulphamethoxazole. Frequencies of susceptibility to ampicillin, carbenicillin and chloramphenicol were, respectively, 79, 80 and 75%. Only 37, 23 and 58% were susceptible to streptomycin, sulphadiazine and tetracycline, respectively. Resistance to one or more drugs was detected in 85% while 72% were multiply resistant. There were 24 different resistance patterns, varying from resistance to one drug to resistance to seven drugs. The findings have been compared with reports from other countries. This study and several others cited support the view that trimethoprim-sulphamethoxazole is the best alternative drug for treatment of shigellosis particularly in regions with multiple drug-resistant strains.

R-factor cointegrate formation in Salmonella typhimurium bacteriophage type 201 strains

The genetic and molecular properties of the plasmids in Salmonella typhimurium phase type 201 isolated are described. Such strains are resistant to streptomycin, tetracycline, chloramphenicol, ampicillin, kanamycin, and several other antimicrobial drugs, and are highly pathogenic for calves. These strains have been encountered with increasing frequency since 1972 in West Germany and The Netherlands. We show that isolates of this phage type constitute a very homogeneous group with regard to their extrachromosomal elements. These bacteria carry three small plasmids: pRQ3, a 4.2-megadalton (Md) colicinogenic plasmid; pRQ4, 3.4-Md plasmid that interferes with the propagation of phages; and pRQ5, a 3.2-Md cryptic plasmid. Tetracycline resistance resides on a conjugative 120-MD plasmid pRQ1, belonging to the incompatibility class H2. Other antibiotic resistance determinants are encoded by a nonconjugative 108-Md plasmid pRQ2. Transfer of multiple-antibiotic resistance to appropriate recipient strains was associated with the appearance of a 230-Md plasmid, pRQ6. It appears that pRQ6 is a stable cointegrate of pRQ1 and pRQ2. This cointegrate plasmid was transferable with the same efficiency as pRQ1. Other conjugative plasmids could mobilize pRQ2, but stable cointegrates were not detected in the transconjugants. Phase type 201 strains carry a prophage, and we show that phage pattern 201 reflects the interference with propagation of typing phages effected by this prophage and plasmid pRQ4 in strains of phage type 201.

Catabolite repression of Escherichia coli heat-stable enterotoxin activity

The Escherichia coli heat-stable enterotoxin (ST) coded for by plasmid pYK007 (Apr ST+) showed a dependence for cyclic adenosine 3',5'-monophosphate (cAMP) to express ST activity in an adenyl cyclase (cya) deletion mutant; no ST activity was detected in the presence of cAMP in a cAMP receptor protein (crp) deletion mutant or in a double deletion mutant (delta cya delta crp). The cya-crp effect on ST activity could not be accounted for by a modification of the copy number of plasmid deoxyribonucleic acid per chromosome equivalent or by an alteration in the secretion of an active intracellular enterotoxin.

Naturally occurring plasmids exhibiting incompatibility with members of incompatibility groups I and P

From a group of naturally occurring antibiotic resistance plasmids, a number of plasmids were identified which were incompatible with members of incompatibility group P and also incompatibility group I alpha or I gamma. These plasmids also exhibited strong entry exclusion with members of group P only and showed a host range which resembled that of plasmids of group I rather than those of group P. Segregants of a number of these plasmids appeared to have lost some of the incompatability and/or surface exclusion functions. Studies of nucleic acid homology indicated that these plasmids were very similar to one another. They exhibited 15 to 20% nucleic acid homology with representatives of the I alpha and I gamma groups, yet showed less than 2% homology with the group P plasmid RP4.

Spontaneous emergence of an Hfr strain with a cit plasmid from natural isolates of citrate-positive Escherichia coli bovine origin

From citrate-utilizing (Cit+) Escherichia coli strain C53 of bovine origin, strains C53A and C53B were obtained. Upon mating with recA+ but not with recA mutant recipients of K-12, C53A produced chromosomal recombinants at quite high frequencies, leading to the following conclusions: (i) C53A is an Hfr strain; (ii) the site of integration of the Cit plasmid (IncH1) is between metA (89 min) and ara (1 min); (iii) the direction of chromosome transfer is clockwise; and (iv) the plasmid-associated determinants are transferred as the terminal markers. A transductant of a dnaA(Ts) strain, CRT46, which acquired Cit determinants from a recombinant, SG13, was also an Hfr strain similar to SG13, and thermoresistant due to suppressive integration. On the other hand, unstable C53B did not produce recombinants, but the frequency of RecA-independent transfer of the Cit plasmid was high, indicating that the Cit plasmid (IncH1) exists autonomously in C53B. Attempts to isolate an Hfr strain from C53B failed.

Determination of pili by conjugative bacterial drug resistance plasmids of incompatibility groups B, C, H, J, K, M, V, and X

Representative plasmids from incompability groups B, C, H, J, K, M, V, and X were transferred to "bald" strains of Escherichia coli or Salmonella typhimurium. By using a new technique, pili were detected by electron microscopy for each incompatibility group. Morphology varied but was similar for plasmids within a group. These findings suggest that all conjugative plasmids in the Enterobacteriaceae may determine pili.

The effect on the virulence and infectivity of Salmonella typhimurium and Salmonella gallinarum of acquiring antibiotic resistance plasmids from organisms that had caused serious outbreaks of disease

Antibiotic resistance plasmids from organisms that had caused serious epidemics, including those responsible for epidemics of chloramphenicol-resistant typhoid fever and dysentery in Central America, were transferred to a strain of Salmonella typhimurium and of Salmonella gallinarum. The virulence and infectivity of these R(+) forms were then compared with the R(-) parent forms in orally inoculated chickens.None of the R(+) forms were more virulent than their R(-) parent forms. The mortality rates they produced were either the same as or less than that of their R(-) parent forms. The mortality rates were not increased by feeding the chickens on diets containing antibiotics against which the plasmids provided resistance.The removal of the plasmids from some R(+) forms of decreased virulence was not accompanied by any alteration in virulence, indicating that they were less virulent mutants of the parent strain that had conjugated preferentially. In other cases their virulence was increased, indicating that the very possession of the plasmid was involved in their decreased virulence. Of four forms of the S. gallinarum strain harbouring the plasmid that had been incriminated in the Central American dysentery outbreak, one was as virulent as the parent R(-) form and the other three were less virulent. Preferential conjugation by an avirulent mutant was responsible for the lack of virulence of one of them but the very possession of the plasmid appeared responsible for the decreased virulence of the other two. The decreased virulence of de-repressed F(+) and I(+) forms of the S. typhimurium strain was increased to that of repressed F(+) form and of the parent form by plasmid removal.Organisms of the R(+) forms of the S. typhimurium strain were not excreted in larger amounts or for longer periods of time by infected chickens than organisms of the R(-) parent form were. Neither did organisms of the R(+) forms of this strain or the S. gallinarum strain spread more rapidly or more extensively from infected chickens to in-contact chickens than organisms of the R(-) parent forms did. When antibiotics against which the infecting R(+) organisms provided resistance were included in the diet of these chickens the R(+) organisms were usually excreted in greater amounts, for longer periods of time and spread more rapidly and more extensively from the infected chickens to the in-contact chickens.

R plasmids of the S incompatibility group belong to the H2 incompatibility group

Plasmids of the S and H2 incompatibility groups showed thermosensitive transfer and a bacteriophage inhibition phenotype and were incompatible with one another.

Elimination of plasmids from several bacterial species by novobiocin

Certain plasmids can be eliminated by exposure to growth-inhibiting concentrations of novobiocin. Novobiocin cured 8 of 14 plasmids (13 R-plasmids and an F' lac) among one or another of four different bacterial hosts.

Further characterization of the F fertility inhibition systems of "unusual" Fin+ plasmids

Flac mutants insensitive to transfer inhibition by R factors. JR66a and R485 were isolated and characterized. Representative mutations were cis dominant and are therefore presumed to be at the sites of action, fisU and fisV, respectively, of the FinU and FinV transfer inhibition systems encoded by JR66a and R485. The mutants were used to confirm that the FinU and FinV fertility inhibition systems are different from each other and from the FinOP, FinQ, and FinW systems of R100, R62, and R455, respectively. Together with traO and fisQ mutants of Flac, the new mutants were also used to investigate the nature of the F fertility inhibition systems encoded by a further group of "unusual" Fin+ plasmids. Of these, two incompatibility group X plasmids were found to carry finO+ genes, and of five incompatibility group I plasmids, three encoded FinQ systems, one the FinU system, and one a new system (FinR). Transfer of a variety of derepressed F-like plasmids was inhibited by the FinQ, FinU, and FinV systems, but a quantitatively very different levels; this emphasizes the differences as well as the similarities between the conjugation systems of F-like plasmids.

Incompatibility and bacteriophage inhibition properties of N-1, a plasmid belonging to the H2 incompatibility group

N-1, a plasmid isolated from a strain of Shigella flexneri in Japan more than 10 years ago, mediates the phage inhibition phenotype which has recently been found to be characteristic of plasmids of the H2 incompatibility group. Using the criteria of phage inhibition, surface exclusion and incompatibility, the N-1 plasmid is shown to be closely related to H2 plasmids isolated from non-typhoid salmonella and distantly related to H1 plasmids isolated from Salmonella typhi. Plasmids of other incompatibility groups did not show the H2 type of phage inhibition.

Changing patterns of plasmid-mediated drug resistance during tetracycline therapy

The patterns of drug resistance and the frequency of conjugative R plasmids in intestinal Escherichia coli from 88 patients treated for a skin disease (acne vulgaris) with low oral doses of tetracycline are reported. The proportion of patients with resistant bacteria was progressively greater in patients who received tetracycline for 1 week, 4 weeks, or longer (from 50 to 88%). No multiply drug-resistant bacteria were detected before treatment or after 1 week of treatment. After more than 4 weeks of treatment, multiply drug-resistant E. coli were isolated from about 50% of the patients. The origin and selection of R plasmid-determined multiple drug resistance are discussed.

Antimicrobial activity of cefamandole against Salmonella typhi

A patient with Salmonella typhi bacteremia was sucessfully treated with cefamandole, a new cephalosporin derivative. Infection has not recurred during 6 months of follow-up observation. Minimum inhibitory concentrations and minimum bactericidal concentrations of cefamandole, cephalothin, ampicillin, and chloramphenicol were compared against 26 strains of S. typhi. All the strains were susceptible to cefamandole in vitro. Seven of the strains were resistant to chloramphenicol, and another seven were resistant to both chloramphenicol and ampicillin. Cefamandole appears to warrant further clinical trial for the treatment of typhoid fever.

Plasmid-determined resistance to tellurium compounds

Transferable plasmids in gram-negative bacteria that confer resistance to potassium tellurite or tellurate were found. This re-istance was distinct from resistance to mercury, silver, or arsenic compounds and was unrelated to antibiotic resistance. In Escherichia coli, plasmids determine a 100-fold increase in the minimal inhibitory concentration for tellurite and a 10-fold increase in tellurate resistance. Many, but not all, of the plasmids belong to incompatibility group S. In Pseudomonas aeruginosa, tellurium resistance is specifically associated with incompatibility group P-2 and involves a 5- to 10-fold increase in tellurite or tellurate resistance.

Compatibility properties of R483, a member of the I plasmid complex

R483, an I pilus-determining plasmid previously reported as belonging to a distinct incompatibility group Ibeta, proved to be an atypical Ialpha plasmid; in a growing culture, the degree of inhibition of replication of one Ialpha plasmid by the presence of another was not uniform within the Ialpha group.

Plasmid-determined beta-lactamase indistinguishable from the chromosomal beta-lactamase of Escherichia coli

A plasmid, derived from a naturally occurring strain of Proteus mirabilis, conferred resistance to cephalosporins, apparently mediated by a beta-lactamase indistinguishable from that determined by the chromosomal gene of Escherichia coli K-12. There was evidence for a recombination event between the wild-type plasmid and a defective F factor (Fsp) in the Escherichia coli K-12 culture in which it was stored.