Genomewide Identification of Genetic Determinants of Antimicrobial Drug Resistance in Pseudomonas aeruginosa

ABSTRACT The emergence of antimicrobial drug resistance is of enormous public concern due to the increased risk of delayed treatment of infections, the increased length of hospital stays, the substantial increase in the cost of care, and the high risk of fatal outcomes. A prerequisite for the development of effective therapy alternatives is a detailed understanding of the diversity of bacterial mechanisms that underlie drug resistance, especially for problematic gram-negative bacteria such as Pseudomonas aeruginosa. This pathogen has impressive chromosomally encoded mechanisms of intrinsic resistance, as well as the potential to mutate, gaining resistance to current antibiotics. In this study we have screened the comprehensive nonredundant Harvard PA14 library for P. aeruginosa mutants that exhibited either increased or decreased resistance against 19 antibiotics commonly used in the clinic. This approach identified several genes whose inactivation sensitized the bacteria to a broad spectrum of different antimicrobials and uncovered novel genetic determinants of resistance to various classes of antibiotics. Knowledge of the enhancement of bacterial susceptibility to existing antibiotics and of novel resistance markers or modifiers of resistance expression may lay the foundation for effective therapy alternatives and will be the basis for the development of new strategies in the control of problematic multiresistant gram-negative bacteria.

[1]  R. Hancock,et al.  Novel Genetic Determinants of Low-Level Aminoglycoside Resistance in Pseudomonas aeruginosa , 2008, Antimicrobial Agents and Chemotherapy.

[2]  Robert E. W. Hancock,et al.  Complex Ciprofloxacin Resistome Revealed by Screening a Pseudomonas aeruginosa Mutant Library for Altered Susceptibility , 2008, Antimicrobial Agents and Chemotherapy.

[3]  Eun Seok Kim,et al.  Clinical significance and predictors of community-onset Pseudomonas aeruginosa bacteremia. , 2008, The American journal of medicine.

[4]  R. Hancock,et al.  Mutator Genes Giving Rise to Decreased Antibiotic Susceptibility in Pseudomonas aeruginosa , 2008, Antimicrobial Agents and Chemotherapy.

[5]  Jeffrey H. Miller,et al.  Determination of Antibiotic Hypersensitivity among 4,000 Single-Gene-Knockout Mutants of Escherichia coli , 2008, Journal of bacteriology.

[6]  J. H. Crosa,et al.  Global Gene Expression as a Function of the Iron Status of the Bacterial Cell: Influence of Differentially Expressed Genes in the Virulence of the Human Pathogen Vibrio vulnificus , 2008, Infection and Immunity.

[7]  J. Goldberg,et al.  Regulation of lipopolysaccharide O antigen expression in Pseudomonas aeruginosa. , 2008, Future microbiology.

[8]  Fernando Baquero,et al.  The Neglected Intrinsic Resistome of Bacterial Pathogens , 2008, PloS one.

[9]  Pei Zhou,et al.  Mechanism and inhibition of LpxC: an essential zinc-dependent deacetylase of bacterial lipid A synthesis. , 2008, Current pharmaceutical biotechnology.

[10]  J. Collins,et al.  A Common Mechanism of Cellular Death Induced by Bactericidal Antibiotics , 2007, Cell.

[11]  L. Rice Emerging issues in the management of infections caused by multidrug-resistant gram-negative bacteria. , 2007, Cleveland Clinic journal of medicine.

[12]  D. Landman,et al.  Role of AmpD, OprF and penicillin-binding proteins in beta-lactam resistance in clinical isolates of Pseudomonas aeruginosa. , 2007, Journal of medical microbiology.

[13]  Jin-Town Wang,et al.  Identification and Characterization of an Organic Solvent Tolerance Gene in Helicobacter pylori , 2007, Helicobacter.

[14]  D. Hocquet,et al.  Cumulative Effects of Several Nonenzymatic Mechanisms on the Resistance of Pseudomonas aeruginosa to Aminoglycosides , 2006, Antimicrobial Agents and Chemotherapy.

[15]  Frederick M Ausubel,et al.  Correction for Liberati et al., An ordered, nonredundant library of Pseudomonas aeruginosa strain PA14 transposon insertion mutants , 2006, Proceedings of the National Academy of Sciences.

[16]  Xiangmin Lin,et al.  Proteomic analysis of the sarcosine-insoluble outer membrane fraction of Pseudomonas aeruginosa responding to ampicilin, kanamycin, and tetracycline resistance. , 2005, Journal of proteome research.

[17]  O. Zaborina,et al.  Recognition of Host Immune Activation by Pseudomonas aeruginosa , 2005, Science.

[18]  N. Høiby,et al.  Occurrence of Hypermutable Pseudomonas aeruginosa in Cystic Fibrosis Patients Is Associated with the Oxidative Stress Caused by Chronic Lung Inflammation , 2005, Antimicrobial Agents and Chemotherapy.

[19]  S. Häussler,et al.  Comparison of the Micronaut Merlin automated broth microtiter system with the standard agar dilution method for antimicrobial susceptibility testing of mucoid and nonmucoid Pseudomonas aeruginosa isolates from cystic fibrosis patients , 2004, European Journal of Clinical Microbiology and Infectious Diseases.

[20]  Eric Haugen,et al.  Comprehensive transposon mutant library of Pseudomonas aeruginosa , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[21]  Stephan Harbarth,et al.  Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. , 2003, The American journal of medicine.

[22]  J. Rello,et al.  Community-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival. , 2003, Chest.

[23]  H. Nakajima,et al.  n-Hexane sensitivity of Escherichia coli due to low expression of imp/ostA encoding an 87 kDa minor protein associated with the outer membrane. , 2003, Microbiology.

[24]  A. Vanderkelen,et al.  Analysis of the Pseudomonas aeruginosa oprD gene from clinical and environmental isolates. , 2002, Environmental microbiology.

[25]  M. Hentzer,et al.  Constitutive High Expression of Chromosomal β-Lactamase in Pseudomonas aeruginosa Caused by a New Insertion Sequence (IS1669) Located in ampD , 2002, Antimicrobial Agents and Chemotherapy.

[26]  J. Goldberg,et al.  Pseudomonas aeruginosa galU is required for a complete lipopolysaccharide core and repairs a secondary mutation in a PA103 (serogroup O11) wbpM mutant. , 2002, FEMS microbiology letters.

[27]  B. Poolman,et al.  Osmosensing and osmoregulatory compatible solute accumulation by bacteria. , 2001, Comparative biochemistry and physiology. Part A, Molecular & integrative physiology.

[28]  Angela Lee,et al.  Identification and Characterization of Inhibitors of Multidrug Resistance Efflux Pumps in Pseudomonas aeruginosa: Novel Agents for Combination Therapy , 2001, Antimicrobial Agents and Chemotherapy.

[29]  G Sherman,et al.  The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. , 2000, Chest.

[30]  A. Oliver,et al.  High frequency of hypermutable Pseudomonas aeruginosa in cystic fibrosis lung infection. , 2000, Science.

[31]  S. Levy,et al.  Reversal of Tetracycline Resistance Mediated by Different Bacterial Tetracycline Resistance Determinants by an Inhibitor of the Tet(B) Antiport Protein , 1999, Antimicrobial Agents and Chemotherapy.

[32]  R. Hancock,et al.  Roles of the Carboxy-Terminal Half of Pseudomonas aeruginosa Major Outer Membrane Protein OprF in Cell Shape, Growth in Low-Osmolarity Medium, and Peptidoglycan Association , 1998, Journal of bacteriology.

[33]  R. Hancock,et al.  Role of gyrA mutation and loss of OprF in the multiple antibiotic resistance phenotype of Pseudomonas aeruginosa G49. , 1996, FEMS microbiology letters.

[34]  K. Poole,et al.  Overexpression of the mexC–mexD–oprJ efflux operon in nfxB‐type multidrug‐resistant strains of Pseudomonas aeruginosa , 1996, Molecular microbiology.

[35]  H. Nikaido,et al.  Role of mexA-mexB-oprM in antibiotic efflux in Pseudomonas aeruginosa , 1995, Antimicrobial agents and chemotherapy.

[36]  K. Poole,et al.  Multiple antibiotic resistance in Pseudomonas aeruginosa: evidence for involvement of an efflux operon , 1993, Journal of bacteriology.

[37]  D. Martin,et al.  Differentiation of Pseudomonas aeruginosa into the alginate‐producing form: inactivation of mucB causes conversion to mucoidy , 1993, Molecular microbiology.

[38]  T. Beveridge,et al.  Interaction of gentamicin with the A band and B band lipopolysaccharides of Pseudomonas aeruginosa and its possible lethal effect , 1993, Antimicrobial Agents and Chemotherapy.

[39]  R. Hancock,et al.  A pleiotropic, posttherapy, enoxacin-resistant mutant of Pseudomonas aeruginosa , 1992, Antimicrobial Agents and Chemotherapy.

[40]  F. Malouin,et al.  Persistence of Pseudomonas aeruginosa during ciprofloxacin therapy of a cystic fibrosis patient: transient resistance to quinolones and protein F-deficiency. , 1990, The Journal of antimicrobial chemotherapy.

[41]  R. Hancock,et al.  Pseudomonas aeruginosa outer membrane protein F: structural role and relationship to the Escherichia coli OmpA protein , 1989, Journal of bacteriology.

[42]  H. Wakebe,et al.  Role of protein F in maintaining structural integrity of the Pseudomonas aeruginosa outer membrane , 1989, Journal of bacteriology.

[43]  R. Hancock,et al.  Construction and characterization of Pseudomonas aeruginosa protein F-deficient mutants after in vitro and in vivo insertion mutagenesis of the cloned gene , 1988, Journal of bacteriology.

[44]  P. Miller,et al.  Bacterial uptake of aminoglycoside antibiotics. , 1987, Microbiological reviews.

[45]  D. Wessel,et al.  A method for the quantitative recovery of protein in dilute solution in the presence of detergents and lipids. , 1984, Analytical biochemistry.

[46]  L. Bryan,et al.  Roles of ribosomal binding, membrane potential, and electron transport in bacterial uptake of streptomycin and gentamicin , 1983, Antimicrobial Agents and Chemotherapy.

[47]  H. Shio,et al.  Polypeptide and phospholipid composition of the membrane of rat liver peroxisomes: comparison with endoplasmic reticulum and mitochondrial membranes , 1982, The Journal of cell biology.

[48]  W. Epstein,et al.  Role of the membrane potential in bacterial resistance to aminoglycoside antibiotics , 1981, Antimicrobial Agents and Chemotherapy.

[49]  Ramon Gonzalez,et al.  Gene Array‐Based Identification of Changes That Contribute to Ethanol Tolerance in Ethanologenic Escherichia coli: Comparison of KO11 (Parent) to LY01 (Resistant Mutant) , 2003, Biotechnology progress.