Service de Bactériologie-Virologie,
Hôpital de Bicêtre, Assistance Publique/Hôpitaux de
Paris, Faculté de Médecine Paris-Sud, 94275 Le
Kremlin-Bicêtre cedex, France
Received 14 September 1999/Returned for modification 24 January
2000/Accepted 17 March 2000
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INTRODUCTION |
Hafnia alvei is a member
of the Enterobacteriaceae family that is associated both
with sporadic cases of diarrhea in humans and with hospital-acquired
systemic infections (4, 21, 42). The inducible biosynthesis
of a naturally occurring Bush group 1
-lactamase (Ambler class C
[2]) has been reported phenotypically for several
enterobacterial species, including Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae,
Morganella morganii, Providencia stuartii,
Serratia marcescens, Yersinia enterocolitica, and
H. alvei (10, 40, 43, 44, 47). The presence of
cephalosporinase in H. alvei may explain its natural
phenotype of resistance to aminopenicillins and restricted-spectrum
cephalosporins (44). As for other cephalosporinase-producing
Enterobacteriaceae, H. alvei isolates may be
grouped into two
-lactamase expression phenotypes, low-level
inducible cephalosporinase production and oxyimino-cephalosporin
sensitivity versus high-level constitutive cephalosporinase production
and oxyimino-cephalosporin resistance (44). Interestingly,
none of these phenotypes confer resistance to cefoxitin
(44).
Both phenotypes of naturally occurring inducible and acquired
high-level constitutive cephalosporinase expression have been studied
in detail for C. freundii, E. cloacae, and
M. morganii (5, 18, 27, 28, 40). An
ampR gene (also identified in P. stuartii and
Y. enterocolitica) is located upstream and reversely
transcribed from ampC. The corresponding protein, a transcriptional regulator belonging to the LysR family, acts as a
repressor in the basal level of AmpC biosynthesis and as an activator
upon addition of several
-lactams, mostly carbapenems, clavulanate
acid, and cephamycins.
The aim of this study was to characterize the cephalosporinase from an
H. alvei clinical isolate and to study the regulation of its
expression. Its amino acid sequence was compared to those of
chromosome-borne and plasmid-mediated cephalosporinases.
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MATERIALS AND METHODS |
Bacterial strains and plasmids.
The bacterial strains and
plasmids used in this study are listed in Table
1. H. alvei clinical isolate 1 was from biliary fluid of a patient hospitalized in 1998 at the
Hôpital de Bicêtre (Le Kremlin-Bicêtre, France). It
was identified with the API20-E system (bioMérieux, Marcy
l'Etoile, France).
In vitro selection of extended-spectrum cephalosporin-resistant
mutants.
Frequencies of in vitro selection of antibiotic-resistant
mutants were determined by counting the number of colonies that arose
by plating a large inoculum (109 CFU) of H. alvei 1 or M. morganii 5 (40) on
antibiotic-containing Mueller-Hinton (MH) agar plates at concentrations
of 5 and 10 µg/ml for ceftazidime and 1 µg/ml for cefepime and
cefpirome. One ceftazidime-resistant mutant, H. alvei 1 DER,
was retained for further analysis.
Susceptibility testing.
The MICs of selected
-lactams
were determined by an agar dilution technique as described before
(40). The MICs of
-lactams were determined alone or in
combination with a fixed concentration of either 2 µg of clavulanic
acid per ml or 4 µg of tazobactam per ml for H. alvei
isolates 1, H. alvei 1 DER, E. coli DH10B, E. coli MC4100, or E. coli JRG582 harboring
several plasmid combinations.
Genetic techniques.
Genomic DNA from H. alvei 1 was extracted, and its Sau3AI-restricted fragments were
cloned in phagemid pBK-CMV and expressed in E. coli DH10B as
described before (40). Antibiotic-resistant colonies were
selected on Trypticase soy (TS) agar plates containing either 50 µg
of amoxicillin and 30 µg of kanamycin per ml or 100 µg of
cephalothin and 30 µg of kanamycin per ml.
Recombinant plasmid DNAs were studied as described before
(39). The cloned DNA fragment from pDEL-1 (see Results and
Discussion) was sequenced on both strands using laboratory-designed
primers and an Applied Biosystems sequencer (ABI 373). The nucleotide and amino acid sequences were analyzed by using the software available over the Internet at the National Center for Biotechnology Information website (http://www.ncbi.nlm.nih.gov) and at Pedro's Biomolecular Research tools (http://www.fmi.ch/biology/research_tools.html). Multiple sequence alignment of deduced peptide sequences was carried out over the Internet at the University of Cambridge at the website using the program ClustalW. The deduced AmpC and AmpR proteins were
compared to those of gram-negative bacterial species possessing ampC or ampR genes.
Using the identified DNA sequence of the cloned fragment of recombinant
plasmid pDEL-1 from H. alvei 1 as the template, a set of
primers, primer 2 (5'-CCGAGAAATCGGTGACTC-3') and primer 1 (5'-AAAAGGATCCTTAGTCCTTAGCC-3') or primer 3 (5'-TCTTTTGCATGCTGATTGGC-3') and primer 2 were used to PCR
amplify the ampC-ampR and ampC genes, respectively, and we cloned the amplimers obtained into the
EcoRV site of pACYC184 (30). Both constructs were
resequenced in their entirety.
-Lactamase assays.
-Lactamase extract from cultures of
H. alvei 1 and E. coli DH10B harboring pDEL-1
were obtained as described before (40). Analytical
isoelectric focusing was performed with these
-lactamase extracts as
reported (40).
-Lactamase extract from a culture of
E. coli DH10B(pDEL-1) was further purified as follows. A
culture of E. coli DH10B(pDEL-1) was grown overnight at
37°C in 4 liters of TS broth containing cephalothin (100 µg/ml).
The bacterial suspension was pelleted, resuspended in 40 ml of 20 mM
Tris buffer (pH 7.5), disrupted by sonification (three times for
30 s each at 80 kHz; Vibra Cell 300 Phospholyser [Bioblock,
Illkirch, France]), and centrifuged for 1 h at 4°C and
48,000 × g. Nucleic acids in the supernatant were
precipitated by addition of 0.2 M spermin (7% [vol/vol]) (Sigma)
overnight at 4°C. This suspension was ultracentrifuged at
100,000 × g for 1 h at 4°C and filtered through
a 0.45-µm Millipore filter prior to loading onto a preequilibrated
Q-Sepharose column (Millipore). The resulting enzyme extract recovered
in the flowthrough was then dialyzed against 50 mM phosphate buffer (pH
6.8) and loaded onto a preequilibrated S-Sepharose column. The proteins were eluted with a linear NaCl gradient (0 to 1 M) in 50 mM phosphate buffer (pH 6.8). The
-lactamase was eluted at a concentration of 200 mM NaCl. The
-lactamase was subsequently dialyzed against 50 mM
phosphate buffer (pH 7.0). The purified
-lactamase extract was
immediately used for determination of relative molecular mass and for
kinetic property determinations as described before (39, 40).
The
-lactamase kinetic constants were determined from a culture of
E. coli DH10B(pDEL-1) by UV spectrophotometry
(spectrophotometer ULTROSPEC 2000; Amersham Pharmacia Biotech, Orsay,
France) as described before (40). Fifty percent inhibitory
concentrations (IC50s) were determined for clavulanic acid,
tazobactam, cloxacillin, and cefoxitin. Various concentrations of these
inhibitors were preincubated with the purified enzyme for 3 min at
30°C to determine the concentrations that reduced the hydrolysis rate
of 100 µM cephalothin by 50%. Results are expressed in micromolar
units. The specific activity of the purified
-lactamase from
E. coli DH10B(pDEL-1) was obtained as described previously
with 100 µM cephalothin as the substrate (40).
-Lactamase basal level determination and induction assays were
performed as described before (40, 47) with H. alvei 1, H. alvei 1 DER, H. alvei 1 DER(pNH5), and E. coli MC4100 harboring recombinant
plasmids (see Results and Discussion). Induction of
-lactamase
content was performed for H. alvei cultures and E. coli cultures with imipenem (0.5 µg/ml) and cefoxitin (5 µg/ml), respectively. The specific
-lactamase activities were
obtained as previously described with cephalothin as the substrate
(40). One unit of enzyme activity was defined as the
activity which hydrolyzed 1 µmol of cephalothin per min. The total
protein content was measured with the Bio-Rad DC protein assay kit
(Bio-Rad, Villejuif, France).
Nucleotide sequence accession number.
The nucleotide
sequence data reported in this paper will appear in the GenBank/EMBL
nucleotide database under accession no. AF 180952.
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RESULTS AND DISCUSSION |
Cloning of the ampC gene from H. alvei 1 and identification of the deduced amino acid sequence.
Twenty
E. coli DH10B strains harboring recombinant plasmids were
obtained by selection on cephalothin-containing MH agar plates, while
only one recombinant plasmid was obtained after selection with
amoxicillin. One of them, pDEL-1, which possessed a 3.1-kb insert was
retained for further restriction digest analysis and sequencing (Fig.
1). A 1,170-bp-long open reading frame
(ORF) encoding a putative protein of 390 amino acids was found (Fig. 2). The first 27 amino acids of this
protein were assumed to be the signal peptide, because it ended with a
typical amino acid sequence (A-X-A) known to be recognized by a signal
peptidase (46) (Fig. 2). Within the deduced amino acid
sequence of the mature protein, a serine-valine-phenylalanine-lysine
tetrad at positions 64 to 67 was found (Fig. 2). It included the
conserved serine and lysine amino acid residues characteristic of
-lactamases possessing a serine active site. Of the three structural
elements also found in class C
-lactamases, two were present: YSN at
positions 150 to 152 and KTG at positions 315 to 317 (31,
32). The third element, although more variable from one AmpC to
another (typically DAEA or DAES) at positions 217 to 220, was the
tetrad GNEA. Multiple sequence alignment revealed that this class C
-lactamase (ACC-2) shared 94% amino acid identity with ACC-1 (Table
2), a plasmid-mediated cephalosporinase
from K. pneumoniae KUS from Germany (6). ACC-2 shared at most 50% identity with other chromosome-borne
cephalosporinases from several gram-negative species, such as those of
S. marcescens and P. stuartii (Table 2).
Interestingly, ACC-2 was not more related to some other enterobacterial
cephalosporinases than to those of nonenterobacterial gram-negative
species (Table 2).

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FIG. 1.
Schematic map of recombinant plasmid pDEL-1, carrying
the ampR and ampC genes from H. alvei
1, and of its derivatives pDEL-2 and pDEL-3, carrying ampR
plus ampC and ampC, respectively. The open lines
represent the cloned inserts from H. alvei 1, thin lines
indicate vector pBK-CMV, and thick lines represent vector pACYC184.
Primers 1, 2, and 3, used to PCR amplify the ampC and
ampR genes for the construction of pDEL-2 and pDEL-3, are
shown.
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FIG. 2.
Nucleotide sequence of a 2,252-bp fragment of pDEL-1
including the ampC and ampR coding regions from
H. alvei 1. The deduced amino acid sequences are designated
in single-letter code. The putative promoter sequences represented by
35 and 10 regions are boxed. The start and stop codons of these
genes are underlined. For AmpC, the putative leader peptide is
indicated in small capitals, and the numbering begins after the
putative leader peptide cleavage site. Additionally, conserved residues
among class C -lactamases are in bold and boxed.
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Susceptibility analysis and biochemical properties.
Analysis
of the contribution of the cephalosporinase to the overall resistance
to
-lactams in H. alvei 1 and E. coli
DH10B(pDEL-1) showed that H. alvei 1 was resistant at a low
level to amoxicillin and cephalothin, showed decreased susceptibility
to ceftazidime, ceftriaxone, and cefpirome, and remained susceptible to
cefoxitin, cefepime, imipenem, and aztreonam (Table
3). Expression of
-lactam resistance
appeared to be inducible in H. alvei 1, as evidenced by the
increased MICs of ceftazidime and cefpirome when clavulanic acid or
tazobactam was added, the latest
-lactam inhibitor usually known as
a weak inducer of expression of enterobacterial cephalosporinase (1) (Table 3). Expression of ACC-2 in the E. coli
host was associated with a significant decrease in susceptibility to
amoxicillin, cephalothin, ticarcillin, ceftazidime, cefotaxime, and,
uncommonly, to cefpirome, but not significantly to ureidopenicillins,
cefoxitin, cefepime, aztreonam, and imipenem (Table 3).
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TABLE 3.
MICs of -lactams for H. alvei 1 clinical
isolate, in vitro-obtained ceftazidime-resistant mutant H. alvei 1 DER, E. coli DH10B harboring recombinant
plasmid pDEL-1, and the E. coli DH10B reference strain
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The specific activity of the purified
-lactamase was 0.75 µmol
min
1 (mg of protein)
1. Its overall recovery
was 8%, with a 21-fold purification. Kinetic analysis of ACC-2
revealed its strong activity against restricted-spectrum cephalosporins
(cephalothin), as known for other cephalosporinases (Table
4) (10). Interestingly, its
hydrolysis activity was also noticeable against extended-spectrum
cephalosporins, mostly against cefpirome (Table 4). Similar activity is
not known for any chromosome- or plasmid-borne cephalosporinases
(1, 10, 38, 47), and cefpirome hydrolysis activity had not
been tested for ACC-1 (6). This result contrasts with the
well-accepted knowledge of resistance of cefpirome to hydrolysis by
class C enzymes even when they are overproduced (9). ACC-2
activity was weakly inhibited by clavulanic acid and tazobactam but
strongly inhibited by cloxacillin and cefoxitin. The IC50s
were 290, 0.008, and 0.0024 µM for tazobactam, cloxacillin, and
cefoxitin, respectively (10% inhibition for 300 µM clavulanic acid).
The cloxacillin-inhibitory property is well known for cephalosporinases
(9), and the cefoxitin-inhibitory property has been reported
at least for the chromosome-borne cephalosporinases of C. freundii and P. stuartii (13). This
inhibitory property of cefoxitin may explain why (i) E. coli
DH10B (pDEL-1) remained susceptible to cefoxitin and (ii) ACC-1 has
been reported as being unable to hydrolyze cefoxitin (6).
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TABLE 4.
Kinetic parameters of several -lactam antibiotics for
the purified AmpC -lactamase (ACC-2) of H. alvei 1 from a
culture of E. coli DH10B(pDEL-1)a
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The determined relative molecular mass of ACC-2 of 37 kDa corresponded
to that calculated by computer for the mature protein. The isoelectric
point (pI) value of 8 for ACC-2 determined either from cultures of
H. alvei 1 or cultures of E. coli DH10B(pDEL-1) was similar to that found for ACC-1 (6). This pI value was within the range of basic pI values of cephalosporinases
(10).
Analysis of the amino acid sequence of ACC-2 did not evidence any
specific positions that might explain either its expanded hydrolysis
profile for cefpirome or its strong inhibition by cefoxitin. Among the
conserved residues of cephalosporinases, only the GNEA motif at
positions 217 to 220 was peculiar (31). However, a glycine
residue at position 217 is also found in the AmpC of P. stuartii and Y. enterocolitica, and the glutamic acid
and alanine residues at positions 219 and 220, respectively, are also
found in the chromosome-borne cephalosporinases of E. coli,
C. freundii, P. immobilis, Aeromonas
sobria, and P. stuartii and in several plasmid-mediated
cephalosporinases such as MOX-1, FOX-1, MIR-1, and CMY-2 (data not
shown). The extended hydrolysis profile of ACC-2 could not be explained
by any amino acid substitutions or additions, as found in several
enterobacterial cephalosporinases, such as the amino acid duplication
at positions 208 to 213 in E. cloacae and C. freundii and the valine-to-glutamic acid change at position 298 in
E. cloacae (17, 31, 34, 37, 45).
In vitro selection of extended-spectrum cephalosporin-resistant
mutants.
Since ACC-2 had the peculiar ability to hydrolyze
cefpirome, experiments were performed to compare the selection
frequency of
-lactam-resistant mutants with several extended
cephalosporins with H. alvei 1 and M. morganii 5, the latest strain reported to produce an inducible cephalosporinase
that does not significantly hydrolyze cefpirome (40). At a
low concentration of ceftazidime (5 µg/ml), the selection frequency
of ceftazidime-resistant mutants with H. alvei 1 was similar
to that obtained with M. morganii 5 cultures (3.3 × 10
6 to 6.3 × 10
7). However, at a
ceftazidime concentration of 10 µg/ml, the selection frequency of
ceftazidime-resistant H. alvei 1 mutants was 2.1 × 10
6 ± 0.9 × 10
6, and no
ceftazidime-resistant M. morganii 5 mutants were obtained (<2 × 10
8). This results may be partially related
to a difference in the MICs of ceftazidime for H. alvei 1 and M. morganii 5, the MICs being 2 and 0.06 µg/ml,
respectively. Susceptibility and
-lactamase quantification of one of
ceftazidime-resistant H. alvei 1 mutant, H. alvei
1 DER, showed constitutive overproduction of its cephalosporinase and
cross resistance to cefpirome (Tables 3 and
5). Resistance to cefpirome in this
cephalosporinase-overproducing mutant contrasted with the
susceptibility to cefpirome reported for several other enterobacterial
species that overproduce their cephalosporinases (9).
Although cefepime-resistant H. alvei 1 and M. morganii 5 mutants were not obtained, only cefpirome-resistant
H. alvei 1 mutants were obtained at a frequency of 1.4 × 10
7 ± 0.3 × 10
7, with a
cefpirome selection of 1 µg/ml. Again, a difference in the MICs of
cefpirome for H. alvei 1 and M. morganii 5 (2 and 0.06 µg/ml, respectively) may account for this result. The clinical significance of these experiments would be that (i) it is possible to
select ceftazidime-resistant and cefpirome-resistant H. alvei strains in vivo with a therapy that includes either a
ceftazidime- or cefpirome-containing treatment and (ii) cefpirome would
not always be efficient for treating infections due to either H. alvei isolates overexpressing their cephalosporinases or
enterobacterial isolates that produced AAC-2-like
plasmid-mediated cephalosporinases such as AAC-1.
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TABLE 5.
MICs of several -lactams and -lactamase activities
for E. coli and H. alvei strains with
different genotypes
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ampR gene from H. alvei 1.
Sequencing
of the entire insert of recombinant plasmid pDEL-1 revealed an
ampR-like gene upstream and divergently transcribed from the
ampC gene (Fig. 2). This gene had an overlapping and divergently oriented promoter, as known for the ampC-ampR
cistrons from C. freundii, E. cloacae, M. morganii, P. stuartii, and Y. enterocolitica
(Fig. 2). The putative binding sites of AmpR for the regulation of its
own expression and of AmpC expression that were identified for C. freundii (29) were also found in H. alvei 1 (Fig. 3). However, just upstream of the
region 1 binding site, a 14-bp addition with unknown significance was
found as well as additional 39-bp segment upstream from the ATG site of
the ampC gene (Fig. 3). The deduced AmpR protein of H. alvei 1 shared significant amino acid identity with AmpR of other
enterobacterial species, 64, 51, 48, 47, and 46% for AmpR from
P. stuartii, M. morganii, E. cloacae,
C. freundii, and Y. enterocolitica, respectively. This identity was mainly within the N-terminal part that contained the
helix-turn-helix motif required for binding to the ampR-ampC intercistronic region in C. freundii (28) (Fig.
4). The percentage of identity among
enterobacterial AmpR proteins was higher than that among
enterobacterial AmpCs. The percentage of amino acid identity among AmpR
proteins did not parallel that found for AmpC proteins, although AmpR
and AmpC from P. stuartii shared the highest homology with
AmpR and AmpC from H. alvei 1. For the 301 bp upstream from
the ampR gene of H. alvei 1, no homology was
found. However, a further 339 bp upstream, part of an identified ORF
shared 74% identity with the glutathione reductase of E. coli (data not shown) (16). Therefore, the location of
ampR-ampC in H. alvei may be different from that
found in the other enterobacterial species such as M. morganii, in which it is located downstream of an
hybF-like gene, and in E. cloacae and C. freundii, in which it is located downstream of the fumarate operon
frdABCD (40). Further work may investigate the
location of the ampR-ampC cistron in other H. alvei isolates.

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FIG. 3.
Alignment of the intercistronic regions of
ampC-ampR from C. freundii, E. cloacae, M. morganii, P. stuartii, Y. enterocolitica, and H. alvei. The start codons and the
35 and 10 regions of the promoters are shown below the DNA
sequences for ampR and above for ampC. The +1
sign indicates the putative mRNA transcription start site. The
sequences marked region 1 and region 2 are the two components of the
putative AmpR binding site. Only region 1 contains a LysR binding motif
(T-N11-A). Dashes indicate gaps introduced in the DNA
sequence to optimize the alignment.
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FIG. 4.
Multiple amino acid sequence alignment of the known
AmpRs from various members of the Enterobacteriaceae. The
sequences are for AmpR from C. freundii OS60, E. cloacae MHN-1, M. morganii 1, P. stuartii
VDG96, Y. enterocolitica IP97, and H. alvei 1. The predicted helix-turn-helix (HTH) DNA-binding motif of the LysR
family is shown. Amino acids that are identical to those found in
H. alvei are shaded.
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Regulation of H. alvei cephalosporinase
expression.
Expression of ampC was studied after it was
cloned into a plasmid of relatively low copy number (20 to 30 copies),
pACYC184. Recombinant plasmids pDEL-2 and pDEL-3 were obtained by
cloning the PCR-amplified ampC and ampR genes and
the ampC gene, respectively (Fig. 1). E. coli
MC4100(pDEL-2) had an inducible cephalosporinase phenotype in the
presence of cefoxitin (170-fold increase), while E. coli
MC4100(pDEL-3), which lacks the ampR gene, showed an
increase in basal cephalosporinase expression (34-fold) along with a
loss of inducibility (Table 5). Similarly, the MICs of
-lactams were higher for E. coli MC4100(pDEL-3) than for E. coli MC4100(pDEL-2), most noticeably for ceftazidime and cefpirome
(Table 5). Similar results were obtained with C. freundii,
E. cloacae, and M. morganii cephalosporinases, for which ampR deletion resulted in an
increase in
-lactamase expression and a loss of inducibility
(5, 18, 19, 40). Thus, AmpR acted in H. alvei as
a negative regulator of cephalosporinase expression in the absence of a
-lactam inducer and as an activator in its presence.
The level of cephalosporinase from H. alvei 1 indicated a
low level and inducible biosynthesis (Table 5). An in vitro-selected ceftazidime-resistant mutant, H. alvei 1 DER, produced a
high level and constitutive expression of this cephalosporinase (Table 5). The susceptibility of H. alvei 1 DER to all
-lactams
was decreased, especially to cefpirome, compared with the parental H. alvei 1 (Table 3). According to the results obtained with the regulatory systems of other enterobacterial cephalosporinases, H. alvei 1 DER might possess mutations either in the
promoter of an ampD-like gene or within its structural gene.
To test this hypothesis, H. alvei 1 DER was transformed with
plasmid pNH5 containing an ampD gene from E. coli. A decrease in
-lactam MICs and cephalosporinase was
obtained together with the recovery of an inducible phenotype (Table
5). Similarly, E. coli JRG582 (
ampDE)
harboring the ampC and ampR genes from H. alvei 1 with or without the same ampD gene showed lower
-lactam MICs in the presence of ampD (Table 5) and an
inducible cephalosporinase expression phenotype (data not shown). These
results indicated that AmpD from E. coli may act in
trans as a regulatory protein for expression of H. alvei cephalosporinase in a similar manner as for the
cephalosporinase of E. cloacae (18). Such
complementation with an ampD gene from another
enterobacterial species is known for cephalosporinase regulation in
C. freundii, E. cloacae, and M. morganii (5, 18, 40). Thus, regulation of the
cephalosporinase of H. alvei may be similar to that
extensively described for E. cloacae (22). In the
absence of a
-lactam as an inducer, the AmpR regulator is maintained
in an inactive form by a peptidoglycan precursor, uridine
pyrophosphoryl-N-acetyl muramyl-L-alanyl-D-glutamyl-meso-diaminopimelic
acid-D-alanyl-D-alanine (UDP-MurNac-pentapeptide) and binds to its operator site between the
ampC and ampR structural genes, leading to
repression of ampC expression. This inactivation of AmpR can
be relieved by either a knockout mutation in the ampD gene
or the presence of a
-lactam. Inactivation of ampD by
mutations in its promoter or in its structural gene, which encodes a
cytosolic amidase specific for the recycling of muropeptides, results
in an accumulation of its substrate, the
1,6-anhydro-N-acetylmuramyl-L-alanyl-D-glutamyl-meso-diaminopimelic acid (anhMurNac-tripeptide). The increased concentration of this muropeptide inside the cell displaces the UDP-MurNac-pentapeptide from
its AmpR binding site, thereby reactivating AmpR. The ampD mutants are therefore highly resistant to
-lactams as a result of
constitutive hyperproduction of the AmpC
-lactamase in the absence
of
-lactams (22).
Conclusion.
Although the chromosome-encoded AmpC enzymes from
H. alvei are not related to any known chromosome-encoded
cephalosporinase, it is related to the recently described
plasmid-encoded cephalosporinase ACC-1 from K. pneumoniae
KUS. This is the fourth example of a plasmid-encoded cephalosporinase
highly related to the chromosome-encoded cephalosporinases of C. freundii (CMY-2, CMY-3, LAT-1, LAT-2, LAT-3, and LAT-4), E. cloacae (MIR-1 and ACT-1), and M. morganii (DHA-1),
showing that members of the Enterobacteriaceae are a reservoir for plasmid-encoded cephalosporinases. The mechanism by which
chromosome-encoded cephalosporinases became plasmid encoded has not yet
been discovered. Interestingly, comparison of the upstream region of
blaACC-1 with that of
blaACC-2 revealed 93% identity among the 66 bp
just upstream of the blaACC-2 ATG site. Further
upstream, the homology was interrupted. A careful analysis of this
region upstream from the blaACC-1 sequence in
K. pneumoniae KUS revealed sequence identities with a
putative insertion sequence, ISEcp1, and, further upstream,
IS26 (25, 33; P. D. Stapleton, unpublished data [GenBank no. AJ242809]). The IS26
outwards-reading promoter is directed in the same orientation as
blaACC-1 indicating that this insertion sequence
may drive
-lactamase expression in K. pneumoniae KUS, as
shown, for example, for blaSHV-2a in a P. aeruginosa isolate (35). Insertion sequences and
transposons are known to capture genes and to transpose them, being
major players in the genetic plasticity of bacteria. It would be
interesting to investigate further the plasmid carrying
blaACC-1 to see whether a composite
IS26 transposon is responsible for its plasmid location.
This work was funded by a grant from the Ministère de
l'Education Nationale et de la Recherche, Université Paris XI,
Faculté de Médecine Paris Sud (grant UPRES, JE-2227).
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Akova, M.,
Y. Yang, and D. M. Livermore.
1990.
Interactions of tazobactam and clavulanate with inducibly- and constitutively-expressed class I -lactamases.
J. Antimicrob. Chemother.
25:199-208[Abstract/Free Full Text].
|
| 2.
|
Ambler, R. P.
1980.
The structure of -lactamases.
Philos. Trans. R. Soc. Lond. B Biol. Sci.
289:321-331[Medline].
|
| 3.
|
Barnaud, G.,
G. Arlet,
C. Verdet,
O. Gaillot,
P. H. Lagrange, and A. Philippon.
1998.
Salmonella enteritidis: AmpC plasmid-mediated inducible -lactamase (DHA-1) with an ampR gene from Morganella morganii.
Antimicrob. Agents Chemother.
42:2352-2358[Abstract/Free Full Text].
|
| 4.
|
Barry, J. W.,
E. A. Dominguez,
D. J. Boken, and L. C. Preheim.
1997.
Hafnia alvei infection after liver transplantation.
Clin. Infect. Dis.
24:1263-1264[Medline].
|
| 5.
|
Bartowsky, E., and S. Normark.
1993.
Interactions of wild-type and mutant AmpR of Citrobacter freundii with target DNA.
Mol. Microbiol.
10:555-565[Medline].
|
| 6.
|
Bauernfeind, A.,
I. Schneider,
R. Jungwirth,
H. Sahly, and U. Ullmann.
1999.
A novel type of AmpC -lactamase, ACC-1, produced by a Klebsiella pneumoniae strain causing nosocomial pneumonia.
Antimicrob. Agents Chemother.
43:1924-1931[Abstract/Free Full Text].
|
| 7.
|
Bauernfeind, A.,
I. Stemplinger,
R. Jungwirth, and H. Giamarellou.
1996.
Characterization of the plasmidic -lactamase CMY-2, which is responsible for cephamycin resistance.
Antimicrob. Agents Chemother.
40:221-224[Abstract].
|
| 8.
|
Bauernfeind, A.,
I. Stemplinger,
R. Jungwirth,
R. Wilhelm, and Y. Chong.
1996.
Comparative characterization of the cephamycinase blaCMY-1 gene and its relationship with other -lactamase genes.
Antimicrob. Agents Chemother.
40:1926-1930[Abstract].
|
| 9.
|
Bonfiglio, G.,
S. Stefani, and G. Nicoletti.
1994.
In vitro activity of cefpirome against beta-lactamase-inducible and stably derepressed Enterobacteriaceae.
Chemotherapy
40:311-316[Medline].
|
| 10.
|
Bush, K.,
G. A. Jacoby, and A. A. Medeiros.
1995.
A functional classification scheme for -lactamases and its correlation with molecular structure.
Antimicrob. Agents Chemother.
39:1211-1233[Medline].
|
| 11.
|
Chang, A. C., and S. N. Cohen.
1978.
Construction and characterization of amplifiable multicopy DNA cloning vehicles derived from the P15A cryptic miniplasmid.
J. Bacteriol.
134:1141-1156[Abstract/Free Full Text].
|
| 12.
|
Feller, G.,
Z. Zekhini,
J. Lamotte-Brasseur, and C. Gerday.
1997.
Enzymes from cold-adapted microorganisms. The class C beta-lactamase from the Antartic psychrophile Psychrobacter immobilis A5.
Eur. J. Biochem.
244:186-191[Medline].
|
| 13.
|
Fu, K. P., and H. C. Neu.
1979.
The comparative beta-lactamase resistance and inhibitory activity of 1-oxa cephalosporin, cefoxitin and cefotaxime.
J. Antibiot. (Tokyo)
32:909-914[Medline].
|
| 14.
|
Galleni, M.,
F. Lindberg,
S. Normark,
S. Cole,
N. Honoré,
B. Joris, and J.-M. Frère.
1988.
Sequence and comparative analysis of three Enterobacter cloacae ampC -lactamase genes and their products.
Biochem. J.
250:753-760[Medline].
|
| 15.
|
Gonzalez Leiza, M.,
J. C. Perez-Diaz,
J. Ayala,
J. M. Casellas,
J. Martinez-Beltran,
K. Bush, and F. Baquero.
1994.
Gene sequence and biochemical characterization of FOX-1 from Klebsiella pneumoniae, a new AmpC-type plasmid-mediated -lactamase with two molecular variants.
Antimicrob. Agents Chemother.
38:2150-2157[Abstract/Free Full Text].
|
| 16.
|
Greer, S., and R. N. Perham.
1986.
Glutathione reductase from Escherichia coli: cloning and sequence analysis of the gene and relationship to other flavoprotein disulfide oxidoreductases.
Biochemistry
25:2736-2742[CrossRef][Medline].
|
| 17.
|
Haruta, S.,
M. Nukaga,
K. Taniguchi, and T. Sawai.
1998.
Resistance to oxyimino -lactams due to a mutation of chromosomal -lactamase in Citrobacter freundii.
Microbiol. Immunol.
42:165-169[Medline].
|
| 18.
|
Honoré, N.,
M. H. Nicolas, and S. T. Cole.
1986.
Inducible cephalosporinase production in clinical isolates of Enterobacter cloacae is controlled by a regulatory gene that has been deleted from Escherichia coli.
EMBO J.
5:3709-3714[Medline].
|
| 19.
|
Honoré, N.,
M. H. Nicolas, and S. T. Cole.
1989.
Regulation of enterobacterial cephalosporinase production: the role of a membrane-bound sensory transducer.
Mol. Microbiol.
3:1121-1130[CrossRef][Medline].
|
| 20.
|
Horii, T.,
Y. Arakawa,
M. Ohta,
T. Sugiyama,
R. Wacharotayankun,
H. Ito, and N. Kato.
1994.
Characterization of a plasmid-borne and constitutively expressed blaMOX-1 gene encoding AmpC-type -lactamase.
Gene
139:93-98[CrossRef][Medline].
|
| 21.
|
Ismaili, A.,
B. Bourke,
J. C. De Azavedo,
S. Ratnam,
M. A. Karmali, and P. M. Sherman.
1996.
Heterogeneity in phenotypic and genotypic characteristics among strains of Hafnia alvei.
J. Clin. Microbiol.
34:2973-2979[Abstract].
|
| 22.
|
Jacobs, C.,
J. M. Frère, and S. Normark.
1997.
Cytosolic intermediates for cell wall biosynthesis and degradation control inducible -lactam resistance in gram-negative bacteria.
Cell
88:823-832[CrossRef][Medline].
|
| 23.
|
Jacoby, G. A., and J. Tran.
1999.
Sequence of the MIR-1 beta-lactamase gene.
Antimicrob. Agents Chemother.
43:1759-1760[Abstract/Free Full Text].
|
| 24.
|
Jaurin, B., and T. Grunström.
1981.
ampC cephalosporinase of Escherichia coli K-12 has a different evolutionary origin from that of -lactamases of the penicillinase type.
Proc. Natl. Acad. Sci. USA
78:4897-4901[Abstract/Free Full Text].
|
| 25.
|
Lee, K. Y.,
J. D. Hopkins, and M. Syvanen.
1990.
Direct involvement of IS26 in an antibiotic resistance operon.
J. Bacteriol.
172:3229-3236[Abstract/Free Full Text].
|
| 26.
|
Lindberg, F., and S. Normark.
1986.
Sequence of the Citrobacter freundii OS60 chromosomal ampC beta-lactamase gene.
Eur. J. Biochem.
156:441-445[Medline].
|
| 27.
|
Lindberg, F.,
L. Westman, and S. Normark.
1985.
Regulatory components in Citrobacter freundii ampC -lactamase induction.
Proc. Natl. Acad. Sci. USA
82:4620-4624[Abstract/Free Full Text].
|
| 28.
|
Lindquist, S.,
F. Lindberg, and S. Normark.
1989.
Binding of the Citrobacter freundii AmpR regulator to a single DNA site provides both autoregulation and activation of the inducible ampC -lactamase gene.
J. Bacteriol.
171:3746-3753[Abstract/Free Full Text].
|
| 29.
|
Lodge, J. M.,
S. D. Minchin,
L. J. Piddock, and J. W. Busby.
1990.
Cloning, sequencing and analysis of the structural gene and regulatory region of Pseudomonas aeruginosa chromosomal AmpC- -lactamase.
Biochem. J.
272:627-631[Medline].
|
| 30.
|
Maniatis, T.,
E. F. Fritsch, and J. Sambrook.
1989.
Molecular cloning: a laboratory manual, 2nd ed.
Cold Spring Harbor Laboratory, Cold Spring Harbor, N.Y.
|
| 31.
|
Matsumura, N.,
S. Minami, and S. Mitsuhashi.
1998.
Sequences of homologous -lactamases from clinical isolates of Serratia marcescens with different substrate specificities.
Antimicrob. Agents Chemother.
42:176-179[Abstract/Free Full Text].
|
| 32.
|
Medeiros, A. A.
1997.
Evolution and dissemination of -lactamases accelerated by generations of -lactam antibiotics.
Clin. Infect. Dis.
24:S19-S45.
|
| 33.
|
Mollet, B.,
S. Iida,
J. Shepherd, and W. Arber.
1983.
Nucleotide sequence of IS26, a new prokaryotic mobile genetic element.
Nucleic Acids Res.
11:6319-6330[Abstract/Free Full Text].
|
| 34.
|
Morosini, M. I.,
M. C. Negri,
B. Shoichet,
M. R. Baquero,
F. Baquero, and J. Blazquez.
1998.
An extended-spectrum AmpC-type -lactamase obtained by in vitro antibiotic selection.
FEMS Microbiol. Lett.
165:85-90[Medline].
|
| 35.
|
Naas, T.,
L. Philippon,
L. Poirel,
E. Ronco, and P. Nordmann.
1999.
An SHV-derived extended-spectrum beta-lactamase in Pseudomonas aeruginosa.
Antimicrob. Agents Chemother.
43:1281-1284[Abstract/Free Full Text].
|
| 36.
|
Nomura, K., and T. Yoshida.
1990.
Nucleotide sequence of the Serratia marcescens SR50 chromosomal ampC beta-lactamase gene.
FEMS Microbiol. Lett.
58:295-299[Medline].
|
| 37.
|
Nukaga, M.,
S. Haruta,
K. Tanimoto,
K. Kogure,
K. Taniguchi,
M. Tamaki, and T. Sawai.
1995.
Molecular evolution of a class C -lactamase extending its substrate specificity.
J. Biol. Chem.
270:5729-5735[Abstract/Free Full Text].
|
| 38.
|
Phelps, D. J.,
D. D. Carlton,
C. A. Farrell, and R. E. Kessler.
1986.
Affinity of cephalosporins for -lactamases as a factor in antibacterial efficacy.
Antimicrob. Agents Chemother.
29:845-848[Abstract/Free Full Text].
|
| 39.
|
Philippon, L. N.,
T. Naas,
A. T. Bouthors,
V. Barakett, and P. Nordmann.
1997.
OXA-18, a class D clavulanic acid-inhibited extended-spectrum -lactamase from Pseudomonas aeruginosa.
Antimicrob. Agents Chemother.
41:2188-2195[Abstract].
|
| 40.
|
Poirel, L.,
M. Guibert,
D. Girlich,
T. Naas, and P. Nordmann.
1999.
Cloning, sequence analyses, expression, and distribution of ampC-ampR from Morganella morganii clinical isolates.
Antimicrob. Agents Chemother.
43:769-776[Abstract/Free Full Text].
|
| 41.
|
Rasmussen, B. A.,
D. Keeney,
Y. Yang, and K. Bush.
1994.
Cloning and expression of a cloxacillin-hydrolyzing enzyme and a cephalosporinase from Aeromonas sobria AER 14M in Escherichia coli: requirement for an E. coli chromosomal mutation for efficient expression of the class D enzyme.
Antimicrob. Agents Chemother.
38:2078-2085[Abstract/Free Full Text].
|
| 42.
|
Ridell, J.,
A. Siitonen,
L. Paulin,
L. Mattila,
H. Korkeala, and M. J. Albert.
1994.
Hafnia alvei in stool specimens from patients with diarrhea and healthy controls.
J. Clin. Microbiol.
32:2335-2337[Abstract/Free Full Text].
|
| 43.
|
Seoane, A.,
M. V. Francia, and J. M. Garcia-Lobo.
1992.
Nucleotide sequence of the ampC-ampR region from the chromosome of Yersinia enterocolitica.
Antimicrob. Agents Chemother.
36:1049-1052[Abstract/Free Full Text].
|
| 44.
|
Thomson, K. S.,
C. C. Sanders, and J. A. Washington, II.
1993.
Ceftazidime resistance in Hafnia alvei.
Antimicrob. Agents Chemother.
37:1375-1376[Abstract/Free Full Text].
|
| 45.
|
Tsukamoto, K.,
R. Ohno, and T. Sawai.
1990.
Extension of the substrate spectrum by an amino acid substitution at residue 219 in the Citrobacter freundii cephalosporinase.
J. Bacteriol.
172:4348-4351[Abstract/Free Full Text].
|
| 46.
|
von Heijne, G.
1985.
Signal sequences: the limits of variation.
J. Mol. Biol.
184:99-105[CrossRef][Medline].
|
| 47.
|
Yang, Y.,
D. M. Livermore, and R. J. Williams.
1988.
Chromosomal -lactamase expression and antibiotic resistance in Enterobacter cloacae.
J. Med. Microbiol.
25:227-233[Abstract].
|