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Antimicrobial Agents and Chemotherapy, September 2003, p. 2892-2896, Vol. 47, No. 9
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.9.2892-2896.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Resistance to the Peptidyl Transferase Inhibitor Tiamulin Caused by Mutation of Ribosomal Protein L3
Jacob Bøsling,1 Susan M. Poulsen,1 Birte Vester,2 and Katherine S. Long1*
Institute of Molecular Biology, University of Copenhagen, DK-1307 Copenhagen K,1
Department of Biochemistry and Molecular Biology, University of Southern Denmark, DK-5230 Odense M, Denmark2
Received 7 April 2003/
Returned for modification 23 May 2003/
Accepted 11 June 2003

ABSTRACT
The antibiotic tiamulin targets the 50S subunit of the bacterial
ribosome and interacts at the peptidyl transferase center. Tiamulin-resistant
Escherichia coli mutants were isolated in order to elucidate
mechanisms of resistance to the drug. No mutations in the rRNA
were selected as resistance determinants using a strain expressing
only a plasmid-encoded rRNA operon. Selection in a strain with
all seven chromosomal rRNA operons yielded a mutant with an
A445G mutation in the gene coding for ribosomal protein L3,
resulting in an Asn149Asp alteration. Complementation experiments
and sequencing of transductants demonstrate that the mutation
is responsible for the resistance phenotype. Chemical footprinting
experiments show a reduced binding of tiamulin to mutant ribosomes.
It is inferred that the L3 mutation, which points into the peptidyl
transferase cleft, causes tiamulin resistance by alteration
of the drug-binding site. This is the first report of a mechanism
of resistance to tiamulin unveiled in molecular detail.

INTRODUCTION
The antibiotic tiamulin (Fig.
1A) is a semisynthetic derivative
of the tricyclic diterpenoid compound pleuromutilin, which was
isolated from the basidiomycete
Pleurotus mutilus (now called
Clitopilus scyphoides) (
11). Pleuromutilins inhibit protein
synthesis by specifically targeting the large subunit of the
bacterial ribosome. A recent study utilized chemical footprinting
to reveal details of the binding of tiamulin and the related
drug valnemulin to 23S rRNA (
18). Nucleotides A2058 and -9,
U2506, and U2584 and -5 exhibit altered reactivities in the
presence of the antibiotics, indicating that they bind at the
ribosomal peptidyl transferase center (Fig.
1B). Competitive
footprinting experiments with macrolide antibiotics show that
tiamulin and valnemulin can bind to the ribosome concurrently
with erythromycin but compete with carbomycin, a peptidyl transferase
inhibitor (
18). These results are consistent with the inhibition
of peptide bond formation by pleuromutilins observed in in vitro
protein synthesis assays (
7,
18). Together with earlier work
indicating that the drugs are displaced by puromycin and chloramphenicol
(
8), the accumulated evidence suggests that the pleuromutilins
bind at the ribosomal A site of the peptidyl transferase center.
Tiamulin is used exclusively in veterinary medicine to treat
swine dysentery and respiratory diseases in pigs and poultry.
In some countries, only a few antibiotics are approved for use
in pigs, and some of the drugs have limited effectiveness due
to increased bacterial resistance. Therefore, tiamulin is an
important option for the eradication of
Brachyspira hyodysenteriae,
a causative agent of swine dysentery, from infected herds. Resistance
to the drugs tylosin and lincomycin in
B. hyodysenteriae develops
rapidly and is caused by a single point mutation in 23S rRNA
at nucleotide A2058 (
9). In contrast, tiamulin resistance develops
relatively slowly and in a stepwise fashion in vitro (
10). However,
there has been an alarming increase in the number of isolates
with decreased tiamulin susceptibility and reports of tiamulin-resistant
isolates from different parts of Europe. To date, the genetic
basis of tiamulin resistance is unknown. Knowledge of antibiotic
resistance mechanisms is important not only for the design of
improved antimicrobial agents but also for guiding policies
on the current set of antibiotics so they can be used most effectively.
In this study, the genetic basis of tiamulin resistance in Escherichia coli was investigated. Strains of E. coli containing a plasmid-encoded or seven chromosomal rRNA operons were used to select for tiamulin-resistant mutants. rRNA mutations were not found as resistance determinants in the isolated mutants with plasmid-encoded rRNA, although the footprinting data point to a binding site in the rRNA. Additional selections produced tiamulin-resistant mutants with various phenotypes. In one isolate we identified a point mutation in ribosomal protein L3 responsible for the tiamulin resistance phenotype. The mutation is located in a nonglobular domain of L3 that extends close to the site of peptide bond formation. We conclude that the mutation in ribosomal protein L3 confers the observed tiamulin resistance phenotype by affecting the binding and inhibitory action of tiamulin at the peptidyl transferase center.

MATERIALS AND METHODS
E. coli strains and plasmids.
The bacterial strains and plasmids used in this study are listed
in Table
1.
Isolation and characterization of tiamulin-resistant mutants in a strain with a plasmid-encoded rRNA operon.
Antibiotic sensitivity testing showed that the growth of
E. coli strain TA542 is completely inhibited at 60 µg of
tiamulin per ml. Twenty-two spontaneous mutants with decreased
tiamulin sensitivity were isolated by growing strain TA542 in
the presence of 60 to 100 µg of tiamulin per ml. Plasmid
DNA from the mutant strains was isolated and transformed into
a strain that had not been exposed to tiamulin, where pHK-rrnC
+ in TA542 was replaced with pFK1 (
4). Tiamulin susceptibilities
of strains containing the wild-type TA542 strain background
and pHK-rrnC
+ from each of the mutant strains were determined
by testing for growth on NZY plates containing tiamulin. In
all cases, the tiamulin susceptibility of a strain containing
pHK-rrnC
+ isolated from a mutant was indistinguishable from
that of TA542.
Isolation and genetic mapping of tiamulin-resistant mutants in a strain with seven chromosomal rRNA operons.
Seventeen spontaneous mutants with decreased tiamulin sensitivity were isolated by growing strain CN2476 on agar plates containing 150 or 200 µg of tiamulin per ml. The position of the mutation in one mutant strain, named JB5, was mapped by using a general strategy described previously (19). Two sets of strains marked with tetracycline resistance were used in the mapping procedure (Table 1), including a set of Hfr strains (CAG5051 to CAG5055, CAG8160, and CAG8209) and a set of strains for P1 transductions (CAG12072, CAG12075, CAG12152, and PG201). Hfr matings and generalized transductions with lysates of bacteriophage P1vir were performed essentially as described previously (12).
Construction of L3-lacZ expression vectors and complementation experiments.
A portion of the E. coli S10 operon from CN2476 and JB5 strains including the last 16 codons of the S10 gene, the entire L3 gene, and the first 16 codons of L4 gene was amplified by PCR and inserted between the BamHI and HindIII sites of the pCN102A vector (15). The cloned inserts were sequenced to verify their identities. The resulting L3-lacZ expression vectors (named pCN102A-wt L3 and pCN102A-mt L3, denoting plasmids containing the wild-type and mutant L3 sequences, respectively), as well as the parent vector, pCN102A, were transformed individually into CN2476 and JB5 strains. For MIC determination, overnight liquid cultures were diluted and 102 to 103 cells were spread on NZY agar plates containing tiamulin and ampicillin. MICs are the results of at least three independent experiments and are expressed as ranges, where the lower value represents the highest antibiotic concentration at which single colonies (>0.25 mm in diameter) were formed and the higher value is the lowest antibiotic concentration at which single colonies (>0.25 mm in diameter) were not formed on NZY agar plates after 48 h of growth at 37°C.
Footprinting experiments.
Ribosome isolation, chemical modification, and primer extension procedures were carried out essentially as described elsewhere (18). Primer 2654 (5'-TCCGGTCCTCTCGTACT-3'), complementary to nucleotides 2654 to 2670 of 23S rRNA, was used in the extension reaction. The cDNA products of the primer extension reactions were separated on 8% polyacrylamide-7 M urea sequencing gels.

RESULTS AND DISCUSSION
Search for tiamulin-resistant mutants with alterations in the rRNA.
Several lines of evidence indicate that tiamulin binds in a
cavity lined with rRNA nucleotides at the peptidyl transferase
center. For many of the peptidyl transferase antibiotics, single
nucleotide alterations in the peptidyl transferase loop have
been found to confer antibiotic resistance. In order to select
for mutations in rRNA that could lead to tiamulin resistance,
an
E. coli strain with a plasmid-borne rRNA operon and seven
inactivated chromosomal rRNA operons was used (Table
1) (
1).
Plasmid DNA from the mutant strains was isolated and transformed
individually into the parent strain, where pHK-rrnC
+ was replaced
with pFK1 (see Materials and Methods and Table
1). The isolated
plasmid did not confer a tiamulin-resistant phenotype for any
of the selected mutants. Thus, the tiamulin resistance determinants
obtained do not reside on the plasmid and in these cases are
therefore not due to mutations in rRNA. The reason that no tiamulin-resistant
rRNA mutants were selected could be that the antibiotic binding
pocket is lined with essential nucleotides that are necessary
for cell growth. Another explanation is that such a plasmid-borne
mutation is not viable or frequent enough to be manifested as
a resistant phenotype under the investigated conditions. Preliminary
investigations (data not shown) indicate that the cause of decreased
sensitivity to tiamulin may be nonribosomal in some cases, although
these strains have not been characterized further.
Isolation and genetic mapping of a tiamulin-resistant E. coli mutant.
A second selection was carried out with an E. coli strain containing all seven chromosomal rRNA operons and a gene conferring chloramphenicol resistance to facilitate genetic mapping (Table 1) (15, 16). Spontaneous mutants were isolated after growth on agar plates containing 150 or 200 µg of tiamulin per ml. One strain, JB5, was selected for further characterization due to its relatively rapid growth in the presence of tiamulin. Strain JB5 exhibits at least a fourfold decrease in sensitivity to tiamulin compared to the parental strain (Table 2). A two-step genetic mapping strategy, involving mating with a set of Hfr strains followed by P1 transductions, was used to identify the genetic determinant of the phenotype (19). The Hfr mating experiment enabled localization of the mutation to the region bounded by min 69 to 83 on the E. coli chromosome. A series of P1 transductions using strains marked with tetracycline resistance in the relevant region indicated that the mutation is contained within min 73.9 to 74.6, a region of the genome that encodes approximately half of the ribosomal proteins. Sequencing of selected genes in the S10 operon including rplC, rplD, and rplV showed that JB5 contained a point mutation in rplC, the gene encoding ribosomal protein L3. The mutation, A445G, results in an Asn149Asp amino acid change. This result is consistent with an earlier report that associated tiamulin resistance with alterations in ribosomal proteins L3 and L4, although the molecular basis of this connection was never characterized (3).
The Asn149Asp mutation in ribosomal protein L3 confers the tiamulin resistance phenotype.
Two approaches were used to obtain genetic evidence that the
Asn149Asp mutation is responsible for the tiamulin resistance
phenotype. First, a group of 30 transductants, composed of 15
tiamulin-resistant and 15 tiamulin-sensitive colonies, was sequenced
in the region of the mutation. In every case, there was a 1:1
correspondence between the presence of the mutation and the
tiamulin resistance phenotype. Second, complementation experiments
were used to determine the effect of overexpressing wild-type
and mutant copies of
rplC on the tiamulin resistance phenotype.
Two L3-
lacZ expression vectors were constructed by inserting
a fragment of the S10 operon flanking
rplC containing either
the wild-type or the mutant
rplC sequence downstream of the
fourth codon of the
lacZ gene carried on a plasmid. The vectors
were transformed into parent and mutant strains, and their subsequent
tiamulin susceptibilities were determined. The MIC for the wild-type
strain increased upon plasmid-encoded expression of the mutated
rplC sequence together with chromosome-encoded expression of
wild-type
rplC, whereas plasmid-encoded expression of the wild-type
rplC sequence did not measurably affect the MIC (Table
2). The
marginal increase in the MIC may reflect reduced expression
of the mutated
rplC sequence, lower incorporation of the mutant
L3 protein into ribosomes, or poor usage of mutated ribosomes
when in competition with those containing the wild-type genome-encoded
L3 protein. Similarly, the MIC for the mutant strain was only
slightly affected by plasmid-encoded expression of the mutated
rplC sequence together with chromosome-encoded expression of
mutant
rplC but decreased significantly upon plasmid-encoded
expression of the wild-type
rplC sequence (Table
2). In addition,
the parent vector did not measurably affect the MIC in either
the wild-type or mutant strain (Table
2). The data show that
the degree of tiamulin sensitivity decreases in the wild-type
strain by expression of the mutated sequence and increases in
the mutant strain by expression of the wild-type L3 sequence.
We conclude that the mutation yielding an Asn149Asp mutation
in ribosomal protein L3 is responsible for the tiamulin resistance
phenotype.
The mutation is located in a region of L3 close to the peptidyl transferase center.
Like many ribosomal proteins, L3 has a globular domain on the ribosome surface plus an extended domain that stretches into the ribosome interior (Fig. 2A). L3 is one of four ribosomal proteins that come closest to the site of peptide bond formation through its extended domain (14). An alignment of selected L3 sequences was carried out to determine whether the mutation occurred at a conserved position in the sequence (Fig. 2B). Although Asn149 itself is not conserved, it lies within a conserved region of the protein with enough amino acid identity to obtain a good alignment between sequences representing the three domains of life. The L3 sequences of Haloarcula marismortui and Deinococcus radiodurans were included to enable localization of the mutation in the three dimensional structures of the large ribosomal subunit solved recently through X-ray crystallography (2, 6). Only the H. marismortui structure provides the resolution needed to position the amino acid side chains. The positions in H. marismortui and D. radiodurans that are equivalent to Asn149 in E. coli are Trp242 and Arg144, respectively. Trp242 is located at the tip of the extended domain and represents the position on L3 that comes closest to the catalytic center (Fig. 2C). The shortest distance between Trp242 and U2541 (U2506 in E. coli numbering), one of the nucleotides in the tiamulin footprint, is about 7 Å. Although amino acid side chains are not included in the D. radiodurans 50S structure, the backbone position of Arg144 is also the closest point on L3 to the peptidyl transferase site. The distance between the
-carbon of Arg144 and the phosphorus atom of nucleotide U2485 (U2506 in E. coli numbering) is approximately 10 Å. Interestingly, alteration of ribosomal protein L3 at the relevant amino acid also affects the action of another class of antibiotics, called the trichothecenes, that specifically target eukaryotic cells. The mutation Trp255Cys at the equivalent amino acid position causes resistance to the antibiotic trichodermin in Saccharomyces cerevisiae (5).
Ribosomes containing the L3 mutation exhibit reduced tiamulin binding.
Chemical footprinting was used to examine tiamulin binding to
wild-type versus L3 mutated ribosomes. Ribosome-tiamulin complexes
were probed with CMCT, which modifies the N-3 of uridine residues.
Primer extension with reverse transcriptase was then used to
identify alterations in protection of U2506 induced by tiamulin
binding to the wild-type and mutant ribosomes at drug concentrations
ranging between 0.1 and 10 µM. In the wild-type ribosomes,
complete protection at U2506 was observed at tiamulin concentrations
above 0.5 µM (Fig.
3). In contrast, complete protection
at U2506 was not observed in the mutant ribosomes even at a
tiamulin concentration of 10 µM. These results reveal
that tiamulin binding to mutant ribosomes is significantly reduced
relative to binding to wild-type ribosomes.
Concluding remarks.
It is well known that single nucleotide or amino acid changes
in ribosomal components can lead to antibiotic resistance. In
this investigation, a point mutation in the gene encoding ribosomal
protein L3 was mapped in a tiamulin-resistant mutant strain
and shown to be a tiamulin resistance determinant in
E. coli.
The mutation produces an Asn-to-Asp alteration at position 149
of ribosomal protein L3 that is in the vicinity of the peptidyl
transferase site. We conclude that the mutation perturbs the
drug-binding site at the peptidyl transferase center. As the
mutated position seems accessible from the peptidyl transferase
center according to the X-ray structures of the large ribosomal
subunit, we believe it is a direct perturbation. The mutation
could function by altering the tiamulin binding site either
directly, by eliminating a specific interaction with tiamulin,
or indirectly, by influencing the RNA structure at the peptidyl
transferase center. This is the first report of a tiamulin resistance
mechanism that has been characterized on a molecular level.
In addition, it is the first account of a ribosomal protein
L3 mutant in bacteria that confers antibiotic resistance. It
will be interesting to learn if clinical isolates from the veterinary
field also contain mutations in ribosomal protein L3.

ACKNOWLEDGMENTS
We thank Novartis for furnishing tiamulin and C. Squires for
strain TA542. C. Petersen is thanked for generously providing
strains, plasmid CN102A, and helpful advice. M. Karlsson is
thanked for helpful discussions and information about tiamulin
usage.
B.V. was supported by the Nucleic Acid Center funded by the Danish National Research Foundation. K.S.L. was supported by a fellowship from Alfred Benzons Fond and a grant from the European Commission's 5th Framework Program (grant QLK2-CT-2002-00892).

FOOTNOTES
* Corresponding author. Mailing address: Institute of Molecular Biology, University of Copenhagen, Sølvgade 83H, DK-1307, Copenhagen K, Denmark. Phone: (45) 35 32 20 23. Fax: (45) 35 32 20 40. E-mail:
long{at}mermaid.molbio.ku.dk.


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Antimicrobial Agents and Chemotherapy, September 2003, p. 2892-2896, Vol. 47, No. 9
0066-4804/03/$08.00+0 DOI: 10.1128/AAC.47.9.2892-2896.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
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