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Antimicrobial Agents and Chemotherapy, December 2004, p. 4800-4807, Vol. 48, No. 12
0066-4804/04/$08.00+0 DOI: 10.1128/AAC.48.12.4800-4807.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Department of Bacteriology, Hiroshima University Graduate School of Biomedical Sciences, Kasumi 1-2-3, Minami-ku, Hiroshima City, Hiroshima,1 Institute for Medical Microbiology, University of Zürich, Zürich, Switzerland2
Received 13 July 2004/ Returned for modification 23 July 2004/ Accepted 29 August 2004
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Spontaneous VISA mutants were previously isolated from an MRSA strain by exposure to vancomycin (11). Characterization of the mutants revealed that they contained a longer glycan chain length within their peptidoglycan and had decreased moenomycin susceptibility. Moenomycin is a cell wall synthesis inhibitor that acts on transglycosylases, which are thought to mediate the formation of the glycan chain of the peptidoglycan and the incorporation of the peptidoglycan precursor into cell wall peptidoglycan (9). Vancomycin also inhibits cell wall synthesis, although its target is different. Vancomycin binds to terminal D-Ala-D-Ala residues of the peptidoglycan precursor, which inhibits peptidoglycan chain elongation (1). Moenomycin-resistant mutants were then selected by exposure of the same parent strain, S. aureus COL, to moenomycin (21). These mutants also had a longer glycan chain length and a vancomycin-intermediate phenotype, thereby strongly suggesting that moenomycin resistance is associated with vancomycin intermediate resistance. Therefore, identification of the factor(s) that affects moenomycin susceptibility may contribute to the resolution of the mechanism of vancomycin intermediate susceptibility. However, when spontaneous mutants are used, it is difficult to identify the genetic factors facilitating phenotypic alterations, such as moenomycin or vancomycin resistance.
In the study described here, we isolated moenomycin-resistant mutants using transposon Tn551 mutagenesis and identified two genes involved in the synthesis of lysyl-phosphatidylglycerol.
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TABLE 1. Strains used in this study
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Antibiotic susceptibility tests. The MICs of various antibiotics were determined by microdilution, as described previously (14). The following concentrations of vancomycin were used for the determination of vancomycin MICs: 0.0625, 0.125, 0.25, 0.5, 1, 2, 3, 4, 5, 6, 8, 16, and 32 µg/ml. Population analysis profiles were determined by plating appropriate dilutions of an overnight culture on plates containing various concentrations of methicillin, vancomycin, or moenomycin. Colonies were counted after 48 h of incubation at 37°C (13). Vancomycin gradient plates were inoculated with a suspension of 107 bacterial cells, applied with a sterile cotton swab, along a gradient of 0 to 4 µg/ml. Gradient plates were incubated for 24 h at 37°C. All susceptibility tests were repeated at least three times to check the reproducibility of the results.
DNA manipulations. Routine DNA manipulations, Southern blots and hybridizations, and DNA sequencing were performed essentially as described earlier (25). Restriction enzymes and shrimp alkaline phosphatase were purchased from Boehringer Mannheim Biochemica, Tokyo, Japan; and T4 DNA ligase was purchased from New England BioLabs, Beverly, Mass. DNA sequences were determined by the dideoxy chain termination method with an Autoread sequencing kit (Pharmacia Biotech, Tokyo, Japan). PCR reagents were from Boehringer Mannheim, and PCR was performed with the GeneAmp PCR System 2400 of Perkin-Elmer. Transductions were performed with phage 80alpha, as described previously (12).
Identification of Tn551 insertion sites. Chromosomal DNA was isolated from the Tn551 mutants and digested with XbaI. After the DNA was heated at 75°C for 10 min, the digested DNA was self-ligated. By using this ligation mixture as a template, PCR amplification was performed with primers (5'-ACG GCG AAG GAT CAC TCA TGG-3' and 5'-ATT TCT GAT GCG AGG TTC-3') whose sequences were derived from the known Tn551 sequence (26). Primers were designed to anneal to the ends of Tn551, in opposite directions, to amplify the regions flanking the Tn551 insertions. PCR products were cloned into the pGEM-Teasy vector, and DNA sequencing was performed. On the basis of the DNA sequence of the regions flanking Tn551, the site of insertion was determined from The Institute for Genome Research database (http://www.tigr.org). To confirm the site of insertion, primers were then designed to amplify the entire gene into which Tn551 had been inserted.
Analysis of membrane composition. Overnight cultures were diluted in fresh TSB and grown at 37°C with shaking until they reached an optical density at 660 nm of 0.3. Then, [2-3H]glycerol (37 kBq/ml) was added, and the cultures were incubated for 2 h at 37°C with shaking. The cells were then harvested by centrifugation and washed three times with phosphate-buffered saline (PBS). The cells were resuspended in chloroform-methanol (2:1 [vol/vol]) and sonicated for 15 min. Distilled water was then added to this suspension to separate the cell debris from the water-soluble fraction. The chloroform-methanol (2:1) phase was then extracted and dried in an evaporator. The samples were solubilized with carrier lipids containing a high concentration of S. aureus membrane lipids in order to visualize each lipid with an iodide stain. The samples were then spotted onto the bottom of a silica gel plate (Advantec), and two-dimensional thin-layer chromatography was performed as described by Kariyama (10). The solvents used for the first and second rounds of chromatography were chloroform-methanol-water (65:25:4) and chloroform-methanol-7 N NH3Cl (60:35:5), respectively. The silica plates were then exposed to iodine vapor in order to visualize the different lipids, including lysyl-phosphatidylglycerol, phosphatidylglycerol, cardiolipin, and glycolipid. Each spot stained by iodine was scraped off the plate and mixed with scintillation cocktail (Clearsol III; Nacalai Tesque), and the radioactivity was then measured with a scintillation counter. The percentage of each radioactive lipid present was calculated relative to the total amount of radioactivity.
Moenomycin and vancomycin binding assay. Overnight cultures of S. aureus were harvested and washed with PBS. The cell suspensions were then divided into two fractions; one was used directly in the binding assay and the other was suspended in 4% sodium dodecyl sulfate (SDS) and boiled for 30 min, washed five times with distilled water, and then used in the binding assay. Several different concentrations of moenomycin and vancomycin (2, 10, 50, and 100 µg/ml) were prepared, with TSB used as the diluent. Two milligrams (wet weight) of S. aureus cells was added to 1 ml of the moenomycin or vancomycin solutions, and the mixtures were gently agitated for 30 min at 37°C. After centrifugation at 8,000 x g for 15 min, the supernatant was filtered through a 0.22-µm-pore-size membrane filter. Sterilized paper disks (diameter, 5 mm) were immersed in the supernatants and were then placed on TSA plates that had previously been swabbed with an overnight culture of S. aureus strain COL. After 24 h of incubation at 37°C, the diameters of the inhibitory zones were measured. For standardization, inhibitory zone diameters were measured for several different concentrations of antibiotic stock solutions that had had no bacterial contact. These standards were then used to calculate the concentration of the drug bound to S. aureus cells. The binding experiments were each repeated three times.
HPLC analysis of peptidoglycan. (i) Muropeptide analysis. The preparation of murein and the reduction of muropeptide were carried out as described previously (11, 23). Mutanolysin-digested muropeptides were then fractionated by reverse-phase high-pressure liquid chromatography (RP-HPLC) (11, 23).
(ii) Glycan chain analysis. Glycan chain analysis was performed by the same procedure used for muropeptide analysis, except that the cell wall was digested with lysostaphin (Sigma Chemical Co.) instead of mutanolysin.
Antibacterial assays of hBD3 and CAP18. Overnight cultures of S. aureus were harvested, washed with PBS, and resuspended in 10 mM sodium phosphate buffer (NaPi) (pH 6.8). The bacterial suspensions were then diluted to 107 cells/ml with NaPi (pH 6.8), and 10-µl aliquots (105 cells) were added to 200 µl of NaPi with or without antibacterial peptides at various concentrations. Samples were then incubated anaerobically for 2 h at 37°C. The antibacterial peptides ß-defensin-3 (hBD3) and CAP18 were synthesized and purified as described elsewhere (17). Appropriate dilutions of the reaction mixtures (100 µl) were then plated and incubated at 37°C overnight, and the numbers of CFU were determined. The antibacterial effects of the peptides were estimated according to the ratio of the number of surviving cells to the total number of cells added. The experiment was repeated at least three times to check the reproducibility of the results.
Growth curve analyses. Growth rate experiments were performed with chemically defined medium (CDM), as described previously (8, 17). CDM depleted of lysine or aspartic acid, or both, was also prepared. Overnight cultures of S. aureus grown in CDM were harvested and then washed with the appropriate CDM. A small amount of bacterial suspension was then added to fresh CDM, CDM depleted of lysine, CDM depleted of aspartic acid, or CDM depleted of both lysine and aspartic acid. Cultures were incubated at 37°C with shaking, and growth was monitored by measuring the optical density at 660 nm.
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TABLE 2. MICs of various antibiotics for the mutants
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FIG. 1. Population analysis of mutants grown in the presence of increasing concentrations of methicillin, moenomycin, and vancomycin. Overnight cultures of S. aureus wild-type strain COL (squares), HN001 (circles), and HN002 (triangles) were diluted and plated on TSA containing various concentrations of antibiotics. Colonies were counted after 48 h of incubation at 37°C.
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FIG. 2. Gradient plate analysis of the mutants. Vancomycin gradient plates (containing a vancomycin concentration gradient from 0 to 4 µg/ml) were inoculated with a suspension of 107 bacterial cells, applied with a sterile cotton swab along the gradient, and grown for 24 h at 37°C.
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FIG. 3. Restriction map of the fmtC and lysC loci in S. aureus. Arrows indicate the positions of Tn551 insertions.
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Effects of lysine and asparatic acid on growth of the lysC mutant. When parent strain COL was grown in the absence of lysine or aspartic acid, or both, its growth rate was decreased compared to its growth rate in normal CDM (Fig. 4). The growth rate of the lysC mutant, however, was decreased in normal CDM compared to that of COL. Depletion of aspartic acid or lysine from CDM decreased the growth rate of the mutant further, and the mutant could not grow in CDM when both amino acids were depleted.
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FIG. 4. Growth curves of S. aureus COL (closed symbols) and lysC mutant HN002 (open symbols) grown in different types of CDM. Growth was determined by measuring the optical density (OD) at 660 nm in CDM (squares), CDM without lysine (circles), CDM without aspartic acid (triangles), and CDM without both lysine and aspartic acid (diamonds).
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TABLE 3. Membrane compositions of S. aureus cells
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FIG. 5. Antibacterial activities of hBD3 and CAP18. Different concentrations of the peptides were added to 200 µl of 10 mM sodium phosphate buffer (pH 6.8) containing 105 bacterial cells. After incubation at 37°C for 2 h, serial dilutions were plated onto TSA. The numbers of CFU were counted after 24 h of incubation at 37°C. Bacterial survival was determined from the number of bacteria that survived in the presence of the peptide as a percentage of the total number of CFU growing in the absence of peptide. The values shown correspond to the means of three independent experiments. Symbols: squares, wild-type strain COL; triangles, mutant HN001; circles, mutant HN002.
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Moenomycin and vancomycin binding assay. Binding assays were performed to test for differences in affinities of binding to moenomycin and vancomycin between the wild type and the mutants. For these assays two types of bacterial cell preparations were used: native bacterial cells and cells boiled in SDS (Fig. 6). The amount of binding and the kinetics of binding of moenomycin to cells boiled in SDS were similar for the mutants and the parent. However, moenomycin bound to native cells at a rate 10-fold higher than it bound to cells boiled in SDS, and the mutant showed a higher binding capacity than the parent. Vancomycin, on the other hand, bound to native cells and cells boiled in SDS at similar rates. The mutants appeared to have a 1.5-fold higher capacity to bind to native cells than the wild type, while the mutants and the wild type showed indistinguishable capacities to bind to boiled cells. We also tested the binding of moenomycin and vancomycin to other fmtC mutants (KSA8 and BB270) and observed similar results (data not shown).
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FIG. 6. Moenomycin and vancomycin binding to S. aureus cells. Different concentrations of moenomycin or vancomycin were mixed with intact S. aureus cells (closed symbols) or S. aureus cells boiled in SDS (open symbols). The amount of antibiotic binding to S. aureus cells was determined as described in Materials and Methods. Symbols: squares, wild-type strain COL; triangles, HN001; circles, HN002.
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In this study, we identified two genes (fmtC and lysC) which, when they were disrupted, increased the levels of resistance to both moenomycin and vancomycin. The fmtC gene was first identified as a factor affecting methicillin resistance (12) and was later identified as a factor affecting susceptibility to antimicrobial peptides (22). Peschel et al. (22) demonstrated that FmtC (MprF) is responsible for the addition of lysine to phosphatidylglycerol, which produces lysyl-phosphatidylglycerol, a major component of the cell membrane. The lysC gene is involved in the biosynthesis of lysine from aspartic acid (31). Lysine is one of the components of peptidoglycan; therefore, lysine synthesis is essential for cell viability. However, the ability of the lysC mutant to grow, albeit at a severely reduced rate, in CDM in the absence of lysine suggests that there is an additional, lysC-independent pathway(s) for lysine biosynthesis. Depletion of both lysine and aspartic acid from CDM reduced the growth rate of wild-type strain COL, while the lysC mutant could not grow at all without lysine and aspartic acid (Fig. 4). These results suggest that the biosynthetic pathway incorporating lysC is the major pathway for lysine biosynthesis. Therefore, the amount of lysine in the lysC mutant is hypothesized to be very low compared to that in the wild type. This decrease in the levels of lysine in the lysC mutant would also affect the levels of lysyl-phosphatidylglycerol (Table 3). Therefore, both lysC and fmtC mutations would result in the same phenotype, that is, a reduction in the lysyl-phosphatidylglycerol content of the membrane.
Due to the positive charge of lysyl-phosphatidylglycerol, the depletion of lysyl-phosphatidylglycerol is likely to result in membranes with a more negative net charge. Therefore, the mutants were tested for their susceptibilities to cationic antimicrobial peptides and gentamicin. Since antimicrobial peptides are thought to target the bacterial cell membrane (17, 22), the stronger the negative charge of the membrane is, the more susceptible to cationic peptides the bacterium is likely to be. Both the lysC and fmtC mutants were more susceptible to CAP18 and hBD3, both of which are positively charged antimicrobial peptides (Fig. 5). Gentamicin susceptibility was also increased in the fmtC and lysC mutants, implying that the more positively charged gentamicin molecules were being sequestered by the negatively charged membrane and entering the cytoplasm with a greater efficiency.
The mutants isolated in this study displayed decreased susceptibilities to moenomycin and vancomycin, although there was no cell wall thickening, no reduction in the degree of cross-linking, and no increase in the glycan chain length, phenotypes previously observed in several VISA strains, including strain COL-VR1 (data not shown). This suggests that there is more than one way for strains to become more resistant to both moenomycin and vancomycin. The nature of the mutations isolated here therefore raised the possibility that alterations in the membrane charge could affect susceptibilities to moenomycin and vancomycin. The results from the moenomycin and vancomycin binding assays support this hypothesis (Fig. 6). When intact cells were used in the binding assay, the amounts of moenomycin and vancomycin that bound to the mutants were higher than the amounts that bound to the wild type. However, when cells boiled in SDS were used in the assay, the amounts of binding were similar for the mutant and the wild type.
Interestingly, although more moenomycin and vancomycin bound to the mutants, it did not render them more susceptible; on the contrary, the mutants became more resistant. The increases in both vancomycin binding and vancomycin MICs were, however, both relatively small. It is possible that the nature in which moenomycin and vancomycin bind to the membranes of the mutants could, to some extent, preclude the drugs from acting on their lethal targets: peptidoglycan precursors in the case of vancomycin and transglycosylases in the case of moenomycin. The increased amount of positively charged vancomycin molecules bound to the cell surface could also affect the activities of autolysins, as autolysin activity has been shown to be dependent on the charge (20), which in turn could influence resistance levels.
Ruzin et al. (24) reported that mprF (fmtC) inactivation reduced the vancomycin resistance level of a VISA strain to that of a vancomycin-susceptible strain. They also showed that more vancomycin bound to the mutant cells than to the wild-type cells and suggested that the increased affinity for vancomycin binding led to the increased susceptibility of the fmtC mutant. However, our data indicate that fmtC inactivation in a vancomycin-susceptible background slightly decreases susceptibility to vancomycin (Table 2).
It was previously reported (12) that fmtC inactivation in S. aureus COL did not affect the vancomycin MIC. However, in that study a twofold broth microdilution method was used to measure the MICs, a method not sufficiently sensitive to measure the small variations in vancomycin susceptibility. When more sensitive methods were used to determine the vancomycin MICs (Table 2) and when the strains were analyzed on vancomycin gradient plates and by population analysis profiling, we found that vancomycin susceptibility was reduced in the COL fmtC mutant (Fig. 1 and Fig. 2).
We further investigated the effect of fmtC inactivation on two other vancomycin-sensitive strains and found that both of these strains also had slightly decreased susceptibilities to vancomycin (data not shown), implying that fmtC inactivation results in decreased susceptibility to vancomycin in most vancomycin-sensitive strains, although the degree to which fmtC inactivation affected vancomycin susceptibility did appear to be strain dependent (data not shown).
We then transduced the fmtC mutation into the VISA strain COL-VR1 and, like Ruzin et al. (24), found that fmtC inactivation in this VISA strain background increased vancomycin susceptibility, although the MIC for the strain was still higher than that for the susceptible parent. The COL-VR1 fmtC mutant also had increased susceptibilities to ß-lactams. In previous studies (12), fmtC inactivation was shown to increase the susceptibilities of several MRSA strains to ß-lactams. Therefore, fmtC inactivation increased the susceptibilities of all strains to ß-lactams; however, its inactivation had different effects on vancomycin susceptibility, depending on the strains' initial resistance levels. These contradictory results suggest that fmtC inactivation may indirectly affect cell wall biosynthesis. We therefore hypothesized that fmtC inactivation could cause two different effects: in strains with a methicillin-resistant or vancomycin intermediate-resistant background, the influence of fmtC inactivation on cell wall biosynthesis could affect expression of the resistance phenotypes, making the strains more susceptible to methicillin and vancomycin, while in sensitive strains the changes in the membrane which potentially alter the way in which vancomycin and moenomycin bind could cause slight decreases in their susceptibilities. Therefore, once again, the genetic background of the strain is likely to have a significant effect on the influence of fmtC inactivation.
In conclusion, we identified two factors, fmtC and lysC, which, when they were inactivated, yielded mutants with altered, more negatively charged cell membranes. The findings obtained with these mutants demonstrate that membrane charge can have an affect on the susceptibilities of S. aureus to glycopeptides and moenomycin and to other, positively charged antibacterial agents, such as gentamicin and cationic antimicrobial peptides.
Part of this study was carried out in the Research Center for Molecular Medicine, Faculty of Medicine, Hiroshima University.
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