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Antimicrobial Agents and Chemotherapy, April 2004, p. 1320-1328, Vol. 48, No. 4
0066-4804/04/$08.00+0 DOI: 10.1128/AAC.48.4.1320-1328.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Enhancement of the mexAB-oprM Efflux Pump Expression by a Quorum-Sensing Autoinducer and Its Cancellation by a Regulator, MexT, of the mexEF-oprN Efflux Pump Operon in Pseudomonas aeruginosa
Hideaki Maseda,1* Isao Sawada,2 Kohjiro Saito,1 Hiroo Uchiyama,2 Taiji Nakae,1 and Nobuhiko Nomura2*
Institute of Applied Biochemistry, University of Tsukuba, Tsukuba, Ibaraki 305-8572,2
Department of Molecular Life Science, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan1
Received 16 May 2003/
Returned for modification 9 August 2003/
Accepted 14 December 2003

ABSTRACT
nfxC-type cells of
Pseudomonas aeruginosa that produce the MexEF-OprN
efflux pump exhibit resistance to fluoroquinolones and chloramphenicol
and hypersusceptibility to most classical ß-lactam
antibiotics. We investigated the molecular mechanism of how
the
nfxC mutation causes ß-lactam hypersusceptibility.
The MexAB-OprM extrusion pump transports and confers resistance
to ß-lactam antibiotics. Interestingly, expression
of the
mexAB-oprM operon reached the highest level during the
mid-stationary growth phase in both wild-type and
nfxC-type
mutant strains, suggesting that expression of the
mexAB-oprM operon may be controlled by cell density-dependent regulation
such as quorum sensing. This assumption was verified by demonstrating
that exogenous addition of the quorum-sensing autoinducer
N-butyryl-
L-homoserine
lactone (C4-HSL) enhanced the expression of MexAB-OprM, whereas
N-(3-oxododecanoyl)-
L-homoserine lactone had only a slight effect.
Furthermore, this C4-HSL-mediated enhancement of
mexAB-oprM expression was repressed by MexT, a positive regulator of the
mexEF-oprN operon. It was concluded that ß-lactam
hypersusceptibility in
nfxC-type mutant cells is caused by MexT-mediated
cancellation of C4-HSL-mediated enhancement of MexAB-OprM expression.

INTRODUCTION
Pseudomonas aeruginosa is an opportunistic pathogen that causes
infections in immunocompromised hosts and colonizes the lungs
of individuals with cystic fibrosis. This organism shows broad
resistance to structurally and functionally dissimilar antibiotics.
This type of multidrug resistance is attributable mainly to
the expression of the xenobiotic extrusion transporter MexAB-OprM
coupled with tight outer membrane permeability (
21,
23,
29).
The
mexAB-oprM operon encodes three protein subunits (
21,
26,
29): the intrinsic inner membrane protein MexB (
9), the inner
membrane-associated periplasmic lipoprotein MexA (
45), and the
outer membrane lipoprotein OprM (
13,
22,
44). The
mexAB-oprM operon is negatively regulated by the product of the
mexR gene,
which is located upstream of the
mexAB-oprM genes and is divergently
transcribed (
1,
5,
14,
34,
37).
nalB-type mutants caused by
the
mexR mutation derepress MexAB-OprM production and are highly
resistant to fluoroquinolones, chloramphenicol, and most classical
ß-lactam antibiotics (
30,
32,
35,
42).
Recently, it was reported that the MexAB-OprM transporter exports quorum-sensing mediators, acylhomoserine lactones (AHSLs), which induce the production of cell density-dependent virulence factors, including proteases, rhamnolipids, exotoxin A, exoenzyme S, and pyocyanin (24, 25). The AHSLs control at least two quorum-sensing systems in P. aeruginosa, namely, LasR-LasI and RhlR-RhlI. LasI and RhlI catalyze the last steps in the syntheses of N-(3-oxododecanoyl)-L-homoserine lactone (3-oxo-C12-HSL) and N-butyryl-L-homoserine lactone (C4-HSL), respectively. LasR and RhlR are specifically activated by the diffusible signaling molecules 3-oxo-C12-HSL and C4-HSL, respectively.
Four resistant-nodulation-division efflux pumps (MexAB-OprM, MexCD-OprJ, MexEF-OprN, and MexXY) have been identified in P. aeruginosa, and they are derepressed in nalB, nfxB, nfxC, and N135 mutant cells, respectively (10, 18-21, 27, 28, 32). Transcription of the mexAB-oprM, mexCD-oprJ, and mexXY operons is derepressed by a mutation of the repressors mexR, nfxB, and an unidentified gene, respectively (2, 3, 28, 40). On the other hand, transcription of the mexEF-oprN operon is dually regulated by a positive regulator, MexT, and a putative negative regulator, MexS (10, 17). Both nfxB and nfxC mutants exhibit resistance to structurally diverse antibiotics and hypersusceptibility to most classical ß-lactam antibiotics (12), suggesting the presence of a common mechanism in which pump protein expression is coupled with ß-lactam hypersusceptibility.
This paper reports the mechanism of nfxC mutation-mediated ß-lactam hypersusceptibility and its connection to quorum sensing and growth phase-dependent expression of MexAB-OprM.

MATERIALS AND METHODS
Bacterial strains and growth conditions.
The bacterial strains and plasmids used are listed in Table
1.
Escherichia coli DH5

was used as the host in DNA manipulations.
Recombinant DNA techniques.
We manipulated recombinant DNA by standard procedures described
previously (
36). PCR amplification of chromosomal DNA was carried
out by using the LA
Taq kit (TaKaRa Shuzo, Osaka, Japan) according
to the manufacturer's instructions.
Construction of conjugative plasmid pG19II.
To construct a conjugative plasmid with a gentamicin resistance gene as a marker, pK19mobsac was treated with BglII and NcoI and then ligated with Gmr gene cassette, which was treated by BamHI and NcoI after amplification with Fgm (5'-CGGGATCCCGAATTGACATAAGCCTGTTCG-3') and Rgm (5'-ACCCATGGACGAATTGTTAGGTGGCGGTACTT-3'), a primer pair containing a newly added cutting site (underlined) for restriction nucleases from pME4510. The resulting plasmid was named pG19II (Fig. 1A).
Insertion of an xylE gene cassette into the chromosomal mexAB-oprM operon.
The
mexAB-oprM reporter with an
xylE fusion was constructed
as follows (Fig.
1B). The
xylE gene from pX1918 was inserted
in the EcoRI site of pBluescript SK(+). The resulting plasmid
was treated with PstI and ligated with a PstI-treated kanamycin
resistance gene (Pharmacia) to yield the pXyl-Km/SK(+) plasmid.
The 2.8-kbp
xyl-Km cassette from pXyl-Km/SK(+) was inserted
into BamHI-treated pMex(sac/Hind)/

RI-pNOT19 plasmid, which carries
the
mexAB-oprM operon. The resulting plasmid, pMex::Xyl, was
treated with NotI and ligated with a NotI-treated Mob cassette
from pMOB3 to yield the suicide plasmid pMex::Xyl-MOB. This
plasmid was introduced into the mobilizer strain
E. coli S17-1
and then was transferred to
P. aeruginosa PAO4290 by conjugation
as reported earlier (
18). The insertion of the
xyl-Km cassette
in the chromosomal
mexAB-oprM operon was confirmed by Southern
hybridization (
36) and PCR analyses. This constructed strain
was designated
P. aeruginosa TNP090.
Deletion of the chromosomal lasI, rhlI, or mexEF-oprN genes.
To construct a series of isogenic mutants lacking the lasI, rhlI, or lasI and rhlI genes, PCR primers for amplification of regions containing the lasI or rhlI gene were synthesized based on nucleotide sequences from the Pseudomonas genome sequencing project database. After amplification of ca. 2.7-kb DNA fragments on PAO1 chromosomal DNA as a template with Flas1 (5'-CGGGATCCGCTGGAACGCTCAAGTGGAAAATTGGAG-3') and Rlas2 (5'-CCCAAGCTTTCTGCGAAGGCCTGGAGAACCTTGC-3') or with Frhl1 (5'-CGAGCTCGCATAACAGATAGGGTTGCCATG-3') and Rrhl2(5'-GGGAAGCTTGGACCAGGCACCAGGATGG-3'), the amplified DNA fragments were ligated into the BamHI-HindIII site or SacI-HindIII site in a multicloning site of pHSG398 to yield pHSG-las12 or rhl12, respectively. Next, 600 bp of lasI or 67 bp of rhlI in these DNA fragments was deleted by inverted PCR with the primer pair Flas3 (5'-GGAAGATCTCTTCACTTCCTCCAAATAGGAAGCTGAAG-3') and Rlas4 (5'-GGAAGATCTCGGGGACCTGTCGGCTCGC-3') or Frhl3 (5'-GGTCTAGACTTCATCGCCAGCTGCGGATCGTCC-3') and Rrhl4 (5'-GCTCTAGACGGCCATGGAGCGCTATTTCGTTCGC-3'), respectively, and both amplified fragments were self-ligated in the BglII or XbaI site to yield pHSG-dellas or -delrhl, respectively. After reinsertion of the insert fragments of pHSG-dellas into pG19II, the resulting plasmid was named pG19-dellas. After amplification of the 2-kb DNA fragment by using the primer pair delrhl1 (5'-GGGAAGCTTATCCGGCGATCCTCAACGGCCTGC-3') and delrhl2 (5'-GGGAAGCTTGCCTTGCCGTCGACGATCTGCTGG-3') from pHSG-delrhl, the amplified DNA fragment was inserted into pG19II to yield pG19-delrhl. For disruption of the chromosomal mexEF-oprN genes, pUC19-mexEFN (18) was treated with SphI and then self-ligated, yielding pUC19-delEFN. An EcoRI-HindIII DNA fragment from pUC19-delEFN was subcloned into pG19II, yielding pG19II-delEFN. pG19-dellas, pG19-delrhl, and pG19-delEFN were mobilized from E. coli S17-1 to P. aeruginosa TNP090 to introduce a deletion of the lasI region, the rhlI region, or the mexEF-oprN region into the recipient chromosomes by allelic exchange as above.
Thus, we constructed mutants lacking the lasI gene, the rhlI gene, the lasI and rhlI genes, and the mexEF-oprN genes from TNP090, and we designated them TNP091, TNP092, TNP093, and TNP099, respectively. The deletions of the lasI, rhlI, and mexEF-oprN genes were confirmed by PCR analyses and phenotypes of the mutants (data not shown).
Experiment to test the effect of C4-HSL on expression of MexAB-OprM.
Cells were grown aerobically in Luria-Bertani (LB) medium and diluted with 4 ml of fresh LB medium to an A600 of ca. 0.025. After incubation for 3 h at 37°C, an appropriate concentration of C4-HSL was added and the cultures were incubated for 3 h at 37°C. At an A600 of 1.3 to 1.8, samples were collected and catechol 2,3-dioxygenase activity was determined as reported previously (39).
Other techniques.
Western blot analysis has been described previously (18). The MICs of antibiotics were determined by the agar dilution method with Mueller-Hinton agar II (Becton Dickinson Microbiology Systems, Cockeysville, Md.). Protein was quantified by the method of Lowry et al. (15). ß-Galactosidase activity was assayed by the method of Miller as described by Sambrook et al. (36). For assay of the activity of catechol 2,3-dioxygenase (the xylE gene product), cells were suspended in 990 µl of assay buffer. The reaction was initiated by adding 10 µl of 100 mM catechol dissolved in water, and the A375 was recorded at 25°C. Specific activity was defined as nanomoles of product formed per minute per milligram of protein (
= 4.4 x 104) (39).

RESULTS
Linkage between the nfxC mutation and MexAB-OprM expression.
To characterize the antibiotic susceptibility of the
nfxC-type
cells used in this experiment, we determined MICs of antibiotics.
The
nfxC-type mutant PAO1SC, which produces the MexEF-OprN efflux
pump, exhibited resistance to fluoroquinolones, tetracycline,
chloramphenicol, and imipenem and hypersusceptibility to ß-lactam
antibiotics, confirming previous results (
7,
12) (Table
2).
In contrast, the
nalB mutant OCR-Lac4, which produces a derepressed
level of the MexAB-OprM efflux pump, showed resistance to most
ß-lactam agents. Because the
nfxC-type PAO1SC cells
exhibited hypersusceptibility to the substrates of the MexAB-OprM
efflux pump, a possible linkage between the
nfxC mutation and
the level of MexAB-OprM expression was suggested. In fact, we
and other investigators observed reduced expression of OprM
and MexA in the
nfxC-type cells compared with the wild-type
cells (
12,
21).
Linkage between growth phase-dependent quorum sensing and mexAB-oprM expression.
To assess the connection between the overall growth phase of
P. aeruginosa cells and the expression of the
mexAB-oprM operon,
a reporter plasmid, pME4510-mexOP, carrying the
mexAB-oprM operator-promoter
region, was introduced into the wild-type strain PAO1S. With
this strain, the expression of the
mexAB-oprM operon was monitored
by measuring ß-galactosidase activity at several different
growth points. The fully grown cells were diluted 200-fold with
prewarmed fresh medium, and the ß-galactosidase activity
dropped dramatically at 3 to 5 h after the dilution. This result
was interpreted to mean that fully expressed MexAB-OprM in the
high-cell-density preculture was repressed to a low level as
the culture was diluted to a low cell density. When the cell
growth reached stationary phase and incubation was continued
for 3 to 5 h, ß-galactosidase activity again reached
a high level, and thereafter it gradually declined (Fig.
2).
This was interpreted to mean that the cells sensed a high population
density in the stationary phase and induced MexAB-OprM expression.
To verify that the regulation of the chromosomal
mexAB-oprM operon is similar to that of the plasmid-borne operon, we constructed
a chromosomal fusion of the
xylE gene downstream of
mexA, generating
strain TNP090. With this strain, the transcription of the chromosomal
mexAB-oprM operon was monitored. The results showed that the
catechol 2,3-dioxygenase activity at several growth points was
close to the ß-galactosidase activity profile (data
not shown). This is consistent with a recent report by Sanchez
et al. which demonstrated that
mexA expression was triggered
at the onset of the stationary growth phase (
37).
MexT-mediated regulation of mexAB-oprM expression.
To ascertain whether the decreased expression of the MexAB-OprM efflux pump in the nfxC-type mutant was under the control of the MexEF-OprN regulator MexT, pME4510-mexOP, encoding mexA::lacZ, was introduced into PAO1SC, which carries a functional mexT gene. As the cells entered the stationary growth phase, expression of the mexAB-oprM operon increased, and it reached the highest level at mid-stationary phase; this profile was comparable to that of the parent strain, PAO1S (Fig. 3). However, the level of gene expression in PAO1SC at most time points was half as high as that in PAO1S carrying an impaired chromosomal mexT gene (compare Fig. 2 and 3). These data are fully consistent with the antibiotic susceptibility profiles of these strains (Table 2).
To ascertain whether the decreased transcription of the
mexAB-oprM operon in
nfxC cells is attributable to the presence of a functional
mexT gene, we introduced pMEXT8380, which carries a functional
mexT gene, in
trans, into the parent cells with the
mexB::
xylE fusion (TNP090) and investigated whether the transcriptional
expression of the
mexAB-oprM operon was modulated. As shown
in Fig.
4, catechol 2,3-dioxygenase activity in TNP090(pMEXT8380)
was about half of that of TNP090 carrying the vector only. The
result is fully consistent with the above-mentioned data and
firmly establishes that expression of MexAB-OprM in the
nfxC-type
cells is down regulated in the presence of functional MexT.
In fact, both PAO4290 and PAO1S with an intact
mexT gene (harboring
pMEXT8380) exhibit an elevated level of ß-lactam susceptibility
compared with cells harboring the vector only (Table
2).
Growth phase-dependent and C4-HSL-mediated regulation of mexAB-oprM expression.
P. aeruginosa produces two major AHSLs, 3-oxo-C12-HSL and C4-HSL
(
6,
24), one of which, 3-oxo-C12-HSL, was reported to be unrelated
to growth phase-dependent regulation of the
mexAB-oprM operon
(
6). An earlier paper reported that production of C4-HSL was
nearly undetectable in culture supernatants at cell densities
below an
A600 of ca. 2 but was quantitatively detectable in
cultures with an
A600 of over 2 (
11). This growth phase-dependent
accumulation of C4-HSL appears to be analogous to the
mexAB-oprM transcription profile (Fig.
2 and
3). This observation suggests
that the growth phase-dependent transcription of
mexAB-oprM might be linked to the accumulation of AHSLs in the stationary
phase. We therefore tested the effects of AHSLs on the expression
of
mexAB-oprM by adding 3-oxo-C12-HSL and/or C4-HSL (final concentration,
50 µM) during the logarithmic growth phase to cultures
of TNP090 and its derivatives lacking the
lasI and/or
rhlI genes.
Addition of C4-HSL enhanced transcription of
mexAB-oprM in TNP090
and derivatives of TNP090. In contrast, addition of 3-oxo-C12-HSL
only slightly affected transcription of
mexAB-oprM on these
strains compared to C4-HSL (Fig.
5), suggesting that especially
the enhancement of
mexAB-oprM expression in the stationary growth
phase can be controlled by the concentration of C4-HSL. Hence,
we additionally tested the effects of C4-HSL on the expression
of
mexAB-oprM by adding various concentrations of C4-HSL to
TNP090 harboring vector only, pMEXEF-OPRN1 (carrying the
mexEF-oprN genes), or pMEXT8380 (carrying an unimpaired
mexT gene). For
strain TNP090 with the
mexB::
xylE reporter, catechol 2,3-dioxygenase
activity sharply increased as the extracellular concentration
of C4-HSL was raised to approximately 20 µM and thereafter
showed a steady expression (Fig.
6). This result clearly indicates
that transcription of the
mexAB-oprM operon is regulated by
C4-HSL and suggests that the increased transcription of
mexAB-oprM in stationary phase is most likely dependent on the concentration
of C4-HSL. Furthermore, we found that the transcription levels
of
mexAB-oprM in stationary growth phase in an
rhlI mutant (TNP092)
were almost lower than those in TNP090 (data not shown). In
contrast, transcription of the
mexAB-oprM operon in TNP090 harboring
pMEXT8380 (carrying an unimpaired
mexT gene) was barely affected
by C4-HSL (Fig.
6), suggesting that MexT canceled the C4-HSL-mediated
enhancement of
mexAB-oprM expression. However, the growth phase-dependent
expression of
mexAB-oprM was observed even in the strains carrying
the
mexT gene (Fig.
2 and
3). Therefore, it seemed that the
expression of
mexAB-oprM is regulated by another, unknown mechanism(s)
as well as C4-HSL.
One may ask whether MexEF-OprN is involved in extrusion of C4-HSL.
This activity would result in a decrease in the cellular concentration
of C4-HSL. When the transcription of
mexAB-oprM in TNP090 cells
harboring pMEXEF-OPRN1 or with the vector only was compared,
we observed a lower level of transcription of
mexAB-oprM in
cells harboring pMEXEF-OPRN1 than in cells with the vector only
(Fig.
6). These data suggest but do not prove that the MexEF-OprN
efflux pump might participate in export of C4-HSL and consequently
decrease the transcription of
mexAB-oprM. Needless to say, the
activity and expression level of MexEF-OprN were similar in
cells carrying pMEXEF-OPRN1 or pMEXT8380 (Table
2 and Fig.
7).

DISCUSSION
We demonstrated in this investigation that the
mexAB-oprM operon
was actively transcribed in the stationary growth phase and
that this observation could be linked with the report that the
quorum-sensing system was switched on in the stationary phase
(
4,
31,
43). In fact, transcription of the
mexAB-oprM operon
in wild-type cells was increased by the extracellular addition
of C4-HSL (Fig.
5 and
6). These results suggest that the enhanced
transcription of
mexAB-oprM in the stationary phase depends
on quorum-sensing autoinducer accumulation in the medium. How
would one summarize the complicated regulation of the
mexAB-oprM expression? We reported recently that the MexR protein negatively
regulates transcription of
mexAB-oprM operon (
34), and we interpret
the available data as follows. In the logarithmic growth phase,
the MexR repressor negatively regulates
mexAB-oprM expression
by binding at the MexR-MexAB-OprM operator-promoter region,
as reported recently (Fig.
8A) (
5,
34). As the cells enter the
stationary growth phase, they sense a high population density
and turn on a quorum-sensing switch producing an autoinducer,
C4-HSL (Fig.
8B). We considered two mechanisms: (i) C4-HSL induces
the expression of
mexAB-oprM operon directly and not through
participation of the
mexR gene, or (ii) C4-HSL inactivates the
MexR repressor or represses the expression of the
mexR gene
by an unknown mechanism and consequently enhances the transcription
of
mexAB-oprM operon. We explain in the final paragraph of Discussion
that probably C4-HSL directly induces the expression of
mexAB-oprM.
Wild-type cells of
P. aeruginosa have the
mexEF-oprN operon,
but it is not transcribed under normal growth conditions due
to the mutation in the positive regulator gene
mexT (
17). The
nfxC-type mutant produces active MexT that promotes transcription
of the
mexEF-oprN operon, simultaneously lowering the growth
phase-dependent enhancement of
mexAB-oprM transcription (Fig.
3 and
4) and rendering the cells hypersusceptible to ß-lactam
antibiotics (Table
2). Both the growth phase-dependent and C4-HSL-mediated
increases in the production of MexAB-OprM were totally repressed
by overdose of the plasmid-borne MexT (Fig.
6). It is likely,
therefore, that ß-lactam hypersusceptibility in the
nfxC-type mutant is caused by the activation of MexT, consequently
decreasing the C4-HSL effect. Thus, all the data presented in
this report suggest that MexT may regulate the expression of
the
mexAB-oprM operon in mediating the quorum-sensing system.
We carried out a further experiment to determine whether it
is MexT itself or MexEF-OprN which affects the expression of
mexAB-oprM. We constructed a
mexEF-oprN disruption mutant of
TNP090, named TNP099, and then observed the induction level
of
mexAB-oprM in TNP099 with or without MexT (pMEXT8380) after
adding exogenous C4-HSL (Fig.
9). The expression of MexAB-OprM
in the
mexEF-oprN disruption mutant (TNP099) was further decreased
in the presence of MexT (pMEXT8380) compared to the level in
the absence of MexT, indicating that MexT also possesses the
regulatory function required for the decrease of the expression
of
mexAB-oprM not through expression of MexEF-OprN. Moreover,
MexT is involved in expression of various genes, including
mexEF-oprN,
oprD,
lasB (encoding elastase),
rhlAB, and swarming and pyocyanin
genes (
10,
11). Hence, the MexT protein may function as a global
regulator. On the other hand, we observed a lower level of transcription
of
mexAB-oprM in TNP090 cells harboring pMEXEF-OPRN1 than that
of vector only (Fig.
6). Therefore, it is concluded that the
MexT-mediated down regulation of the transcription of the
mexAB-oprM operon is caused by the regulatory function of MexT itself and
the MexEF-OprN efflux pump expressed by MexT (Fig.
8C).
MexT may bind either the MexR binding site or a putative second
repressor binding site (
34) at the
mexR-mexAB-oprM operator-promoter
region and repress the transcription of the
mexAB-oprM operon
in a MexR-independent manner (Fig.
8C). If this was the case,
the
nfxC-type cells would lower the transcription of
mexAB-oprM even in the absence of MexR. In fact, the
mexR nfxC double mutant
showed a 50% lower MIC of aztreonam, which is one of the ß-lactam
agents and is extruded effectively by the MexAB-OprM efflux
pump, than the cells with a
mexR single mutation. Needless to
say, the former cells showed a MIC of nolfloxacin that is eight
times higher than that for the latter cells (H. Maseda, unpublished
results). To substantiate such a possibility, the transcriptional
expression of
mexR and
mexT at different growth phases needs
to be tested. Such experiments are in progress in our laboratory.

ACKNOWLEDGMENTS
This study was partially supported by a grant to N.N. from Industrial
Technology Research Grant Program '01 of the New Energy and
Industrial Technology Development Organization (NEDO) of Japan.

FOOTNOTES
* Corresponding authors. Mailing address for Hideaki Maseda: Gene Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan. Phone: 81-298-53-7792. Fax: 81-298-53-7723. E-mail:
maseda{at}sakura.cc.tsukuba.ac.jp. Mailing address for Nobuhiko Nomura: Institute of Applied Biochemistry, University of Tsukuba, Tsukuba, Ibaraki 305-8572, Japan. Phone: 81-298-53-6627. Fax: 81-298-53-6627. E-mail:
nomunobu{at}sakura.cc.tsukuba.ac.jp.


REFERENCES
1 - Adewoye, L., A. Sutherland, R. Srikumar, and K. Poole. 2002. The mexR repressor of the mexAB-oprM multidrug efflux operon in Pseudomonas aeruginosa: characterization of mutations compromising activity. J. Bacteriol. 184:4308-4312.[Abstract/Free Full Text]
2 - Aires, J. R., T. Köhler, H. Nikaido, and P. Plesiat. 1999. Involvement of an active efflux system in the natural resistance of Pseudomonas aeruginosa to aminoglycosides. Antimicrob. Agents Chemother. 43:2624-2628.[Abstract/Free Full Text]
3 - Beinlich, K. L., R. Chuanchuen, and H. P. Schweizer. 2001. Contribution of multidrug efflux pumps to multiple antibiotic resistance in veterinary clinical isolates of Pseudomonas aeruginosa. FEMS Microbiol. Lett. 198:129-134.[CrossRef][Medline]
4 - de Kievit, T. R., and B. H. Iglewski. 2000. Bacterial quorum sensing in pathogenic relationships. Infect. Immun. 68:4839-4849.[Free Full Text]
5 - Evans, K., L. Adewoye, and K. Poole. 2001. MexR repressor of the mexAB-oprM multidrug efflux operon of Pseudomonas aeruginosa: identification of MexR binding sites in the mexA-mexR intergenic region. J. Bacteriol. 183:807-812.[Abstract/Free Full Text]
6 - Evans, K., and K. Poole. 1999. The MexA-MexB-OprM multidrug efflux system of Pseudomonas aeruginosa is growth-phase regulated. FEMS Microbiol. Lett. 173:35-39.[CrossRef][Medline]
7 - Fukuda, H., M. Hosaka, K. Hirai, and S. Iyobe. 1990. New norfloxacin resistance gene in Pseudomonas aeruginosa PAO. Antimicrob. Agents Chemother. 34:1757-1761.[Abstract/Free Full Text]
8 - Fürste, J. P., W. Pansegrau, R. Frank, H. Blocker, P. Scholz, M. Bagdasarian, and E. Lanka. 1986. Molecular cloning of the plasmid RP4 primase region in a multi-host-range tacP expression vector. Gene 48:119-131.[CrossRef][Medline]
9 - Guan, L., M. Ehrmann, H. Yoneyama, and T. Nakae. 1999. Membrane topology of the xenobiotic-exporting subunit, MexB, of the MexA, B-OprM extrusion pump in Pseudomonas aeruginosa. J. Biol. Chem. 274:10517-10522.[Abstract/Free Full Text]
10 - Köhler, T., S. F. Epp, L. K. Curty, and J. C. Pechére. 1999. Characterization of MexT, the regulator of the MexE-MexF-OprN multidrug efflux system of Pseudomonas aeruginosa. J. Bacteriol. 181:6300-6305.[Abstract/Free Full Text]
11 - Köhler, T., C. van Delden, L. K. Curty, M. M. Hamzehpour, and J. C. Pechére. 2001. Overexpression of the MexEF-OprN multidrug efflux system affects cell-to-cell signaling in Pseudomonas aeruginosa. J. Bacteriol. 183:5213-5222.[Abstract/Free Full Text]
12 - Li, X. Z., N. Barre, and K. Poole. 2000. Influence of the MexA-MexB-OprM multidrug efflux system on expression of the MexC-MexD-OprJ and MexE-MexF-OprN multidrug efflux systems in Pseudomonas aeruginosa. J. Antimicrob. Chemother. 46:885-893.[Abstract/Free Full Text]
13 - Li, X. Z., and K. Poole. 2001. Mutational analysis of the OprM outer membrane component of the MexA-MexB-OprM multidrug efflux system of Pseudomonas aeruginosa. J. Bacteriol. 183:12-27.[Abstract/Free Full Text]
14 - Lim, D., K. Poole, and N. C. Strynadka. 2002. Crystal structure of the MexR repressor of the mexRAB-oprM multidrug efflux operon of Pseudomonas aeruginosa. J. Biol. Chem. 277:29253-29259.[Abstract/Free Full Text]
15 - Lowry, O. H., N. J. Rosebrough, A. L. Farr, and R. J. Randall. 1951. Protein measurement with the Folin phenol reagent. J. Biol. Chem. 193:265-275.[Free Full Text]
16 - Maseda, H., M. Kitao, S. Eda, E. Yoshihara, and T. Nakae. 2002. A novel assembly process of the multicomponent xenobiotic efflux pump in Pseudomonas aeruginosa. Mol. Microbiol. 46:677-686.[CrossRef][Medline]
17 - Maseda, H., K. Saito, A. Nakajima, and T. Nakae. 2000. Variation of the mexT gene, a regulator of the MexEF-oprN efflux pump expression in wild-type strains of Pseudomonas aeruginosa. FEMS Microbiol. Lett. 192:107-112.[CrossRef][Medline]
18 - Maseda, H., H. Yoneyama, and T. Nakae. 2000. Assignment of the substrate-selective subunits of the MexEF-OprN multidrug efflux pump of Pseudomonas aeruginosa. Antimicrob. Agents Chemother. 44:658-664.[Abstract/Free Full Text]
19 - Masuda, N., E. Sakagawa, S. Ohya, N. Gotoh, H. Tsujimoto, and T. Nishino. 2000. Contribution of the MexX-MexY-OprM efflux system to intrinsic resistance in Pseudomonas aeruginosa. Antimicrob. Agents Chemother. 44:2242-2246.[Abstract/Free Full Text]
20 - Mine, T., Y. Morita, A. Kataoka, T. Mizushima, and T. Tsuchiya. 1999. Expression in Escherichia coli of a new multidrug efflux pump, MexXY, from Pseudomonas aeruginosa. Antimicrob. Agents Chemother. 43:415-417.[Abstract/Free Full Text]
21 - Morshed, S. R., Y. Lei, H. Yoneyama, and T. Nakae. 1995. Expression of genes associated with antibiotic extrusion in Pseudomonas aeruginosa. Biochem. Biophys. Res. Commun. 210:356-362.[CrossRef][Medline]
22 - Nakajima, A., Y. Sugimoto, H. Yoneyama, and T. Nakae. 2000. Localization of the outer membrane subunit OprM of resistance-nodulation-cell division family multicomponent efflux pump in Pseudomonas aeruginosa. J. Biol. Chem. 275:30064-30068.[Abstract/Free Full Text]
23 - Nikaido, H. 1989. Outer membrane barrier as a mechanism of antimicrobial resistance. Antimicrob. Agents Chemother. 33:1831-1836.[Free Full Text]
24 - Parsek, M. R., and E. P. Greenberg. 2000. Acyl-homoserine lactone quorum sensing in gram-negative bacteria: a signaling mechanism involved in associations with higher organisms. Proc. Natl. Acad. Sci. USA 97:8789-8793.[Abstract/Free Full Text]
25 - Pearson, J. P., C. Van Delden, and B. H. Iglewski. 1999. Active efflux and diffusion are involved in transport of Pseudomonas aeruginosa cell-to-cell signals. J. Bacteriol. 181:1203-1210.[Abstract/Free Full Text]
26 - Poole, K. 2000. Efflux-mediated resistance to fluoroquinolones in gram-negative bacteria. Antimicrob. Agents Chemother. 44:2233-22241.[Free Full Text]
27 - Poole, K. 2001. Multidrug efflux pumps and antimicrobial resistance in Pseudomonas aeruginosa and related organisms. J. Mol. Microbiol. Biotechnol. 3:255-264.[Medline]
28 - Poole, K., N. Gotoh, H. Tsujimoto, Q. Zhao, A. Wada, T. Yamasaki, S. Neshat, J. Yamagishi, X. Z. Li, and T. Nishino. 1996. Overexpression of the mexC-mexD-oprJ efflux operon in nfxB-type multidrug-resistant strains of Pseudomonas aeruginosa. Mol. Microbiol. 21:713-724.[CrossRef][Medline]
29 - Poole, K., K. Krebes, C. McNally, and S. Neshat. 1993. Multiple antibiotic resistance in Pseudomonas aeruginosa: evidence for involvement of an efflux operon. J. Bacteriol. 175:7363-7372.[Abstract/Free Full Text]
30 - Poole, K., K. Tetro, Q. Zhao, S. Neshat, D. E. Heinrichs, and N. Bianco. 1996. Expression of the multidrug resistance operon mexA-mexB-oprM in Pseudomonas aeruginosa: mexR encodes a regulator of operon expression. Antimicrob. Agents Chemother. 40:2021-2028.[Abstract/Free Full Text]
31 - Rahmati, S., S. Yang, A. L. Davidson, and E. L. Zechiedrich. 2002. Control of the AcrAB multidrug efflux pump by quorum-sensing regulator SdiA. Mol. Microbiol. 43:677-685.[CrossRef][Medline]
32 - Rella, M., and D. Haas. 1982. Resistance of Pseudomonas aeruginosa PAO to nalidixic acid and low levels of beta-lactam antibiotics: mapping of chromosomal genes. Antimicrob. Agents Chemother. 22:242-249.[Abstract/Free Full Text]
33 - Rist, M., and M. A. Kertesz. 1998. Construction of improved plasmid vectors for promoter characterization in Pseudomonas aeruginosa and other gram-negative bacteria. FEMS Microbiol. Lett. 169:179-183.[CrossRef][Medline]
34 - Saito, K., S. Eda, H. Maseda, and T. Nakae. 2001. Molecular mechanism of MexR-mediated regulation of MexAB-OprM efflux pump expression in Pseudomonas aeruginosa. FEMS Microbiol. Lett. 195:23-28.[Medline]
35 - Saito, K., H. Yoneyama, and T. Nakae. 1999. nalB-type mutations causing the overexpression of the MexAB-OprM efflux pump are located in the mexR gene of the Pseudomonas aeruginosa chromosome. FEMS Microbiol. Lett. 179:67-72.[CrossRef][Medline]
36 - Sambrook, J., E. Fritsch, F., and T. Maniatis. 1989. Molecular cloning: a laboratory manual, 2nd ed. Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y.
37 - Sanchez, P., F. Rojo, and J. L. Martinez. 2002. Transcriptional regulation of mexR, the repressor of Pseudomonas aeruginosa mexAB-oprM multidrug efflux pump. FEMS Microbiol. Lett. 207:63-68.[Medline]
38 - Schweizer, H. P. 1992. Allelic exchange in Pseudomonas aeruginosa using novel ColE1-type vectors and a family of cassettes containing a portable oriT and the counter-selectable Bacillus subtilis sacB marker. Mol. Microbiol. 6:1195-1204.[Medline]
39 - Schweizer, H. P. 1993. Two plasmids, X1918 and Z1918, for easy recovery of the xylE and lacZ reporter genes. Gene 134:89-91.[CrossRef][Medline]
40 - Shiba, T., K. Ishiguro, N. Takemoto, H. Koibuchi, and K. Sugimoto. 1995. Purification and characterization of the Pseudomonas aeruginosa NfxB protein, the negative regulator of the nfxB gene. J. Bacteriol. 177:5872-5877.[Abstract/Free Full Text]
41 - Simon, R., M. O'Connell, M. Labes, and A. Pühler. 1986. Plasmid vector for the genetic analysis and manipulation of rhizobia and other gram-negative bacteria. Methods Enzymol. 118:640-659.[Medline]
42 - Srikumar, R., C. J. Paul, and K. Poole. 2000. Influence of mutations in the mexR repressor gene on expression of the MexA-MexB-OprM multidrug efflux system of Pseudomonas aeruginosa. J. Bacteriol. 182:1410-1414.[Abstract/Free Full Text]
43 - Whitehead, N. A., A. M. Barnard, H. Slater, N. J. Simpson, and G. P. Salmond. 2001. Quorum-sensing in Gram-negative bacteria. FEMS Microbiol. Rev. 25:365-404.[CrossRef][Medline]
44 - Wong, K. K., F. S. Brinkman, R. S. Benz, and R. E. Hancock. 2001. Evaluation of a structural model of Pseudomonas aeruginosa outer membrane protein OprM, an efflux component involved in intrinsic antibiotic resistance. J. Bacteriol. 183:367-374.[Abstract/Free Full Text]
45 - Yoneyama, H., H. Maseda, H. Kamiguchi, and T. Nakae. 2000. Function of the membrane fusion protein, MexA, of the MexA, B-OprM efflux pump in Pseudomonas aeruginosa without an anchoring membrane. J. Biol. Chem. 275:4628-4634.[Abstract/Free Full Text]
Antimicrobial Agents and Chemotherapy, April 2004, p. 1320-1328, Vol. 48, No. 4
0066-4804/04/$08.00+0 DOI: 10.1128/AAC.48.4.1320-1328.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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