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Antimicrobial Agents and Chemotherapy, September 2005, p. 3803-3809, Vol. 49, No. 9
0066-4804/05/$08.00+0 doi:10.1128/AAC.49.9.3803-3809.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Mycobacterium smegmatis Erm(38) Is a Reluctant Dimethyltransferase
Christian Toft Madsen,
Lene Jakobsen, and
Stephen Douthwaite*
Department of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark
Received 7 April 2005/
Returned for modification 14 April 2005/
Accepted 9 June 2005

ABSTRACT
The waxy cell walls of mycobacteria provide intrinsic tolerance
to a broad range of antibiotics, and this effect is augmented
by specific resistance determinants. The inducible determinant
erm(38) in the nontuberculous species
Mycobacterium smegmatis confers high resistance to lincosamides and some macrolides,
without increasing resistance to streptogramin B antibiotics.
This is an uncharacteristic resistance pattern falling between
the type I and type II macrolide, lincosamide, and streptogramin
B (MLS
B) phenotypes that are conferred, respectively, by Erm
monomethyltransferases and dimethyltransferases. Erm dimethyltransferases
are typically found in pathogenic bacteria and confer resistance
to all MLS
B drugs by addition of two methyl groups to nucleotide
A2058 in 23S rRNA. We show here by mass spectrometry analysis
of the mycobacterial rRNA that Erm(38) is indeed an A2058-specific
dimethyltransferase. The activity of Erm(38) is lethargic, however,
and only a meager proportion of the rRNA molecules become dimethylated
in
M. smegmatis, while most of the rRNAs are either monomethylated
or remain unmethylated. The methylation pattern produced by
Erm(38) clarifies the phenotype of
M. smegmatis, as it is adequate
to confer resistance to lincosamides and 14-member ring macrolides
such as erythromycin, but it is insufficient to raise the level
of resistance to streptogramin B drugs above the already high
intrinsic tolerance displayed by this species.

INTRODUCTION
Mycobacteria are the causative agents of several human diseases,
the most serious being leprosy and tuberculosis, while other
nontuberculous members including
Mycobacterium smegmatis and
Mycobacterium fortuitum are potential human pathogens associated
primarily with wound or lung infections (
3,
23,
30). Antimicrobial
treatment of nontuberculous mycobacteria is often challenging,
as drug uptake is hampered by their relatively impervious cell
wall, and this effect is often augmented by the presence of
specific resistance determinants (
2,
7). Such determinants are
erm(38) in
M. smegmatis and the closely related
erm(39) in
M. fortuitum, both of which confer resistance to macrolide and
lincosamide drugs (
18,
19).
These determinants are members of the erm family of genes that are found in a diverse range of pathogenic and drug-producing bacteria (24, 25, 31). All erm genes encode methyltransferases that specifically target the N6 position of nucleotide A2058 in 23S rRNA (Escherichia coli numbering) (28) but differ as to whether they monomethylate or dimethylate this nucleotide (31, 33). Erm monomethyltransferases confer the so-called macrolide, lincosamide, and streptogramin B (MLSB) type I phenotype with high resistance to lincosamides and low to moderate resistance to macrolide and streptogramin B antibiotics; Erm dimethyltransferases confer the type II phenotype with high resistance to all the MLSB antibiotics (25, 31, 33). Dimethylation at 23S rRNA nucleotide A2058 is the common MLSB resistance mechanism in pathogenic bacteria (24). Erm(38) and Erm(39) confer high resistance to macrolides and lincosamide but no resistance to streptogramin B drugs (18, 19). This resistance phenotype falls somewhere between the typical MLSB type I and type II patterns and could reflect that either the activities of Erm(38) and Erm(39) differ from other Erm mono- and dimethyltransferases or that there are anomalies in the Mycobacterium ribosomes so that ML drugs target a site other than streptogramin B (18).
With a view to explaining the molecular mechanism of the resistance conferred by Erm(38), we determined the methylation status of M. smegmatis rRNA. The masses of each nucleotide in the sequence around A2058 of M. smegmatis 23S rRNA were accurately determined using matrix-assisted laser desorption ionization (MALDI)-time of flight tandem mass spectrometry (1); rRNA methylation was verified by using a primer extension assay with reverse transcriptase. The methylation by Erm(38) was compared with the well-characterized monomethyltransferase Erm(O) (SrmA from Streptomyces ambofaciens) and the dimethyltransferase Erm(E) (from Saccharopolyspora erythraea). When constitutively expressed in the M. smegmatis host, Erm(O) and Erm(E) retain their specificities and exclusively modify nucleotide A2058, adding one and two methyl groups, respectively. Expression of Erm(38) from its natural promoter requires prior induction with subinhibitory concentrations of the macrolide erythromycin. Erm(38) is also specific for nucleotide A2058 although, in comparison with the Erm(O) and Erm(E) methyltransferases, Erm(38) is lethargic in its activity and gives rise to a mixture of unmethylated, monomethylated, and dimethylated products. The data provide clear evidence that Erm(38) is indeed an A2058 dimethyltransferase, although the small proportion of dimethylated product is insufficient to confer high resistance to streptogramin B drugs.

MATERIALS AND METHODS
Bacterial strains and growth conditions.
The
M. smegmatis strain and plasmids used here are listed in
Table
1. Cells were grown at 37°C in Middlebrook 7H9 (Difco)
liquid broth containing 0.2% (vol/vol) glycerol or on solid
Middlebrook 7H10 medium (Difco) containing 0.5% (vol/vol) glycerol.
Kanamycin was added at 15 µg/ml to maintain the plasmids.
The
erm(38) gene was induced by overnight incubation in liquid
medium containing a subinhibitory level (6.4 µg/ml) of
erythromycin (Sigma) followed by dilution and growth to late
log phase in the same medium for ribosome preparations. The
efficiency of
erm(38) induction was tested by measuring MICs
on agar plates containing stepwise twofold dilutions of the
lincosamide clindamycin, the macrolide erythromycin (Sigma),
the streptogramin B quinupristin (a pristinamycin derivative),
and the ketolide telithromycin (Sanofi-Aventis). The
erm(O)
and
erm(E) genes were constitutively expressed from plasmids;
rRNA preparations and MIC measurements for the
erm(O) and
erm(E)
strains were carried out under conditions where the chromosome-encoded
erm(38) was silent.
Preparation of ribosomes and RNA purification.
M. smegmatis cells were grown to late log phase in 100 ml of
medium and were harvested by centrifugation. Cells were washed
by being resuspended twice in 100 ml buffer A (10 mM Tris-Cl,
pH 7.2, 4 mM MgCl
2, 10 mM NH
4Cl, 100 mM KCl) and pelleted by
centrifugation. The following steps were carried out at 4°C:
cells were lysed by sonication in 10 ml buffer A, debris was
removed by centrifugation at 16,000 rpm for 20 min, and ribosomes
were recovered by centrifugation at 18,000 rpm for 19 h. Ribosomes
were resuspended in 200 µl of buffer A, proteins were
removed by phenol-chloroform extraction, and the rRNA was redissolved
in 30 µl of H
2O.
MALDI mass spectrometry analysis of rRNAs.
The 23S rRNA region around A2058 was isolated by a hybridization method (1). A mixture of 33 pmol of M. smegmatis rRNA and 330 pmol of an oligodeoxynucleotide complementary to the nucleotide sequence G2035 to G2087 (Fig. 1) in 66 µl of 80 mM HEPES (pH 7.0) and 180 mM KCl was heated for 5 min at 90°C, followed by slow cooling to 45°C. Mung bean nuclease (3 U; New England Biolabs) and RNase A (1.5 µg) were added in 25 µl of 50 mM sodium acetate (pH 5.0), 30 mM NaCl, and 1 mM ZnCl2, followed by further incubation for 50 min at 35°C, before the reaction was stopped by extraction with phenol-chloroform. The RNA-DNA hybrid was recovered by ethanol precipitation and run on a denaturing 13% polyacrylamide gel to release the protected rRNA fragment (approximately 53 nucleotides), which was then excised and extracted from the gel.
Samples of the 53-mer rRNA fragment (2.5 pmol in 1 µl)
were mixed with 0.5 µl 3-hydroxypicolinic acid (0.5 M
in 50% acetonitrile), 2.0 µl RNase T1 (0.5 µg/µl;
Sigma-Aldrich), and 1.5 µl H
2O and were digested for 2.5
h at 37°C. The oligonucleotides produced by RNase T1 digestion
were analyzed by MALDI mass spectrometry as previously described
(
1,
14,
16).
Primer extension.
Dimethylation of the rRNA was quantified by an adapted primer extension procedure with reverse transcriptase (13, 27). Briefly, a 5'-32P-labeled deoxynucleotide primer complementary to the region spanning C2063 to C2080 of Mycobacterium 23S rRNA (Fig. 1) was extended with 1 U of reverse transcriptase (Life Sciences) and 1 mM dTTP, 1 mM dCTP and 5 mM dideoxyguanosine triphosphate, with 1.5 pmol of intact rRNA as the template. Extension products were run on a 13% polyacrylamide-7 M urea gel alongside dideoxy sequencing reactions.
Erm alignments.
Representative erm mono- and dimethyltransferase genes (http://faculty.washington.edu/marilynr/) together with their upstream sequences were obtained from the National Center for Biotechnology Information website (http://www.ncbi.nih.gov/) and compared using the MultAlin online website (http://prodes.toulouse.inra.fr/multalin/multalin.html) (5). Secondary structural elements within the erm(38) leader mRNA were predicted with the help of the Mfold program (http://bioweb.pasteur.fr/seqanal/interfaces/mfold-simple.html).

RESULTS
Resistance phenotypes.
Prior to induction of the
erm(38) gene, the growth of
M. smegmatis was inhibited by erythromycin at 32 µg/ml, fitting well
with observations from other studies (
4,
18,
21,
22). Preincubation
of cells with subinhibitory amounts of erythromycin led to induction
of
erm(38) expression and rRNA methylation (see below) and increased
the MIC for erythromycin to 256 µg/ml (Table
2). The extent
of cell growth on clindamycin and telithromycin is indicative
of MLS
B type I and type II phenotypes (
13), and these phenotypes
tallied here with the MICs for
M. smegmatis strains expressing
erm(O) and
erm(E), respectively (Table
2).
Mass spectrometry analysis of the A2058 region.
MALDI mass spectrometry was used to determine the methylation
status of the mycobacterial 23S rRNA. This technique measures
the masses of RNA oligonucleotides to within 0.1 Da (
10), and
thus the presence of one methyl group (plus 14 Da) or two methyl
groups (plus 28 Da) is readily detected. For technical reasons,
oligonucleotides in the range of 3 to 10 nucleotides in length
are easiest to identify, and intact rRNAs are too large to be
directly analyzed by this method. Fragments of the rRNA with
predictable and suitable sizes can be formed by digestion with
the nucleotide-specific RNases A and T1, although many fragments
have similar or identical masses and produce overlapping signals
(
14). For instance, after digestion of the rRNA with RNase T1,
nucleotide A2058 resides in a pentamer fragment of
m/z 1680
together with five other rRNA fragments. This problem was overcome
by a hybridization method (
1) that enabled us to isolate the
23S rRNA sequence G2035 to G2087 (Fig.
1) and derive an unambiguous
oligonucleotide containing A2058.
The target of Erm(38).
The Erm methyltransferase target at nucleotide A2058 is contained in the RNase T1 fragment, 5'-AAAAGp at m/z 1680.3, which is a unique signal under the analytical conditions used here (Fig. 2). Without expression of erm(38), no methylated fragments were observed (Fig. 2B). Induction of erm(38) expression resulted in new spectral signals at m/z 1694.3 and 1708.3 (Fig. 2C), corresponding to the addition of one methyl group (plus 14 Da) or two methyl groups (plus 28 Da). To determine the precise location of the methyl groups, the m/z 1694.3 and 1708.3 ions were analyzed further by MALDI quadrupole-time of flight tandem mass spectrometry. This technique was used to select and fragment ions to yield a degradation pattern from which the mass of each nucleotide could be deduced (Fig. 3A). The 14-Da and 28-Da mass increases were both shown to reside at nucleotide A2058 (Fig. 3B and C).
Similar mass spectrometry analyses were carried out for the
rRNAs from
M. smegmatis strains constitutively expressing
erm(O)
and
erm(E). In cells with
erm(O), the predominant AAAAGp fragment
was at 1694.3
m/z (Fig.
2D); and in cells with
erm(E), this
fragment was exclusively at 1708.3
m/z (Fig.
2E). Analyses of
the 1694.3 and 1708.3
m/z ions by quadrupole mass spectrometry
established that Erm(O) and Erm(E) had, respectively, monomethylated
and dimethylated nucleotide A2058. The qualitative data derived
from the MALDI mass spectrometry were backed up with a quantitative
assay using primer extension. N6,N6-dimethylation of adenosines
halts the progress of reverse transcriptase, giving rise to
a gel band that can be quantified, but the enzyme reads past
unmethylated or N6-monomethylated adenines (
13). Consistent
with the mass spectrometry data, primer extension detected no
dimethylation in rRNA from the
erm(O) strain; expression of
erm(38) gave rise to a minor amount of A2058 dimethylation;
and A2058 dimethylation was stoichiometric in cells expressing
erm(E) (Table
2).

DISCUSSION
In this report, we have characterized the rRNA methylation pattern
produced in
M. smegmatis by the resistance methyltransferase
Erm(38). There was no evidence of
erm(38) expression in the
absence of inducer (Fig.
2B), and methyltransferase expression
required prior incubation with noninhibitory amounts of an antibiotic
such as erythromycin (
18). A short leader sequence is located
immediately upstream of the
erm(38) cistron and encodes a peptide
of 19 amino acids (Fig.
4). The structure of the leader sequence
is reminiscent of the leader prefixing
erm(C), which is inducible
in a manner similar to that of
erm(38) (
9,
32). The upstream
sequence of the
erm(C) mRNA can fold into (at least) two conformations,
and equivalent structures are evident in the corresponding region
of the
erm(38) mRNA. The more stable conformation (Fig.
4A)
sequesters the start of the
erm cistron, preventing its translation,
whereas in an alternative conformation (Fig.
4B) this sequence
is accessible for ribosomes to initiate translation of
erm.
Small amounts of inducers such as erythromycin presumably cause
ribosomes to pause on the leader sequence and interfere with
the folding of the mRNA, so that it adopts the conformation
in Fig.
4B and
erm(38) can be expressed.
Induction of
erm(38) expression in
M. smegmatis led to an appreciable
increase in the minimal concentration of erythromycin that was
required to inhibit cell growth (Table
2). This change in growth
pattern on erythromycin correlated with a change in the methylation
status at 23S rRNA nucleotide A2058. No methylation at A2058
was observed prior to
erm(38) induction, whereas a mixture of
unmethylated, monomethylated, and dimethylated rRNA was evident
after induction. Monomethylated A2058 has previously been shown
to confer high resistance to lincosamides and moderate resistance
to 14-member ring macrolide drugs such as erythromycin (
13,
31,
33). The predominant modification signal (Fig.
2C) corresponded
to monomethylated A2058, fitting the resistance pattern observed
previously for Erm(38) expression in
M. smegmatis (
18). The
small amount of dimethylation at A2058 would marginally enhance
erythromycin resistance without further improving lincosamide
resistance (
13,
31,
33).
M. smegmatis is not particularly permeable to streptogramin B compounds; consequently, this species has a relatively high intrinsic tolerance towards quinupristin (MIC, 64 µg/ml). Higher resistance to quinupristin is conferred by dimethylation at A2058, with monomethylation having no detectable effect (Table 2). It follows that the methylation pattern in M. smegmatis rRNA after erm(38) induction (Fig. 2C) would hardly be expected to increase quinupristin tolerance beyond the ground state. Thus, we conclude that the resistance phenotypes conferred against streptogramin B and other drugs (Table 2) (18) fit well with the methylation activity of the Erm(38) enzyme. We cannot of course rule out that M. smegmatis ribosomes bind streptogramin B drugs in an anomalous manner (18), but there is no necessity to invoke such an explanation on the basis of the present data.
RNA modification by Erm dimethyltransferases is thought to follow the same reaction pathway seen for Erm(C) (6). The Erm(C) dimethyltransferase modifies 23S rRNA via a monomethylated intermediate, and the kinetics of the second methyl group addition is highly dependent on the concentration of the cofactor, S-adenosylmethionine (6). Whether an Erm enzyme adds a second methyl group to nucleotide A2058 is probably determined by the structure of the catalytic site and by how A2058 is accommodated there (26); however, alignments and comparison of the different Erm sequences give very few clear clues to distinguish between the mono- and dimethyltransferases. The empirical data presented here show that Erm(38) is indeed capable of dimethylating the rRNA and thus belongs to the dimethyltransferase branch of this enzyme family.
Erm(38) is, however, a rather lazy family member. The erythromycin induction conditions used here resulted in only a small proportion of the rRNA becoming dimethylated at nucleotide A2058. Possibly, Erm(38) activity could be boosted by raising the erythromycin concentration step-wise or by using other erm inducers (17). However, the increase in erythromycin resistance seen here is consistent (albeit 1 dilution less) with a previous report of erm(38) induction with the erythromycin derivative clarithromycin (18), which is markedly more effective at penetrating the M. smegmatis cell wall (4, 18, 21). The other two methyltransferases, Erm(O) and Erm(E), stoichiometrically methylated A2058, suggesting that the sluggish activity of Erm(38) is not due to physiological factors within M. smegmatis cells, such as limiting amounts of S-adenosylmethionine. The homologue erm(39) in M. fortuitum confers a ML resistance phenotype similar to that of erm(38) in M. smegmatis (19), presumably also by producing incompletely methylated rRNA. It remains to be determined whether the lackluster activity of the erm resistance determinants in nontuberculous mycobacteria is due to restrained gene expression or is an intrinsic property of the enzyme structure.

ACKNOWLEDGMENTS
We thank Jean-Luc Pernodet for providing the
M. smegmatis strains,
as well as for scientific discussions. Jacob Poehlsgaard, Jens
Øbro, and Rikke Lind Jensen are thanked for discussions
and critical comments on the manuscript.
Support from the Danish Research Agency (FNU-rammebevilling 21-04-0520) and the Nucleic Acid Center of the Danish Grundforskningsfond is gratefully acknowledged.

FOOTNOTES
* Corresponding author. Mailing address: Department of Biochemistry and Molecular Biology, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark. Phone: 45 6550 2395. Fax: 45 6550 2467. E-mail:
srd{at}bmb.sdu.dk.

Present address: The Biotechnology Group, Danish Institute of Agricultural Sciences, DK-1871 Frederiksberg C, Denmark. 

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Antimicrobial Agents and Chemotherapy, September 2005, p. 3803-3809, Vol. 49, No. 9
0066-4804/05/$08.00+0 doi:10.1128/AAC.49.9.3803-3809.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
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