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Antimicrobial Agents and Chemotherapy, July 2006, p. 2544-2546, Vol. 50, No. 7
0066-4804/06/$08.00+0 doi:10.1128/AAC.00609-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Common Region CR1 for Expression of Antibiotic Resistance Genes
Jose-Manuel Rodriguez-Martinez,1,2
Laurent Poirel,1
Rafael Canton,3 and
Patrice Nordmann1*
Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris-Sud, Université Paris Sud, K.-Bicêtre, France,1
University Hospital Virgen Macarena, University of Sevilla, Sevilla,2
Servicio de Microbiologia, Hospital Universitario Ramon y Cajal, Madrid, Spain3
Received 16 May 2005/
Returned for modification 29 July 2005/
Accepted 10 April 2006

ABSTRACT
The CR1 element defined by an
orf513 gene encoding a putative
recombinase and a recombination crossover site has been identified
upstream of several antibiotic resistance genes in
Enterobacteriaceae.
This CR1 element was shown to bring promoter sequences that
play a role in the expression of unrelated antibiotic resistance
genes.

TEXT
The role of class 1 integrons in acquisition, dissemination,
and expression of antibiotic resistance genes is now well established
in
Enterobacteriaceae (
1,
3,
8). Class 1 integrons possess two
conserved features consisting of an integrase gene,
intI1, in
a so-called 5' conserved sequence (5'-CS) and
qacE
1 and
sul1 genes in a so-called 3' conserved sequence (3'-CS) (
1). Promoter
sequences that drive the expression of downstream-located antibiotic
resistance genes have been identified in the 5' end of the integrase
gene (
1). The complex class 1 integrons contain the 5'-CS and
part of the 3'-CS flanking one or more gene cassettes (
6). Following
the 3'-CS is a region known as the common region (CR) consisting
of
orf513 and a recombination crossover site followed by genes
that do not resemble a gene cassette and flanked by another
copy of the
qacE
1/
sul1 complex (
6). The encoded Orf513 may play
a role in the integration of genes located nearby (mostly antibiotic
resistance genes) (
6). The
orf513 gene and the 33-bp DNA sequence
located at its right-hand boundary that may correspond to a
recombination crossover site (RCS) are the common region CR1.
We have recently shown that CR1 plays a role in the expression
of the plasmid-mediated quinolone resistance
qnrA gene by providing
a promoter structure (
5). The aim of the study was to analyze
CR1 elements and their putative role in the expression of other
antibiotic resistance determinants from nonrelated enterobacterial
isolates. Six strains that encoded resistance determinants including
QnrA and emerging extended-spectrum ß-lactamases of
the CTX-M type were included in this study (Table
1). Since
the nucleotide sequence separating CR1 from the antibiotic resistance
gene may vary, strains with different structures located upstream
of identical
qnrA and
blaCTX-M-9 genes were studied (Table
1).
Primers used for PCR identification and sequencing of CR1 elements
and associated resistance genes are shown in Table
2.
Mapping of the transcription start sites was performed by 5'
rapid amplification of cDNA ends (5'-RACE). Total RNA was isolated
from the different strains studied using the RNeasy Midi kit
(QIAGEN, Courtaboeuf, France). 5'-RACE reactions were performed
using 5 µg of total RNA of each strain and the 5'-RACE
System kit (version 2.0; Invitrogen Life Technologies, Cergy
Pontoise, France) according the manufacturer's recommendations.
After a reverse transcription step with gene-specific primer
GSP1 and reverse transcriptase, the cDNA was tailed with terminal
deoxynucleotidyl transferase and was subsequently amplified
with another gene-specific primer, GSP2, combined with an oligo(dT)
adapter primer provided with the kit (Table
2). This PCR product
was used as a template for a nested PCR with another adapter
primer and primer GSP3. The PCR product obtained was cloned
into pCR-BluntII-Topo (Invitrogen), and the corresponding clones
possessing the larger insert were sequenced. Analysis of the
cloned sequence allowed the determination of the transcription
initiation site(s), defined as the first nucleotide following
the sequence of the adapter primer. Promoter sequences were
determined subsequently. For each transcription assay, at least
10 clones were analyzed, and the entire experiment was repeated
twice for all strains.
Identical CR1 elements were identified in all cases, and their 3' ends are shown in Fig. 1. The CR1 element was associated with the qnrA gene in two cases, with blaCTX-M-9 in two cases, with blaCTX-M-2 in one case, and with the dfrA10 gene encoding trimethoprim resistance in one case (Table 1 and Fig. 1). The distance separating the RCS of CR1 from the start codon of the antibiotic resistance genes varied. This distance upstream of the qnrA gene was 98 and 31 bp for Escherichia coli Lo and Klebsiella pneumoniae K149, respectively (Table 1). An identical 94-bp region was identified between the RCS of CR1 and the start codon of the blaCTX-M-9 gene in E. coli B36 and K. pneumoniae KP40. However, a 95-bp duplication was identified at the right-hand boundary of CR1 in E. coli B36 (Fig. 1). A 149-bp sequence was identified between CR1 and the dfrA10 gene in Acinetobacter baumannii AYE, whereas a 266-bp region was identified upstream of the blaCTX-M-2 gene in E. coli JAB.
Analysis of the 5'-RACE PCR products obtained from QnrA-positive
E. coli Lo revealed a single type of transcription product that
was different from that previously reported (
5). Although promoter
PCR1-2 has been identified previously (
5), a +1 transcription
site located 136 bp upstream of the
qnrA gene led to the identification
of another promoter, termed
PCR1-1 (Fig.
1). In the previous
study, identification of the
PCR1-2 promoter was likely the
result of selection of truncated transcripts during the 5'-RACE
experiment. The same promoter,
PCR1-1, controlled the expression
of the
qnrA gene in
K. pneumoniae K149, the
blaCTX-M-9 gene
in
E. coli strain B36 and in
K. pneumoniae KP40C, and the
dfr10 gene in
A. baumannii AYE (Fig.
1). These results also indicated
that promoter
PCR1-1, provided by the CR1 element, was active
in
Enterobacteriaceae and
A. baumannii. The expression of the
blaCTX-M-2 gene in
E. coli JAB depended on another promoter,
PORI, located outside the CR1 element between the CR1 and the
initiation codon of the resistance gene (Fig.
1).
Our results showed that CR1-mediated promoter sequences were involved in the expression of the qnrA, dfrA10, and blaCTX-M-9 genes (Fig. 1) and that PCR1-1 plays a major role in antibiotic resistance gene expression when CR1 is present. This study emphasizes that CR1 plays a significant role by providing promoter sequences for the expression of unrelated antibiotic resistance genes.

ACKNOWLEDGMENTS
This work was funded by a grant from the Ministère de
l'Education Nationale et de la Recherche (UPRES-EA3539), Université
Paris XI, France, and by a grant from the European Community
(6th PCRD, LSHM-CT-2003-503335). L.P. is a researcher from the
INSERM (Paris, France), and J.-M.R.-M. was a recipient of a
travel grant from the Spanish Society for Clinical Microbiology
and Infectious Diseases in 2004.
We thank A. Pascual for constant support of J.-M.R.-M.

FOOTNOTES
* Corresponding author. Mailing address: Service de Bactériologie-Virologie, Hôpital de Bicêtre78, rue du General Leclerc, 94275 Le Kremlin-Bicêtre, France. Phone: 33-1-45-21-36-32. Fax: 33-1-45-21-63-40. E-mail:
nordmann.patrice{at}bct.ap-hop-paris.fr.


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Antimicrobial Agents and Chemotherapy, July 2006, p. 2544-2546, Vol. 50, No. 7
0066-4804/06/$08.00+0 doi:10.1128/AAC.00609-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
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