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Antimicrobial Agents and Chemotherapy, June 2007, p. 2260-2264, Vol. 51, No. 6
0066-4804/07/$08.00+0 doi:10.1128/AAC.00242-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
ß-Lactam Resistance in Haemophilus parasuis Is Mediated by Plasmid pB1000 Bearing blaROB-1
Alvaro San Millan,
Jose Antonio Escudero,
Ana Catalan,
Silvia Nieto,
Fidel Farelo,
Magdalena Gibert,
Miguel Angel Moreno,
Lucas Dominguez, and
Bruno Gonzalez-Zorn*
Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
Received 16 February 2007/
Returned for modification 21 March 2007/
Accepted 5 April 2007

ABSTRACT
ß-Lactam resistance in
Haemophilus parasuis is an
emerging phenomenon that has not yet been characterized from
a molecular perspective. Clinical high-level ß-lactam-resistant
isolates from Spain bore a novel plasmid, pB1000, expressing
a functionally active ROB-1 ß-lactamase. Pulsed-field
gel electrophoresis was applied for the first time to
H. parasuis and showed that ß-lactam resistance is due to clonal
spread of a resistant strain, BB1018, bearing pB1000.

TEXT
Haemophilus parasuis is a gram-negative bacillus, responsible
for Glässer's disease, a disease with worldwide distribution
characterized by fibrinous polyserositis, polyarthritis, and
meningitis in swine (
2,
9,
14). The incidence and prevalence
of
H. parasuis infection are especially high in developed countries,
where it is one of the main causes of lethality and economic
loss (
18). Since no definite vaccination is available, antimicrobial
treatment is the sole weapon for fighting this pathogen once
infection is established. Although tetracyclines are the major
antimicrobials used against this bacterium, resistance has been
found in many instances (
4,
12,
20). In Spain, a recent report
indicated that up to 40% of the clinical isolates are highly
resistant to tetracyclines, showing that other, more effective
molecules are needed to treat infected animals (
3). For this
reason, penicillins and aminopenicillins are being used as the
alternative treatment of infections due to
H. parasuis. Phenotypically,
clinical isolates resistant to ß-lactams have largely
been found in Switzerland, the United Kingdom, and Spain (
3,
20).
From 2002 to 2005, 90 H. parasuis clinical isolates from diseased pigs were obtained in our laboratory at the Veterinary School in Madrid in the course of routine diagnostics (5). Identification was performed using phenotypic characteristics in combination with a PCR based on species-specific amplification of the 16S rRNA gene with primers HPS-F and HPS-R (Table 1), essentially as described by Oliveira et al. (17). Bacteria were cultured on chocolate agar PolyViteX plates (BioMérieux) and in Haemophilus test medium broth (Wider; Francisco Soria Melguizo, SA, Madrid, Spain) at 37°C under microaerophilic conditions (5% CO2). To assess antimicrobial resistance of H. parasuis in Spain, a complete antimicrobial profile using disk diffusion and microdilution methods was performed as described by Aarestrup et al. (1) using Haemophilus test medium for fastidious bacteria. MIC determinations were performed using a commercially prepared, dehydrated panel (Sensititre). All plates were inoculated and interpreted following CLSI (formerly NCCLS) guidelines (16). Specific breakpoints for respiratory disease were used when available (1). Eight isolates (
1%) were highly resistant to the ß-lactams penicillin (MIC > 16) and amoxicillin (MIC > 256) (Table 2). All resistant isolates were susceptible to third-generation cephalosporins (Table 2) and to ß-lactams in combination with clavulanate (data not shown). Further, all strains were positive in the nitrocefin test. Overall, these data implied that a non-inhibitor-resistant ß-lactamase could be responsible for ß-lactam resistance in H. parasuis.
In order to assess the type of ß-lactamase responsible
for the resistance phenotype in
H. parasuis, a second-generation
cephalosporin, cefaclor (Sigma Chemical Co., St. Louis, Mo),
was used as a phenotypic marker. For
Haemophilus influenzae,
this molecule is used to specifically detect
blaROB-1-expressing
ß-lactam-resistant clinical isolates (
11). Analysis
of
H. parasuis showed that all ß-lactam-resistant
isolates also had high-level resistance to cefaclor (MIC, >16).
In contrast, ß-lactam-susceptible clinical isolates
and type strain ATCC 19417, obtained from the Collection of
the Pasteur Institute (Paris, France) (Table
2), were susceptible
to cefaclor, indicating that resistance to this cephalosporin
is not intrinsic to
H. parasuis but is a characteristic associated
with penicillin and amoxicillin resistance. To determine the
ß-lactamase responsible for this phenotype, a PCR
was set up that specifically amplified the
blaROB-1 gene (
10)
(Table
1). All resistant isolates were positive for
blaROB-1,
whereas all susceptible
H. parasuis strains were negative (data
not shown). The 821-bp DNA amplicon of all strains was purified
and sequenced on both strands. Nucleotide sequences were 100%
identical among all
H. parasuis isolates. The predicted amino
acid sequence was identical to that of ROB-1 of
Actinobacillus porcitonsilarum (GenBank accession no. AJ830712.1),
Actinobacillus pleuropneumoniae (GenBank accession no. S51028.1),
Mannheimia haemolytica (GenBank accession no. Z21724.1), and
H. influenzae (GenBank accession no. AF022114.1). Recently,
blaROB-1 from
H. influenzae could be altered in vitro into an enzyme that
confers high-level resistance to clavulanate and cefotaxime,
changing only two amino acids (R169W and A237T) (
8). Thus, the
presence of
blaROB-1 in
H. parasuis should not be underestimated,
because this resistance determinant may elicit the spread of
these bacteria among the animal population, and accumulation
of mutations may lead to a novel extended-spectrum cephalosporinase
resistant to ß-lactamase inhibitors that may spread
among animal and human pathogens (
15).
Plasmid extraction from the eight ß-lactam-resistant H. parasuis isolates showed that all strains possessed plasmids. In order to determine whether blaROB-1 was located in one of these plasmids, a simple PCR-based technique that was named GPS-PCR (for Gene Positioning System) was developed. The technique is based on extraction and purification of plasmids and subsequent PCR with (i) primers of the gene to probe and (ii) universal primers of the chromosomally encoded 16S rRNA. A positive signal with the probe primers indicates that the gene is located in a plasmid, whereas a negative signal with the 16S rRNA primers shows that no chromosomal DNA is present in the preparations. Extraction and purification of plasmids from the ß-lactam-resistant H. parasuis isolates was performed. GPS-PCR showed that all plasmid preparations were positive for the blaROB-1 gene, whereas PCRs of the 16S rRNA gene were negative (Fig. 1A). Hybridizations confirmed the plasmid location of the blaROB-1 gene (Fig. 1B). These data show that blaROB-1 of H. parasuis is encoded in an extra chromosomal plasmid and demonstrate that GPS-PCR is a valuable technique for assessing plasmid locations of genes in H. parasuis.
A pair of divergent primers was designed for
blaROB-1, rob-1D
and rob-1U, in order to amplify the complete replicon bearing
the
blaROB-1 gene through inverted PCR. All isolates gave a
single amplicon of approximately 4.3 kb that was completely
sequenced in one representative strain, BB1021, using the primers
listed in Table
1. The complete plasmid had 4,613 bp and was
designated pB1000. PCR mapping, using primer pairs MAP-1/MAP-2,
MAP-3/rob-1U, MAP-4/rob-1F, and rob-1D/MAP-5 (Table
1), of all
resistant strains together with restriction analysis with PstI
showed that all
H. parasuis isolates resistant to ß-lactams
bore plasmid pB1000 encoding
blaROB-1. Sequence analysis of
pB1000 showed that the coding sequence was preceded by putative
35 5'-TTGCTA and 10 5'-CGCCAAAAT boxes, together
with a putative ribosome binding sequence, 5'-AAGGA, at an appropriate
distance. The
blaROB-1 gene was followed by a transcriptional
terminator with a stem of 18 nucleotides (with two mismatches)
and a loop formed by CTTGC. To ensure functionality of these
signals and the
blaROB-1 gene, pB1000 was transformed into
Escherichia coli Novablue Singles competent cells (Novagen, Merck Chemicals
Ltd., United Kingdom). The resulting transformants were highly
resistant to penicillin (MIC > 16), amoxicillin (MIC >
256), and cefaclor (MIC > 16) (Table
2), demonstrating that
the
blaROB-1 gene was functionally active and responsible for
the ß-lactam resistance phenotype. Apart from this
gene, pB1000 bore three genes,
mobA,
mobB, and
mobC, encoding,
respectively, three proteins of the relaxase family, MobA, MobB,
and MobC (Fig.
2A). The genetic organization of pB1000 suggests
that this replicon belongs to the recently described MOB
HEN family (
7). pB1000 was similar to plasmid pAB2 of a bovine
M. haemolytica isolate containing
blaROB-1 from Scotland (
21).
Interestingly, pB1000 was almost identical to an
H. parasuis plasmid, pHS-Tet, recovered from a clinical strain in Australia,
but with the
blaROB-1 gene instead of the
tet(B) gene (Fig.
2A) (
13). Detailed analysis showed that the
blaROB-1 gene was
flanked by a perfect direct repeat, GACTT (Fig.
2B), in pB1000
and pAB2, indicating that these sequences can mediate insertion
of the
blaROB-1 gene. Supporting this notion, the pHS-Tet replicon
contains a single copy of this sequence exactly in the insertion
site of the
blaROB-1 gene (Fig.
2B).
All ß-lactam-resistant
H. parasuis isolates bore plasmid
pB1000. In order to assess whether conjugation was implicated
in the spread of pB1000, liquid and filter mating experiments
were performed using
E. coli as the recipient. None of the experiments
gave transconjugants, showing that the conjugation machinery
for pB1000 was absent in all isolates. To get insight into the
diversity of the different isolates bearing pB1000, genetic
characterization was performed. For this purpose, pulsed-field
gel electrophoresis (PFGE) was applied for the first time to
H. parasuis with a novel protocol performed as follows.
Preparation of chromosomal DNA.
H. parasuis colonies were resuspended in 2 ml TE buffer (1x) (10 mM Tris-HCl, 1 mM EDTA [pH 8]) and adjusted to an optical density at 600 nm of 2; 200 µl of this suspension was mixed with 10 µl of 20-mg/ml proteinase K. Agarose plugs were made from a 1:1 mixture of agarose D-1 (low electroendosmosis; Pronadisa SA) and the cell suspension. After solidification, plugs were incubated in 5 ml of lysis buffer (50 mM Tris-HCl, 50 mM EDTA, 1% lauroylsarcosine, 2 µg/ml proteinase K) for 2 h at 55°C with agitation. Cells were then washed two times with 10 ml of MiliQ water and four times with 10 ml buffer TE (1x) for 10 min each at 50°C with agitation.
Restriction endonuclease digestion.
For analysis, one-half of a DNA-agarose plug was digested for 16 h with 10 U of SmaI (Takara Bio, Inc.) at 30°C according to the manufacturer's instructions. Preliminary experiments using XbaI and BspI gave rise to small (<200 kb) or few (<4) bands/strain, respectively.
PFGE analysis.
Plugs were loaded into a 1% agarose gel. PFGE was performed in 0.5x Tris-borate-EDTA buffer in a CHEF-DR III system (Bio-Rad). The following parameters were used: running time, 22 h; temperature, 14°C; field strength 6 V/cm; included angle, 120°; initial pulse time, 0.1 s; final pulse time, 25 s. The gels were stained with Sybr Safe (Invitrogen, Paisley, United Kingdom) for 20 min, distained in MiliQ water, and photographed under UV light. Lambda-ladder PFGE marker (New England Biolabs, Ipswich, MA) was used for molecular weight determinations. As a control, eight ß-lactam-susceptible H. parasuis clinical isolates and type strain ATCC 19417 were included. All susceptible strains, including ATCC 19417, showed a different PFGE pattern, whereas the profiles of all ß-lactam-resistant isolates were indistinguishable (Fig. 3). Thus, PFGE is a valuable technique for characterization of H. parasuis isolates that, in this study, has demonstrated that ß-lactam resistance in H. parasuis is the consequence of clonal spread of a ß-lactam-resistant strain. Analysis of the origin of the strains showed that they originated from different geographical regions. However, epidemiologic data strongly indicate that one of the farms could be the source of the strain, because it was the provider of piglets for the farms in which the rest of resistant strains were isolated.
This is the case for the isolates from Spain used in this study.
We cannot discard the possibility that in other countries, resistance
may be due to other factors. Such differences are very remarkable
in the case of the geographic distribution of TEM-1- and ROB-1-mediated
ß-lactam resistance in
H. influenzae. ROB-1-like ß-lactamases
are responsible for 0% of resistant isolates in Sweden, Argentina,
or Israel, whereas the prevalence of ROB-1 is 31.6% in Mexico,
13.2% in the United States, and 9.2% in Canada (
6). Such geographic
differences may also be encountered with
H. parasuis. However,
to our knowledge, the present study is the first work characterizing
ß-lactam resistance in this species. Work in other
regions will bring to light the implications of TEM-1 or ROB-1
enzymes in ß-lactam resistance in
H. parasuis.
(An initial report of this study was presented at the 16th European Congress for Clinical Microbiology and Infectious Diseases [19].)
Nucleotide sequence accession numbers.
Nucleotide sequences of this study have been deposited in GenBank under the following accession numbers: pB1000 from BB1021, DQ840517; blaROB-1 internal fragments, BB1018, DQ845801; BB1019, DQ845802; BB1020, DQ845803; BB1022, DQ845805; BB1023, DQ845806; BB1024, DQ845807; and BB1025, DQ845808.

ACKNOWLEDGMENTS
We thank J. F. Fernandez-Garayzabal for critical reading of
the manuscript. Patrice Courvalin and Bruno Perichon are acknowledged
for helpful discussion and help with hybridizations and A. Casamayor
for excellent technical support with PFGE. The VISAVET Group
is acknowledged for the clinical isolates.
We thank the National Ramon y Cajal Program from the Spanish Ministry of Education and Science for support of B.G.-Z., the Spanish Ministry of Education and Science for supporting the Ph.D. scholarships of A.S.M. and A.C., and the Universidad Complutense de Madrid for the Ph.D. scholarship of J.A.E. This work was partially financed by project PR1-A/07-15397 from the Universidad Complutense de Madrid and S-0505/AGR/000265 (Vigilancia Sanitaria Program) from the Consejeria de Educacion, Comunidad de Madrid, Madrid, Spain.

FOOTNOTES
* Corresponding author. Mailing address: Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, 28040 Madrid, Spain. Phone: 34 91 3943707. Fax: 34 91 3943908. E-mail:
bgzorn{at}vet.ucm.es 
Published ahead of print on 16 April 2007. 

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Antimicrobial Agents and Chemotherapy, June 2007, p. 2260-2264, Vol. 51, No. 6
0066-4804/07/$08.00+0 doi:10.1128/AAC.00242-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
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