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Antimicrobial Agents and Chemotherapy, October 2008, p. 3810-3813, Vol. 52, No. 10
0066-4804/08/$08.00+0 doi:10.1128/AAC.00233-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
Mutator Genes Giving Rise to Decreased Antibiotic Susceptibility in Pseudomonas aeruginosa
Irith Wiegand,
Alexandra K. Marr,
Elena B. M. Breidenstein,
Kristen N. Schurek,
Patrick Taylor, and
Robert E. W. Hancock*
Centre for Microbial Diseases and Immunity Research, Room 232, 2259 Lower Mall Research Station, University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z4
Received 20 February 2008/
Returned for modification 11 April 2008/
Accepted 23 July 2008

ABSTRACT
Screening of the PA14 genomic transposon mutant library for
resistance to ceftazidime, tobramycin, and ciprofloxacin led
to the discovery of several mutants that appeared in more than
one screen. Testing of the frequency of mutation to ciprofloxacin
resistance revealed previously known mutator genes, including
mutS and
mutL, as well as mutators that have not yet been described
for
P. aeruginosa, including PA3958 and RadA (PA4609).

TEXT
Pseudomonas aeruginosa is a metabolically versatile bacterium
capable of living in multiple ecological niches (
18), including
the airways of cystic fibrosis (CF) patients. One of the challenges
that it faces in the CF lung environment is intensive antibiotic
therapy. Hypermutable
P. aeruginosa isolates, with an increased
chromosomal mutation frequency leading to multidrug resistance
acquisition, are very frequently found in chronic CF lung infections
(37% [
1] and 54.5% [
14], respectively). Weak hypermutators with
modestly increased mutation frequencies are also observed in
the early stages of infection (5%), but the genetic basis for
these is unknown (
8). For
Escherichia coli, more than 30 different
mutator genes with functions in DNA repair or error avoidance
systems have been described to date (
5), some of which have
also been reported to lead to an increase in mutation frequency
in
P. aeruginosa.
We addressed the question of whether we would detect novel mutator genes in P. aeruginosa when screening the PA14 nonredundant transposon mutant library (10) for decreased susceptibility to different antibiotics, assuming that a hypermutator phenotype would lead to a decreased susceptibility to more than one class of antibiotics.
Overnight cultures were used to inoculate antibiotic-containing Mueller-Hinton agar plates with approximately 3 x 104 cells per spot, which still allowed the detection of resistant variants in a hypermutable population (15). The antibiotic concentrations used for screening were 2x the MIC of the parent strain, PA14, for ceftazidime, ciprofloxacin, and tobramycin (i.e., 4, 0.2, and 1 µg/ml, respectively), with tobramycin also being screened at 1 x the MIC (0.5 µg/ml). Low antibiotic concentrations were chosen to also detect mutations that lead to small decreases in antibiotic susceptibility, since these might be clinically significant if accumulated in a stepwise manner. Agar plates were checked after 24 h and 48 h of incubation at 37°C. The mutants corresponding to growth on the respective agar plates were confirmed to be less susceptible to the selective drug by determination of the MICs (22) after 24 h and 48 h. Mutants with a reproducible
2-fold increase in the MIC detected in more than one screen were studied further, as were transposon mutants with known mutator genes and genes that were annotated to be involved in DNA repair even if they appeared in only one screen.
Not all mutants that were detected in more than one antibiotic resistance screen showed an increase in mutation frequency (Table 1). For these (PA5001, PA1767, and PA1766), other, as yet undetermined mechanisms must have led to the observed reduced susceptibility.
As expected, several mutants with a mutator phenotype had disruptions
in DNA repair genes. The mutators
mutS and
mutL were detected
in all three screens (Table
1). The mechanism of the mismatch
repair has been well characterized for
E. coli and involves
MutS, MutL, MutH, and UvrD. While MutS, MutL, and UvrD homologs
are present in
P. aeruginosa and mutations in the respective
genes are found in clinical isolates with mutator phenotypes
(
12,
13),
P. aeruginosa lacks a MutH endonuclease homolog (
7).
A transposon interruption in gene PA3958, belonging to the endonuclease/exonuclease/phosphatase
family (
2), led to a threefold increase in the mutation frequency.
Reintroducing a functional copy of the gene PA3958 on a plasmid
lowered the mutation frequency to the wild-type level. Similarly,
an independently generated PA3958 mutant (
6) showed a fourfold
increase in mutation frequency. Thus, the PA3958 gene product
may be involved in DNA repair. Although
uvrD was not detected
in any of the screens, we confirmed that the deletion of the
uvrD gene in PA14 led to the expected increase in the mutation
frequency (Table
1). Growth curves of the UvrD parent and selected
ciprofloxacin-resistant mutants showed a decreased fitness compared
to the PA14 wild-type and selected ciprofloxacin-resistant mutants,
respectively (Fig.
1). This might explain why none of the resistance
screens detected the
uvrD transposon mutant and also the lower
occurrence of
uvrD mutants in the clinic (
12,
13).
Components of the oxidized guanine residue repair system, MutT,
MutY, and MutM, have strong, moderate, and weak mutator phenotypes,
respectively, in
E. coli (
3). The same tendencies occurred in
P. aeruginosa PA14 homologs, since
mutT,
mutY, and
mutM deletions
lead to 24-, 11-, and 6-fold increases in mutation frequencies,
respectively. To date, clinical isolates
of P. aeruginosa with
mutT or
mutM mutations have not been described (
16), although
the lack of a
mutY PCR band for clinical mutator strains from
two different patients was reported (
14).
AhpF is another component of defense against oxidative damage caused by reactive oxygen intermediates during aerobic growth. The ahpF transposon mutant of PA14 was detected in the ciprofloxacin screen. An ahpF deletion in E. coli leads to an approximately fourfold increase in the rifampin resistance mutation frequency (4), while Salmonella enterica serovar Typhimurium ahp deletion mutants do not show an elevated mutation frequency (5). We did not observe an increased mutation frequency of the aphF mutant compared to the wild type.
The above-mentioned mechanisms of prevention of damage due to reactive oxygen intermediates are relevant only during aerobic growth. For E. coli, it was shown that even the strong mutator phenotype of mutT deletion mutants was completely suppressed under anaerobic conditions (19). Since P. aeruginosa is thought to grow under reduced oxygen tension during chronic lung infections (17), the lung environment might not select for mutations in ahpF, mutT, mutM, or mutY.
A transposon mutant interrupted in the gene PA4609, the product of which is 78% similar to the E. coli RadA/Sms protein, was detected in two screens. It was shown to have a 15-fold-increased mutation frequency compared to the wild type, PA14 (Table 1), which was complemented to the wild-type level by reintroducing the gene PA4609 on a plasmid. RadA plays a role in the repair of collapsed replication forks by recombinational events. However, effects of radA deletions in E. coli are generally observed only when they are combined with recG or ruvABC mutations due to redundancy in recombinational functions (11). The increase in mutation frequency in Pseudomonas due to a transposon insertion in radA opens interesting questions about recombinational repair mechanisms in this species.
Mutants with disruptions of the two genes of the operon, PA3002 and PA3003, were detected in the tobramycin screen and in the tobramycin and ciprofloxacin screen, respectively. While we could not detect an increase in the mutation frequency for the PA3003 mutant, we observed a fourfold increase for the PA3002 deletion mutant (where PA3002 is the first gene in the operon). The annotated gene product Mfd shows 73% similarity to Mfd from E. coli. The latter displaces the RNA polymerase stalled at transcriptional blockages due to DNA damage and stimulates the recruitment of repair proteins to DNA lesions on the transcribed strand. The modestly increased mutation frequency of the PA14 mfd transposon mutant can thus most likely be attributed to the fact that a stalled RNA polymerase inhibits the repair of DNA lesions (20). An mfd transposon mutant was also detected in an independent gentamicin resistance screen of the PA01 lux fusion library (9) performed previously (data not shown). This previous screen also detected a mutant with a disruption of PA0750, coding for the uracil glycosylase Ung. The respective PA14 ung mutant showed a fourfold increase in mutation frequency. This result is in accordance with a sevenfold increase in the rifampin mutation frequency caused by inhibition of Ung via an inhibitory protein in P. aeruginosa (21).
This study demonstrates that broad screening of genomic libraries for resistance to multiple antibiotics can be utilized to identify mutator genes. Apart from the expected high-level hypermutators, we also detected mutators with modest increases in mutation frequencies. Disruption in those genes might be the genetic basis for the weak hypermutator phenotype seen in early CF isolates. Further work is needed to confirm the clinical relevance of these observations.

ACKNOWLEDGMENTS
This work was supported by grants from the Canadian Cystic Fibrosis
Foundation and the Canadian Institutes of Health Research. R.E.W.H.
holds a Canada Research Chair. I.W. thanks the Juergen Manchot
Foundation and the Mukoviszidose e.V., Bonn, Germany (German
Cystic Fibrosis Association), for financial support. K.N.S.
was supported by NSERC and the Michael Smith Foundation for
Health Research. E.B.M.B. was a recipient of a scholarship from
CCFF.

FOOTNOTES
* Corresponding author. Mailing address: Centre for Microbial Diseases and Immunity Research, Room 232, 2259 Lower Mall Research Station, University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z4. Phone: (604) 822 2682. Fax: (604) 827 5566. E-mail:
bob{at}cmdr.ubc.ca 
Published ahead of print on 28 July 2008. 

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Antimicrobial Agents and Chemotherapy, October 2008, p. 3810-3813, Vol. 52, No. 10
0066-4804/08/$08.00+0 doi:10.1128/AAC.00233-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
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