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Antimicrobial Agents and Chemotherapy, August 2008, p. 2929-2932, Vol. 52, No. 8
0066-4804/08/$08.00+0 doi:10.1128/AAC.00349-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
ISEcp1-Mediated Transposition of qnrB-Like Gene in Escherichia coli
Vincent Cattoir,1
Patrice Nordmann,1*
Jesus Silva-Sanchez,2
Paula Espinal,3 and
Laurent Poirel1
Service de Bactériologie-Virologie, INSERM U914 "Emerging Resistance to Antibiotics," Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, K.-Bicêtre, France,1
Departamento de Resistencia Bacteriana, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico,2
Facultad de Ciencias de la Salud, Universidad del Sinú, Montería, Colombia3
Received 12 March 2008/
Returned for modification 27 April 2008/
Accepted 24 May 2008

ABSTRACT
A novel QnrB-like plasmid-mediated resistance determinant, QnrB19,
was identified from an
Escherichia coli clinical isolate from
Colombia. Its gene was associated with an IS
Ecp1-like insertion
element that did not act as a promoter for its expression. Using
an in vitro model of transposition, we showed that the IS
Ecp1-like
element was able to mobilize the
qnrB19 gene.

TEXT
Resistance to quinolones in
Enterobacteriaceae most commonly
arises stepwise as a result of chromosomal mutations responsible
for the modification of target enzymes (DNA gyrase and topoisomerase
IV) or decreased intracellular drug accumulation by the upregulation
of efflux pumps and/or modified outer-membrane porins (
27).
Since the discovery of the first plasmid-mediated quinolone
resistance (PMQR) determinant, QnrA, in 1998 (
15), four other
PMQR determinants have been identified to date: the QnrB (
12)
and QnrS (
10) proteins, the aminoglycoside acetyltransferase
AAC(6')-Ib-cr (
25), and the efflux pump QepA (
19,
30). Resistance
due to Qnr determinants is increasingly reported worldwide in
enterobacterial isolates (
18,
26) and has been recently identified
outside
Enterobacteriaceae in environmental
Aeromonas isolates
from France (
3). The three types of Qnr determinants, QnrA,
QnrB, and QnrS, belong to the pentapeptide repeat family of
proteins (
18,
26). By protecting DNA gyrase and topoisomerase
IV from the inhibitory activity of quinolones, Qnr proteins
confer resistance to quinolones (e.g., nalidixic acid) and decreased
susceptibility to fluoroquinolones, therefore facilitating the
recovery of chromosome-encoded target mutants with a higher
level of resistance to fluoroquinolones (
18,
26). Whereas
qnrA-like
genes have only been identified as part of the complex
sul1-type
integrons in association with the
orf513 transposase gene (
18,
26), which is part of a region redefined as IS
CR1 (
28),
qnrB-like
genes have been found to be associated with either the
orf1005 gene encoding a putative transposase (
12) or the IS
CR1 element
(
8,
24).
The aim of this study was (i) to investigate the genetic environment of a qnrB-like gene from an Escherichia coli clinical isolate, (ii) to evaluate experimentally the mobility of that putative transposon in E. coli, and (iii) to determine the promoter sequences of the qnrB-like gene responsible for the expression of that gene.
E. coli R4525 expressing an extended-spectrum β-lactamase (ESBL) phenotype had been isolated in 2002 from a wound culture of a patient hospitalized at the Hospital San Jeronimo in Monteria, Colombia. In the course of studying the genetic support of the ESBL determinant in E. coli R4525, conjugation experiments followed by selection with sodium azide (100 µg/ml) and amoxicillin (50 µg/ml) as previously described (3) gave E. coli J53 transconjugants displaying an ESBL phenotype and decreased susceptibility to fluoroquinolones. This result prompted us to search for the presence of PMQR determinants. The screening of qnr genes using a multiplex strategy (5) identified a qnrB-like gene in both E. coli R4525 and its transconjugant. By contrast, PCR screening performed as described previously (16) did not detect any AAC(6')-Ib-cr- or QepA-encoding gene. The qnrB-like gene was sequenced and found to encode a novel determinant, which was termed QnrB19 in accordance with the recent qnr gene nomenclature (11). It differed by a single amino acid substitution at position 212 from QnrB5 (GenBank accession no. DQ303919) previously identified in a non-Typhi Salmonella isolate from the United States (9). The MICs were determined on Mueller-Hinton solid agar plates and the results interpreted according to the Clinical and Laboratory Standards Institute guidelines (6). E. coli R4525 was resistant to aminoglycosides (except amikacin), chloramphenicol, tetracycline, sulfonamides, and trimethoprim (data not shown). It was resistant to nalidixic acid (MIC > 32 µg/ml) and fluoroquinolones (MICs > 32 µg/ml) (Table 1). Sequence analysis of the quinolone-resistance determining regions (QRDRs) of the gyrA and parC genes by using primers previously described (2) showed that E. coli R4525 possessed two amino acid substitutions both in GyrA (Ser83Leu and Asp87Tyr) and ParC (Ser80Ile and Glu84Gly), compared to wild-type QRDRs of E. coli (Table 1), known to confer resistance to quinolones and fluoroquinolones (27). Plasmid analysis of the E. coli J53 transconjugant using the Kieser technique (13) identified a single 40-kb plasmid (pR4525) shown by PCR to carry the blaCTX-M-12, blaSHV-12, and qnrB19 genes (data not shown). As previously reported for QnrB-like proteins, QnrB19 expressed in the E. coli transconjugant conferred increased MICs of quinolones and fluoroquinolones (Table 1) (9, 12, 24).
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TABLE 1. MICs of quinolones for the E. coli clinical isolate R4525, its transconjugant, and reference strain E. coli J53 Azr
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Since preliminary experiments failed to identify genetic structures
that had been associated with
qnrB-like genes (
8,
12,
24), cloning
experiments were performed with EcoRI-restricted whole-cell
DNA of an
E. coli R4525 isolate, followed by the ligation of
DNA fragments into the EcoRI site of cloning vector pBK-CMV
(Stratagene, La Jolla, CA), as previously described (
3). Analysis
of a 3.2-kb DNA fragment carrying the
qnrB19 gene identified
its location downstream of the extremity of an IS
Ecp1-like element
(Fig.
1). The transposase of the IS
Ecp1-like element (termed
IS
Ecp1C) differed by one and two amino acids from those of IS
Ecp1 (GenBank accession no. AJ242809) and IS
Ecp1B (GenBank accession
no. AF458080), respectively, whereas its imperfect inverted
repeat left (IRL) and right (IRR1) sequences (2 bp mismatches)
were identical to those of IS
Ecp1 and IS
Ecp1B (Fig.
1). IS
Ecp1-like
elements have been identified at the 5' end of several β-lactamase
genes, such as the
blaCTX-M,
blaCMY, and
blaACC genes, and associated
with the 16S rRNA methyltransferase gene
rmtC, enabling those
genes to be transposed (
7,
14,
17,
22,
23,
29).
The
qnrB19 gene was part of a 2,739-bp potential transposon
flanked by a 5-bp duplication of the target site (ATCAA), likely
evidence of a transposition event (Fig.
1). This potential transposon
(named Tn
2012), comprising IS
Ecp1C and
qnrB19, was inserted
inside the
orf1 gene of the transposon Tn
1721 (Fig.
1). Tn
1721 is an 11.1-kb nonconjugative transposon belonging to the Tn
21 subgroup of the Tn
3 family of bacterial transposons that confers
inducible tetracycline resistance (
1). The novel transposon
Tn
2012 was bracketed by two imperfect 14-bp IR sequences (seven
mismatches), namely, the IRL of IS
Ecp1C and an IRR named IRR2
(Fig.
1). This IRR2 sequence shared 7 out of 14 bp with the
original IRR1 of IS
Ecp1C. This observation is in accordance
with previous studies (
14,
22,
23), showing that IS
Ecp1B was
able to use as IRRs sequences sharing weak identity with its
original IRR1, corresponding to a one-ended transposition mechanism.
Transposition experiments were performed as previously described (14, 22) in order to determine whether ISEcp1C was able to mobilize the qnrB19 gene. Briefly, the sequence of the entire Tn2012 transposon was amplified by PCR using primers orf1-A (5'-CGACAACGGATATTCAAAGC-3') and orf1-B (5'-ACTTTGCAAATTATTCTGCCC-3') and then cloned into the kanamycin-resistant pCR-BluntII-TOPO plasmid (Invitrogen). This recombinant plasmid, first transferred and selected in E. coli TOP10 (Invitrogen), was used for the electrotransformation of E. coli RZ211 (pOX38-Gm). Plasmid pOX38-Gm is a self-conjugative and insertion element-free plasmid carrying a gentamicin resistance marker. The transposition of Tn2012 from the recombinant pCR-BluntII-TOPO derivative to plasmid pOX38-Gm was investigated after 24 h of growth in Trypticase soy broth by mating RZ211 with azide-resistant E. coli J53 and selecting for transconjugants growing on agar plates containing 8 µg of gentamicin per ml, 6 µg of nalidixic acid per ml, and 100 µg of azide per ml. The plasmid DNA of several nalidixic acid-resistant transconjugants was extracted and pOX38-Gm sequencing confirmed the ISEcp1C-mediated transposition of qnrB19. The transposition frequency, calculated by dividing the number of transconjugants by the number of donors, was estimated to be 10–6 to 10–7 per donor cell. Moreover, an analysis of five insertion events of ISEcp1C-qnrB19 sequences in plasmid pOX38-Gm showed that transposition had occurred into five different sites distantly located on the recipient plasmid. Alignment of the target sites revealed variable sequences (ATTAT, ATTAC, TCATA, TACAT, and TTCAT), exhibiting an AT-rich content as previously observed (14, 22).
It has been shown that ISEcp1-like elements may bring promoter sequences for the high-level expression of downstream-located β-lactamase genes (17, 23, 29). However, as opposed to what has been reported for those genes, the qnrB19 gene was located in an opposite orientation with respect to the transposase gene of ISEcp1C (Fig. 1). The promoter sequences for the qnrB19 expression were determined by using the 5' rapid amplification of cDNA ends technique (Invitrogen). Total RNA was extracted from cultures of E. coli R4525 by using the RNeasy Protect mini kit (Qiagen, Courtaboeuf, France). The +1 transcription start site was identified 28 bp upstream of an ATG codon located inside the presumed qnrB19 gene. This prompted us to consider the qnrB19 gene to be only 645 bp long and the QnrB19 protein to be 214 amino acids long, not 226 amino acids long as previously considered for QnrB1 (11, 12). This result is in accordance with other observations showing that the putative QnrB1 sequence was longer than the QnrA and QnrS sequences but also than other chromosome-encoded Qnr-like sequences from Vibrionaceae (11, 21). The deduced promoter region based on the +1 start site identified a –35 box (TTGACG) and a –10 box (TACCAT) separated by a 17-bp sequence (Fig. 2).
We have demonstrated here that an IS
Ecp1 element was at the
origin of the acquisition of a
qnrB-like gene (
qnrB19) and that
it was not involved in the expression of that gene, as opposed
to what has been reported for other antibiotic resistance genes.
Although several
qnrB-like genes have been reported to be associated
with IS
CR1, we report here a novel genetic structure responsible
for
qnrB acquisition and dissemination. It remains to be determined
what could be the natural reservoir of IS
Ecp1-like elements
since it is associated with structurally unrelated resistance
determinants of various origins, such as the
blaCTX-M and
blaCMY genes from
Enterobacteriaceae and the
qnr-like genes from
Vibrionaceae and
Shewanellaceae (
4,
20).
Nucleotide sequence accession number.
The nucleotide sequence of the qnrB19 gene and that of Tn2012 shown in Fig. 1 were submitted to the GenBank database and can be found under accession no. EU432277 and EU523120, respectively.

ACKNOWLEDGMENTS
This work was financed by a grant from the Ministère
de l'Education Nationale et de la Recherche (grant UPRES, EA3539),
Université Paris XI, Paris, France, and by the European
Community (6th PCRD,
LSHM-
CT-
2005-
018705).

FOOTNOTES
* Corresponding author. Mailing address: Service de Bactériologie-Virologie-Hygiène, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France. Phone: 33-1-45-21-36-32. Fax: 33-1-45-21-63-40. E-mail:
nordmann.patrice{at}bct.aphp.fr 
Published ahead of print on 2 June 2008. 

REFERENCES
1 - Allmeier, H., B. Cresnar, M. Greck, and R. Schmitt. 1992. Complete nucleotide sequence of Tn1721: gene organization and a novel gene product with features of a chemotaxis protein. Gene 111:11-20.[CrossRef][Medline]
2 - Cattoir, V., P. Lesprit, C. Lascols, E. Denamur, P. Legrand, C. J. Soussy, and E. Cambau. 2006. In vivo selection during ofloxacin therapy of Escherichia coli with combined topoisomerase mutations that confer high resistance to ofloxacin but susceptibility to nalidixic acid. J. Antimicrob. Chemother. 58:1054-1057.[Abstract/Free Full Text]
3 - Cattoir, V., L. Poirel, C. Aubert, C. J. Soussy, and P. Nordmann. 2008. Unexpected occurrence of plasmid-mediated quinolone resistance determinants in environmental Aeromonas spp. Emerg. Infect. Dis. 14:231-237.[Medline]
4 - Cattoir, V., L. Poirel, D. Mazel, C. J. Soussy, and P. Nordmann. 2007. Vibrio splendidus as the source of plasmid-mediated QnrS-like quinolone resistance determinants. Antimicrob. Agents Chemother. 51:2650-2651.[Free Full Text]
5 - Cattoir, V., L. Poirel, V. Rotimi, C. J. Soussy, and P. Nordmann. 2007. Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates. J. Antimicrob. Chemother. 60:394-397.[Abstract/Free Full Text]
6 - Clinical and Laboratory Standards Institute. 2006. Performance standards for antimicrobial disk susceptibility tests. Approved standard, M2-A9, 9th ed. Clinical and Laboratory Standards Institute, Wayne, PA.
7 - Doloy, A., C. Verdet, V. Gautier, D. Decré, E. Ronco, A. Hammami, A. Philippon, and G. Arlet. 2006. Genetic environment of acquired blaACC-1 β-lactamase gene in Enterobacteriaceae isolates. Antimicrob. Agents Chemother. 50:4177-4181.[Abstract/Free Full Text]
8 - Garnier, F., N. Raked, A. Gassama, F. Denis, and M.-C. Ploy. 2006. Genetic environment of quinolone resistance gene qnrB2 in a complex sul1-type integron in the newly described Salmonella enterica serovar Keurmassar. Antimicrob. Agents Chemother. 50:3200-3202.[Abstract/Free Full Text]
9 - Gay, K., A. Robicsek, J. Strahilevitz, C. H. Park, G. Jacoby, T. J. Barrett, F. Medalla, T. M. Chiller, and D. C. Hooper. 2006. Plasmid-mediated quinolone resistance in non-Typhi serotypes of Salmonella enterica. Clin. Infect. Dis. 43:297-304.[CrossRef][Medline]
10 - Hata, M., M. Suzuki, M. Matsumoto, M. Takahashi, K. Sato, S. Ibe, and K. Sakae. 2005. Cloning of a novel gene for quinolone resistance from a transferable plasmid in Shigella flexneri 2b. Antimicrob. Agents Chemother. 49:801-803.[Abstract/Free Full Text]
11 - Jacoby, G., V. Cattoir, D. Hooper, L. Martinez-Martinez, P. Nordmann, A. Pascual, L. Poirel, and M. Wang. 2008. qnr gene nomenclature. Antimicrob. Agents Chemother. 52:2297-2299.[Free Full Text]
12 - Jacoby, G. A., K. E. Walsh, D. M. Mills, V. J. Walker, H. Oh, A. Robicsek, and D. C. Hooper. 2006. qnrB, another plasmid-mediated gene for quinolone resistance. Antimicrob. Agents Chemother. 50:1178-1182.[Abstract/Free Full Text]
13 - Kieser, T. 1984. Factors affecting the isolation of CCC DNA from Streptomyces lividans and Escherichia coli. Plasmid 12:19-36.[CrossRef][Medline]
14 - Lartigue, M. F., L. Poirel, D. Aubert, and P. Nordmann. 2006. In vitro analysis of ISEcp1B-mediated mobilization of naturally occurring β-lactamase gene blaCTX-M of Kluyvera ascorbata. Antimicrob. Agents Chemother. 50:1282-1286.[Abstract/Free Full Text]
15 - Martinez-Martinez, L., A. Pascual, and G. A. Jacoby. 1998. Quinolone resistance from a transferable plasmid. Lancet 351:797-799.[CrossRef][Medline]
16 - Minarini, L. A., L. Poirel, V. Cattoir, A. L. Darini, and P. Nordmann. Plasmid-mediated quinolone resistance determinants among enterobacterial isolates from outpatients in Brazil. J. Antimicrob. Chemother., in press.
17 - Nakano, R., R. Okamoto, N. Nagano, and M. Inoue. 2007. Resistance to gram-negative organisms due to high-level expression of plasmid-encoded ampC β-lactamase blaCMY-4 promoted by insertion sequence ISEcp1. J. Infect. Chemother. 13:18-23.[CrossRef][Medline]
18 - Nordmann, P., and L. Poirel. 2005. Emergence of plasmid-mediated resistance to quinolones in Enterobacteriaceae. J. Antimicrob. Chemother. 56:463-469.[Abstract/Free Full Text]
19 - Périchon, B., P. Courvalin, and M. Galimand. 2007. Transferable resistance to aminoglycosides by methylation of G1405 in 16S rRNA and to hydrophilic fluoroquinolones by QepA-mediated efflux in Escherichia coli. Antimicrob. Agents Chemother. 51:2464-2469.[Abstract/Free Full Text]
20 - Poirel, L., J. M. Rodriguez-Martinez, H. Mammeri, A. Liard, and P. Nordmann. 2005. Origin of plasmid-mediated quinolone resistance determinant QnrA. Antimicrob. Agents Chemother. 49:3523-3525.[Abstract/Free Full Text]
21 - Poirel, L., A. Liard, J. M. Rodriguez-Martinez, and P. Nordmann. 2005. Vibrionaceae as a possible source of Qnr-like quinolone resistance determinants. J. Antimicrob. Chemother. 56:1118-1121.[Abstract/Free Full Text]
22 - Poirel, L., M. F. Lartigue, J. W. Decousser, and P. Nordmann. 2005. ISEcp1B-mediated transposition of blaCTX-M in Escherichia coli. Antimicrob. Agents Chemother. 49:447-450.[Abstract/Free Full Text]
23 - Poirel, L., J. W. Decousser, and P. Nordmann. 2003. Insertion sequence ISEcp1B is involved in the expression and mobilization of a blaCTX-M β-lactamase gene. Antimicrob. Agents Chemother. 47:2938-2945.[Abstract/Free Full Text]
24 - Quiroga, M. P., P. Andres, A. Petroni, A. J. C. S. Bistué, L. Guerriero, L. J. Vargas, A. Zorreguieta, M. Tokumoto, C. Quiroga, M. E. Tolmasky, M. Galas, and D. Centron. 2007. Complex class 1 integrons with diverse variable regions, including aac(6')-Ib-cr, and a novel allele, qnrB10, associated with ISCR1 in clinical enterobacterial isolates from Argentina. Antimicrob. Agents Chemother. 51:4466-4470.[Abstract/Free Full Text]
25 - Robicsek, A., J. Strahilevitz, G. A. Jacoby, M. Macielag, D. Abbanat, C. H. Park, K. Bush, and D. C. Hooper. 2006. Fluoroquinolone-modifying enzyme: a new adaptation of a common aminoglycoside acetyltransferase. Nat. Med. 12:83-88.[CrossRef][Medline]
26 - Robicsek, A., G. A. Jacoby, and D. C. Hooper. 2006. The worldwide emergence of plasmid-mediated quinolone resistance. Lancet Infect. Dis. 6:629-640.[CrossRef][Medline]
27 - Ruiz, J. 2003. Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J. Antimicrob. Chemother. 51:1109-1117.[Abstract/Free Full Text]
28 - Toleman, M. A., P. M. Bennett, and T. R. Walsh. 2006. ISCR elements: novel gene-capturing systems of the 21st century? Microbiol. Mol. Biol. Rev. 70:296-316.[Abstract/Free Full Text]
29 - Wachino, J., K. Yamane, K. Kimura, N. Shibata, S. Suzuki, Y. Ike, and Y. Arakawa. 2006. Mode of transposition and expression of 16S rRNA methyltransferase gene rmtC accompanied by ISEcp1. Antimicrob. Agents Chemother. 50:3212-3215.[Abstract/Free Full Text]
30 - Yamane, K., J. Wachino, S. Suzuki, K. Kimura, N. Shibata, H. Kato, K. Shibayama, T. Konda, and Y. Arakawa. 2007. New plasmid-mediated fluoroquinolone efflux pump, QepA, found in an Escherichia coli clinical isolate. Antimicrob. Agents Chemother. 51:3354-3360.[Abstract/Free Full Text]
Antimicrobial Agents and Chemotherapy, August 2008, p. 2929-2932, Vol. 52, No. 8
0066-4804/08/$08.00+0 doi:10.1128/AAC.00349-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
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