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Antimicrobial Agents and Chemotherapy, March 2009, p. 1256-1259, Vol. 53, No. 3
0066-4804/09/$08.00+0 doi:10.1128/AAC.01284-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
CMY-31 and CMY-36 Cephalosporinases Encoded by ColE1-Like Plasmids
A. Zioga,1
J. M. Whichard,2
S. D. Kotsakis,1
L. S. Tzouvelekis,3
E. Tzelepi,1 and
V. Miriagou1*
Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece,1
Division of Foodborne, Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia,2
Department of Microbiology, School of Medicine, University of Athens, Athens, Greece3
Received 24 September 2008/
Returned for modification 21 November 2008/
Accepted 13 December 2008

ABSTRACT
Two CMY-2 derivatives, CMY-31 (Gln
215
Arg) from
Salmonella enterica serotype Newport and CMY-36 (Ala
77
Cys and Gln
193
Glu) from
Klebsiella pneumoniae, were characterized. Both cephalosporinases functionally
resembled CMY-2.
blaCMY alleles occurred as parts of a putative
transposon comprising IS
Ecp1B and a
Citrobacter freundii-derived
sequence carried by ColE1-like plasmids similar to CMY-5-encoding
pTKH11 from
Klebsiella oxytoca.

INTRODUCTION
Various plasmid-mediated cephalosporinases, mainly from enterobacteria,
have been described. Producers of these enzymes are commonly
resistant to penicillins, penicillin-inhibitor combinations,
narrow-spectrum cephalosporins, and cefoxitin. Activities of
expanded-spectrum cephalosporins (ESCs) are also compromised
depending on the amount of cephalosporinase (
3,
17). Plasmid-mediated
cephalosporinases are classified into five evolutionary groups,
the most widespread being the group of
Citrobacter freundii-derived
enzymes, including CMY-2 and more than 30 variants (
17;
www.lahey.org/Studies/).
The
blaCMY-2 alleles are encountered in both hospital- and community-acquired
enterobacteria worldwide. Notably, they have emerged also in
nontyphoid salmonellae, including
Salmonella enterica serotype
Newport, currently spreading epidemically in the United States
(
9,
14,
17). The important role of IncA/C and IncI plasmids
in the diffusion of CMYs has been documented (
10). A CMY-5-encoding
ColE1-like plasmid has also been described (
24). We report here
on two CMY variants, CMY-31 and CMY-36, encoded by ColE1-like
plasmids.

CMY-producing microorganisms.
Serotype Newport AM17274 was submitted to the National Antibiotic
Resistance Monitoring System (CDC, Atlanta, GA) in 2003 from
Nevada.
Klebsiella pneumoniae HP205 was recovered in a hospital
in Athens, Greece, in 2005. β-Lactam MICs, determined by
agar dilution, indicated cephalosporinase production, i.e.,
resistance to penicillins, penicillin-inhibitor combinations,
cefoxitin, and ESCs and susceptibility to cefepime and imipenem
(Table
1). Isolates exhibited resistance also to sulfonamides
and streptomycin.
K. pneumoniae HP205 was, additionally, resistant
to trimethoprim, gentamicin, and tobramycin. Isolates were positive
in a
blaCMY-2-specific PCR (
6) and produced β-lactamases
with alkaline isoelectric points (pIs > 8.5 as determined
by isoelectric focusing) that, most likely, represented the
CMY cephalosporinases.
K. pneumoniae HP205 also produced a β-lactamase
with a pI of 7.6, consistent with the resident β-lactamase
of this species.
View this table:
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TABLE 1. β-Lactam susceptibility of the CMY-producing clinical isolates serotype Newport AM17274 and K. pneumoniae HP205 and E. coli DH5 clones carrying the wild-type plasmids pA172 and pH205 and the respective CMY-encoding recombinant plasmids
|

Characterization of CMY-31 and CMY-36.
Plasmids from AM17274 and HP205 were isolated with a Midi kit
(Qiagen, Hilden, Germany) and introduced into
Escherichia coli DH5

by transformation, yielding cephalosporin-resistant clones
(Table
1) containing
blaCMY-2-type genes located in similar
plasmids, pA172 from serotype Newport and pH205 from
K. pneumoniae.
Entire plasmid sequences were determined on both strands by
a primer walking approach using an API377 sequencer (Applied
Biosystems, Foster City, CA). Sequencing data showed that the
blaCMY gene in pA172 differed by a single nucleotide from
blaCMY-2 (GenBank accession no. X91840), resulting in a Gln
215
Arg substitution.
An identical gene (
blaCMY-31) has recently been identified in
K. pneumoniae in Switzerland (GenBank accession no. EF622224)
(
1). In pH205 the respective gene differed from
blaCMY-2 by
7 nucleotides (nt), and the putative novel cephalosporinase
(CMY-36) would include the substitutions Ala
77
Cys and Gln
193
Glu
compared to CMY-2. Each CMY protein comprised 381 amino acids,
including a 20-amino-acid putative signal peptide. The calculated
pIs (9.02 for CMY-31 and 8.94 for CMY-36) were in accordance
with those determined by isoelectric focusing (9.2 and 9.0,
respectively). Based on the structure of the
Enterobacter cloacae 908R β-lactamase (PDB entry 1Y54) (
13), it seems that Arg
215 is located in the

loop that is involved in the interaction
with β-lactam substrates (
15). Both substitutions in CMY-36
occur at positions distant from the active site cavity (Fig.
1).
The entire
blaCMY-type genes from pA172 and pH205, along with
the IS
Ecp1B-located promoter (
8), were amplified by PCR using
the primers ecp-F2 (5'-CG
GAATTCGTTGCTCTGTGGATAACTTG-3') and
ampC2 (5'-CG
GAATTCTTGCAGCTTTTCAAGAATGCGC-3') (nt 2084 to 2103
and 3496 to 3517, respectively [GenBank accession no. EU331425
and EU331426, respectively]), which also contained EcoRI restriction
sites (underlined). Amplicons (1,434 bp) were restricted with
EcoRI and ligated into the high-copy-number vector pBCSK(+)
(Stratagene, La Jolla, CA), resulting in plasmids pB-cmy31 and
pB-cmy36. Plasmid pB-cmy31 was utilized to construct a similar
blaCMY-2-carrying plasmid (pB-cmy2) by site-directed mutagenesis
with a QuikChange mutagenesis kit (Stratagene) and the mutagenic
primers cmF (5'-TTTCTCCGGGAC
AACTTGACGCCGA-3') and cmR (5'-TCGGCGTCAAGT
TGTCCCGGAGAAA-3')
(nt 3066 to 3090 in EU331425; G

A [underlined] in codon 215,
resulting in Arg

Gln). Mutations were verified by sequencing
at least two independently amplified PCR products.
Plasmids pB-cmy31, pB-cmy36, and pB-cmy2 were introduced into E. coli DH5
. β-Lactam MICs showed that the three CMY variants conferred comparable levels of resistance to cefotaxime, ceftazidime, ceftriaxone, piperacillin, and piperacillin-tazobactam. MICs of ampicillin, amoxicillin (amoxicilline)-clavulanate, ticarcillin, and cefoxitin, however, exceeded the range of dilutions tested. The strains were susceptible to cefepime and imipenem (Table 1).
Substrate and inhibition profiles of the CMY enzymes were also determined. Cell suspensions of the E. coli DH5
clones carrying pB-cmy31, pB-cmy36, and pB-cmy2 were sonicated, and extracts were clarified by ultracentrifugation. Cephalosporinase purification was performed by two ion-exchange chromatography steps using Q- and S-Sepharose (16). Purity of the preparations was >90%, as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Kinetic parameters for penicillin G, ampicillin, cephaloridine, cephalothin (cefalotin), nitrocefin, and cefotaxime hydrolysis were studied by spectrophotometry (16). Interaction of CMY-31 and CMY-36 with β-lactam substrates was typical for enterobacterial AmpCs (i.e., rapid hydrolysis of early-generation cephalosporins and significantly lower rates of hydrolysis of penicillins and oxyimino-cephalosporins). Kinetic parameters of the two CMY enzymes did not differ significantly from those of CMY-2, determined in parallel (Table 2). Inhibitory activities of cloxacillin, aztreonam, and Ro 48-1220 against CMY-31, CMY-36, and CMY-2 were studied by UV spectrophotometry using cephalothin (100 µM) as a reporter substrate. Results were expressed as 50% inhibitory concentrations (IC50s). Inhibition profiles for the three CMY variants were similar. Both cloxacillin and aztreonam were potent inhibitors (IC50s were 0.004 and 0.006 to 0.007 µM, respectively). IC50 values for Ro 48-1220 ranged from 0.3 to 0.35 µM. Taken together with the similar MICs under isogenic conditions, these data indicated that CMY-31 and CMY-36 are functionally similar to CMY-2.

Characteristics of CMY-encoding plasmids.
pA172 and pH205 each comprised 8,197 bp and differed at 33 and
40 nt positions, respectively, from pTKH11 (GenBank accession
no. Y17716), a ColE1-like
blaCMY-5-carrying plasmid from
K. oxytoca isolated in Sweden in 1991 (
24). Sequence annotation
for pA172 and pH205 (GenBank accession no. EU331425 and EU331426)
complements that proposed for pTKH11 (
24) by including recently
characterized IS
Ecp1B (
18) as well as the
oriT and
cer regions.
Each plasmid carried an ISEcp1B-associated C. freundii-derived sequence of 2,088 bp (blaCMY, blc [encoding lipocalin], and sugE [encoding a small multidrug resistance protein]) flanked by 5-bp target site duplications (5'-GATTA-3'; nt 604 to 608 and 4634 to 4638 in EU331425 and EU331426) and inserted into a ColE1-like backbone of 4,167 bp. An oriV (nt 1599 to 1601) was located 40 bp from the regulatory elements RNA II (511 bases) and RNA I (105 bases) (4). ORF7 (471 bp), downstream of RNA I, resembled a remnant (mobB) of the mob gene array of ColE1 (23). ORF6 (594 bp), of unknown function, was located between mobB and the CMY-encoding element. An AT-rich 227-bp sequence (nt 7094 to 7311) exhibiting 81% homology with the transfer origin (oriT) from pIP843 and pJHCMW1 (5, 20) and a 266-bp sequence (nt 7964 to 8182) 95% homologous to the cer (ColE1 resolution) recombination site implicated in plasmid monomerization and stability (22) were also identified (Fig. 2).
To test their mobilization capability, plasmids pA172 and pH205
were introduced into
E. coli XL1-Blue, which harbors fertility
factor F', an IncFIA conjugative plasmid. The resulting transformants
were able to transfer the CMY-encoding plasmids to
E. coli DH5a
during conjugation at a relatively low frequency (10
–7 blaCMY-positive clones per donor cell).

Conclusions.
Most plasmid-mediated
blaCMY genes have likely originated from
blaCMY-2 through point mutations, leading to the present array
of CMY variants (
2). CMY-31 and CMY-36 exhibit activities similar
to that of CMY-2. Therefore, the respective amino acid changes,
including Gln
215
Arg in the

loop, are probably not associated
with selective pressure exerted by drugs such as ESCs. The common-origin
hypothesis of the plasmid-borne
blaCMY alleles is also in line
with the similarity of their genetic environments. The elements
from the ColE1-like plasmids, as well as a similar CMY-2-encoding
transposon from an IncI plasmid (
21), occur as shorter versions
of IS
Ecp1B-associated sequences from a variety of plasmids (
8,
10,
11). It can be hypothesized that these transposon-like sequences
are derived from a common element through alterations in the
right-hand end that may arise during IS
Ecp1B-mediated transposition
(
18,
19). Nevertheless, an alternative evolutionary route, such
as multiple transposition events in a
blaCMY-containing sequence
from a single
C. freundii strain, cannot be ruled out.
A possible role for a ColE1-like plasmid in the global spread of CMYs is also indicated. This plasmid species was probably formed through transposition of a C. freundii-originating sequence into a ColE1 replicon and diverged by point mutations. It was first identified in clinical Enterobacteriaceae in the early 1990s in Sweden (24) and Greece (7; our unpublished data) and, as indicated here, persists in the latter country. Notably, the CMY-encoding ColE1-like plasmid has also been acquired by an important food-borne pathogen, Salmonella serotype Newport. ColE1 can be mobilized by plasmids with apparently different conjugation systems such as InFI, IncI1, and IncP. Mobilization efficiency depends on the proteins encoded by the mob genes of ColE1 (23). Nevertheless, there have been examples of mobilization of ColE1 derivatives, in which, as in the ones described here, the full array of mob genes are deleted. The presence of an oriT sequence may play a role in this process (12). Whichever the mechanism, the in vitro mobilization shown here and the carriage by different bacterial species underscore the spreading potential of these CMY-encoding ColE1-like plasmids.

ACKNOWLEDGMENTS
This work was supported by the Hellenic Pasteur Institute and
Kapodistrias grant 70/4/9103 from the University of Athens.
The National Antibiotic Resistance Monitoring System is funded
through an interagency agreement between the U.S. Food and Drug
Administration Center for Veterinary Medicine and the Centers
for Disease Control and Prevention.

FOOTNOTES
* Corresponding author. Mailing address: Laboratory of Bacteriology, Hellenic Pasteur Institute, Vas. Sofias 127, Athens 11521, Greece. Phone: 30-210-6478810. Fax: 30-210-6426323. E-mail:
miriagou{at}pasteur.gr 
Published ahead of print on 22 December 2008. 

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Antimicrobial Agents and Chemotherapy, March 2009, p. 1256-1259, Vol. 53, No. 3
0066-4804/09/$08.00+0 doi:10.1128/AAC.01284-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
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