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[青霉素结合蛋白2B、1A、2X的氨基酸替换对β-内酰胺类药物对肺炎链球菌最低抑菌浓度的影响]

[Effects of amino acid substitutions of penicillin-binding proteins 2B, 1A, 2X on minimal inhibitory concentration of beta-lactams against Streptococcus pneumoniae].

作者信息

Xu Min, Zhang Jian-hua, Ding Yun-fang, Tao Yun-zhen, Wang Zi-cai

机构信息

Department of Pediatrics, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China.

出版信息

Zhonghua Er Ke Za Zhi. 2010 Jan;48(1):60-4.

Abstract

OBJECTIVE

To observe the effect of amino acid substitution in conserved sequence of penicillin-binding protein (PBP) 1A, 2B, 2X on antimicrobial activity of beta-lactams against Streptococcus pneumoniae (SP).

METHOD

Minimal inhibitory concentration (MIC) of 6 beta-lactams was determined by the E-test in 59 SP strains. The penicillin-binding protein genes pbp1a, 2b, 2x in every SP strain were amplified by nested-polymerase chain reaction (nPCR), then the PCR products were sequenced using automatic genetic analyzer directly. To analyze the amino acid substitutions, the DNA sequences were converted to protein sequences and aligned by Clustalx software. According to amino acid substitution in conserved sequence of PBP2B, 3 phenotypes were observed, including: PBP2B phenotype I (no amino acid substitution); PBP2B phenotype II (Glutamine 432-->Leucine and/or Threonine 445/451-->Alanine/Serine, Glutamic 481-->Glycine, 1 strain had proline insertion between residues 431/432); PBP2B phenotype III (Alanine 624-->Glycine with the addition of phenotype II). According to amino acid substitution in conserved sequence of PBP1A, 3 phenotypes were observed, including: PBP1A phenotype I (no amino acid substitution); PBP1A phenotype II (Threonine 574-->Asparagine, Serine 575-->Threonine, Glutamine 576-->Glycine, Phenylalanine 577-->Tyrosine, 574TSQF-->NTGY); PBP1A III (Threonine 371-->Alanine/Serine, Proline 432-->Threonine with the addition of 574TSQF-->NTGY). According to amino acid substitution in conserved sequence of PBP2X, 4 phenotypes were observed, including: PBP2X phenotype I (no amino acid substitution); PBP2X phenotype II (Histidine 394-->Leucine or Threonine 338-->Alanine); PBP2X phenotype III (Threonine 338-->Alanine, Isoleucine 371-->Threonine, Arginine 384-->Glycine and Leucine 546-->Valine); PBP2X phenotype IV (Methionine 339-->Phenylalanine, Methionine 400-->Threonine with the addition of PBP2X phenotype III).

RESULT

Among 59 SP strains antibacterial activities distribution (sensitive strains, intermediate strains and resistant strains) of 6 beta-lactams were penicillin (12, 29, 18); amoxicillin(49, 9, 1); cefuroxime (16, 16, 27); ceftriaxone (47, 1, 11); cefotaxime (47, 3, 9); imipenem (49, 10, 0). beta-lactam antibiotics insensitive strains (intermediate + resistant strain) in PBP2B phenotype III, PBP1A phenotype III, PBP2X phenotype III and IV were significantly increased, the MIC(50) of these strains were significantly higher than that of the others.

CONCLUSION

The amino acid substitutions in or vicinal conserved sequence of PBP of SP increase MIC for beta-lactam antibiotics.

摘要

目的

观察青霉素结合蛋白(PBP)1A、2B、2X保守序列中的氨基酸替代对β-内酰胺类抗生素抗肺炎链球菌(SP)抗菌活性的影响。

方法

采用E-test法测定59株SP菌株对6种β-内酰胺类抗生素的最低抑菌浓度(MIC)。通过巢式聚合酶链反应(nPCR)扩增各SP菌株中的青霉素结合蛋白基因pbp1a、2b、2x,然后直接使用自动基因分析仪对PCR产物进行测序。为分析氨基酸替代情况,将DNA序列转换为蛋白质序列并使用Clustalx软件进行比对。根据PBP2B保守序列中的氨基酸替代情况,观察到3种表型,包括:PBP2B表型I(无氨基酸替代);PBP2B表型II(谷氨酰胺432→亮氨酸和/或苏氨酸445/451→丙氨酸/丝氨酸,谷氨酸481→甘氨酸,1株在残基431/432之间有脯氨酸插入);PBP2B表型III(丙氨酸624→甘氨酸并伴有表型II)。根据PBP1A保守序列中的氨基酸替代情况,观察到3种表型,包括:PBP1A表型I(无氨基酸替代);PBP1A表型II(苏氨酸574→天冬酰胺,丝氨酸575→苏氨酸,谷氨酰胺576→甘氨酸,苯丙氨酸577→酪氨酸,574TSQF→NTGY);PBP1A III(苏氨酸371→丙氨酸/丝氨酸,脯氨酸432→苏氨酸并伴有574TSQF→NTGY)。根据PBP2X保守序列中的氨基酸替代情况,观察到4种表型,包括:PBP2X表型I(无氨基酸替代);PBP2X表型II(组氨酸394→亮氨酸或苏氨酸338→丙氨酸);PBP2X表型III(苏氨酸338→丙氨酸,异亮氨酸371→苏氨酸,精氨酸384→甘氨酸,亮氨酸546→缬氨酸);PBP2X表型IV(甲硫氨酸339→苯丙氨酸,甲硫氨酸400→苏氨酸并伴有PBP2X表型III)。

结果

在59株SP菌株中,6种β-内酰胺类抗生素的抗菌活性分布(敏感菌株、中介菌株和耐药菌株)情况为:青霉素(12, 29, 18);阿莫西林(49, 9, 1);头孢呋辛(16, 16, 27);头孢曲松(47, 1, 11);头孢噻肟(47, 3, 9);亚胺培南(49, 10, 0)。PBP2B表型III、PBP1A表型III、PBP2X表型III和IV中的β-内酰胺类抗生素不敏感菌株(中介+耐药菌株)显著增加,这些菌株的MIC(50)显著高于其他菌株。

结论

SP的PBP中或其邻近保守序列中的氨基酸替代增加了β-内酰胺类抗生素的MIC。

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