Service de Bactériologie, Centre Hospitalo-Universitaire d'Amiens, Hôpital Nord, Faculté de Médecine d'Amiens, Université de Picardie Jules Verne, Amiens, France.
Antimicrob Agents Chemother. 2012 Mar;56(3):1151-6. doi: 10.1128/AAC.05630-11. Epub 2012 Jan 9.
The Citrobacter freundii isolate CHA, which was responsible for postoperative peritonitis after 10 days of cefepime therapy, displayed a phenotype of resistance consistent with extended-spectrum AmpC (ESAC) β-lactamase. The chromosome-borne bla(AmpC-CHA) gene was amplified and sequenced, revealing five amino acid substitutions, I125V, R148H, Q196H, V305A, and V348A, in the product compared to the sequence of native AmpC. A cloning experiment yielded the Escherichia coli TOP10(pAmpC-CHA) strain, which was resistant to all extended-spectrum cephalosporins (ESCs), including cefepime. To ascertain whether the R148H substitution accounted for the hydrolysis spectrum extension, it was reverted by site-directed mutagenesis. The resulting E. coli TOP10(pAmpC-CHA-H148R) strain was fully susceptible to cefepime, thus confirming that the Arg-148 replacement was mandatory for substrate profile enlargement. To further characterize the phenotypical and biochemical effects induced by the R148H change, it was introduced by site-directed mutagenesis into the CMY-2 β-lactamase, which is structurally related to the chromosome-borne cephalosporinase of C. freundii. The CMY-2-R148H variant conferred increased MICs of ESCs, whereas those of carbapenems were unchanged even in a porin-deficient E. coli strain. Moreover, it exhibited increased catalytic efficiency (k(cat)/K(m)) toward ceftazidime (100-fold) due to an enhanced hydrolysis rate (k(cat)), whereas the enzymatic parameters toward imipenem were unchanged. The structural analysis of the AmpC variant showed that the R148H replacement occurred in the loop containing the Y-X-N motif, which is the counterpart of the SDN loop in class A β-lactamases. This study shows that the Y-X-N loop is a novel hot spot for mutations accounting for hydrolysis spectrum extension in CMY-2-type enzymes.
导致头孢吡肟治疗 10 天后发生术后腹膜炎的阴沟肠杆菌分离株 CHA 表现出与扩展谱 AmpC(ESAC)β-内酰胺酶一致的耐药表型。染色体携带的 bla(AmpC-CHA)基因被扩增和测序,与天然 AmpC 序列相比,该基因在产物中显示出 5 个氨基酸取代,即 I125V、R148H、Q196H、V305A 和 V348A。克隆实验产生了对所有扩展谱头孢菌素(ESCs),包括头孢吡肟均耐药的大肠杆菌 TOP10(pAmpC-CHA)菌株。为了确定 R148H 取代是否导致水解谱扩展,通过定点诱变使其回复。所得大肠杆菌 TOP10(pAmpC-CHA-H148R)菌株对头孢吡肟完全敏感,从而证实 Arg-148 替换对于底物谱扩大是必需的。为了进一步表征 R148H 变化引起的表型和生化效应,通过定点诱变将其引入与阴沟肠杆菌染色体头孢菌素酶结构相关的 CMY-2β-内酰胺酶。CMY-2-R148H 变体赋予 ESC 的 MIC 增加,而在缺乏孔蛋白的大肠杆菌菌株中,碳青霉烯类的 MIC 不变。此外,它表现出对头孢他啶的水解速率(k(cat))增强,导致对 ESC 的 MIC 增加,而对亚胺培南的酶学参数不变。AmpC 变体的结构分析表明,R148H 取代发生在包含 Y-X-N 基序的环中,该基序是 A 类β-内酰胺酶中 SDN 环的对应物。本研究表明,Y-X-N 环是导致 CMY-2 型酶水解谱扩展的突变的新热点。