Bontron Séverine, Poirel Laurent, Nordmann Patrice
Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland.
Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland INSERM U914 Emerging Resistance to Antibiotics, Faculté de Médecine et Université Paris Sud, Le Kremlin-Bicêtre, France
Antimicrob Agents Chemother. 2015 Mar;59(3):1664-70. doi: 10.1128/AAC.04450-14. Epub 2015 Jan 5.
Resistance to β-lactams is constantly increasing due to the emergence of totally new enzymes but also to the evolution of preexisting β-lactamases. GES-1 is a clinically relevant extended-spectrum β-lactamase (ESBL) that hydrolyzes penicillins and broad-spectrum cephalosporins but spares monobactams and carbapenems. However, several GES-1 variants (i.e., GES-2 and GES-5) previously identified among clinical isolates display an extended spectrum of activity toward carbapenems. To study the evolution potential of the GES-1 β-lactamase, this enzyme was submitted to in vitro-directed evolution, with selection on increasing concentrations of the cephalosporin cefotaxime, the monobactam aztreonam, or the carbapenem imipenem. The highest resistance levels were conferred by a combination of up to four substitutions. The A6T-E104K-G243A variant selected on cefotaxime and the A6T-E104K-T237A-G243A variant selected on aztreonam conferred high resistance to cefotaxime, ceftazidime, and aztreonam. Conversely, the A6T-G170S variant selected on imipenem conferred high resistance to imipenem and cefoxitin. Of note, the A6T substitution involved in higher MICs for all β-lactams is located in the leader peptide of the GES enzyme and therefore is not present in the mature protein. Acquired cross-resistance was not observed, since selection with cefotaxime or aztreonam did not select for resistance to imipenem, and vice versa. Here, we demonstrate that the β-lactamase GES-1 exhibits peculiar properties, with a significant potential to gain activity against broad-spectrum cephalosporins, monobactams, and carbapenems.
由于全新酶的出现以及现有β-内酰胺酶的进化,对β-内酰胺类药物的耐药性持续增加。GES-1是一种具有临床相关性的超广谱β-内酰胺酶(ESBL),可水解青霉素类和广谱头孢菌素类,但对单环β-内酰胺类和碳青霉烯类药物无作用。然而,先前在临床分离株中鉴定出的几种GES-1变体(即GES-2和GES-5)对碳青霉烯类药物表现出更广泛的活性谱。为了研究GES-1β-内酰胺酶的进化潜力,将该酶进行体外定向进化,并在头孢噻肟、单环β-内酰胺类氨曲南或碳青霉烯类亚胺培南浓度递增的情况下进行筛选。高达四个替换位点的组合赋予了最高的耐药水平。在头孢噻肟上筛选出的A6T-E104K-G243A变体和在氨曲南上筛选出的A6T-E104K-T237A-G243A变体对头孢噻肟、头孢他啶和氨曲南具有高耐药性。相反,在亚胺培南上筛选出的A6T-G170S变体对亚胺培南和头孢西丁具有高耐药性。值得注意的是,所有β-内酰胺类药物中导致更高最低抑菌浓度(MIC)的A6T替换位于GES酶的前导肽中,因此不存在于成熟蛋白中。未观察到获得性交叉耐药,因为用头孢噻肟或氨曲南筛选并未选择出对亚胺培南的耐药性,反之亦然。在此,我们证明β-内酰胺酶GES-1具有独特的特性,具有显著的潜力获得对广谱头孢菌素类、单环β-内酰胺类和碳青霉烯类药物的活性。