Department of Biochemistry, Molecular Biology and Biophysics, Biotechnology Institute, University of Minnesota, St Paul, MN, USA.
VA Medical Center, Minneapolis, MN, USA.
Int J Antimicrob Agents. 2019 Mar;53(3):318-324. doi: 10.1016/j.ijantimicag.2018.12.004. Epub 2018 Dec 21.
Fluoroquinolone (FQ)-resistant bacteria pose a major global health threat. Unanalysed genomic data from thousands of sequenced microbes likely contain important hints regarding the evolution of FQ resistance, yet this information lies fallow. Here we analysed the co-occurrence patterns of quinolone resistance mutations in genes encoding the FQ drug targets DNA gyrase (gyrase) and topoisomerase IV (topo-IV) from 36,402 bacterial genomes, representing 10 Gram-positive and 10 Gram-negative species. For 19 species, the likeliest routes toward resistance mutations in both targets were determined, and for 5 species those mutations necessary and sufficient to predict FQ resistance were also determined. Target mutation hierarchy was fixed in all examined Gram-negative species, with gyrase being the primary and topo-IV the secondary quinolone target, as well as in six of nine Gram-positive species, with topo-IV being the primary and gyrase the secondary target. By contrast, in three Gram-positive species (Staphylococcus haemolyticus, Streptococcus pneumoniae and Streptococcus suis), under some conditions gyrase became the primary and topo-IV the secondary target. The path through individual resistance mutations varied by species. Both linear and branched paths were identified in Gram-positive and Gram-negative organisms alike. Finally, FQ resistance could be predicted based solely on target gene quinolone resistance mutations for Acinetobacter baumannii, Escherichia coli and Staphylococcus aureus, but not Klebsiella pneumoniae or Pseudomonas aeruginosa. These findings have important implications both for sequence-based diagnostics and for understanding the emergence of FQ resistance.
氟喹诺酮(FQ)耐药菌对全球健康构成重大威胁。未经分析的数千个测序微生物的基因组数据可能包含有关 FQ 耐药性进化的重要线索,但这些信息尚未得到利用。在这里,我们分析了编码 FQ 药物靶标 DNA 回旋酶(gyrase)和拓扑异构酶 IV(topo-IV)的基因中喹诺酮耐药突变的共现模式,这些基因来自 36402 个细菌基因组,代表 10 种革兰氏阳性菌和 10 种革兰氏阴性菌。对于 19 个物种,确定了两个靶标中耐药突变的最可能途径,对于 5 个物种,还确定了预测 FQ 耐药性所必需和充分的突变。在所有检查的革兰氏阴性物种中,靶标突变层次是固定的,gyrase 是主要的,topo-IV 是次要的喹诺酮靶标,在 9 个革兰氏阳性物种中的 6 个中也是如此,topo-IV 是主要的,gyrase 是次要的靶标。相比之下,在 3 个革兰氏阳性菌(解血链球菌、肺炎链球菌和猪链球菌)中,在某些条件下,gyrase 成为主要的,topo-IV 成为次要的靶标。单个耐药突变的途径因物种而异。在革兰氏阳性菌和革兰氏阴性菌中都发现了线性和分支路径。最后,仅基于目标基因喹诺酮耐药突变就可以预测鲍曼不动杆菌、大肠杆菌和金黄色葡萄球菌的 FQ 耐药性,但不能预测肺炎克雷伯菌或铜绿假单胞菌。这些发现对基于序列的诊断和理解 FQ 耐药性的出现具有重要意义。