Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada.
National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
Sci Rep. 2022 Jul 15;12(1):12149. doi: 10.1038/s41598-022-15775-6.
Bacterial resistance to the antiseptic chlorhexidine (CHX), is a growing problem, recently shown to be caused by deleterious mutations to the phospholipid transport system component (mlaA) as well as efflux pump overexpression. Comparisons of CHX resistance mechanisms, such as porin deletions (ompCF), and over-expressed efflux pumps (acrB, qacE, aceI), are lacking and may be distinguishable using antiseptic rapid fluorescent dye testing assays. Using E. coli K-12 CHX adapted isolates (CHXR1), gene deletion mutants, and over-expressed transformants the phenotypes of these CHX resistance genes were compared using antimicrobial susceptibility tests (AST), rapid fluorescent propidium iodide dye-based membrane integrity assays (RFDMIA), and scanning electron microscopy (SEM). AST findings showed CHXR1, ΔacrB, ΔompCF, and transformants pCA24N-aceI and pCA24N-mlaA conferred greater (two to fourfold) MIC changes when compared to matched controls. Examination of these mutants/transformants using CHX RFDMIA showed that porin dual-deletions (ΔompCF) and mlaA alterations (ΔmlaA; pCA24N-mlaA, CHXR1) were distinguishable from controls. Results for over-expressed (pMS119EH-aceI) and deleted (ΔacrB) efflux pump RFDMIA could not be distinguished with propidium iodide, only with ethidium bromide, suggesting propidium iodide is better suited for detecting porin and mlaA associated CHX resistance mechanisms. SEM of CHXR1 and unadapted E. coli cells exposed to increasing CHX concentrations revealed that CHX does not visibly damage cell envelope integrity at any tested concentration but did identify elongated CHXR1 cells. ΔmlaA confers similar levels of CHX resistance as efflux overexpression and porin deletions, however, only outer membrane-altering porin and mlaA deletions can be reliably distinguished using RFDMIA.
细菌对防腐剂洗必泰(CHX)的耐药性是一个日益严重的问题,最近的研究表明,这种耐药性是由于磷脂转运系统成分(mlaA)的有害突变以及外排泵过度表达引起的。CHX 耐药机制的比较,如孔蛋白缺失(ompCF)和过度表达的外排泵(acrB、qacE、aceI),尚缺乏研究,并且可能可以使用防腐剂快速荧光染料检测试验来区分。使用大肠杆菌 K-12 CHX 适应株(CHXR1)、基因缺失突变体和过表达转化体,通过抗菌药物敏感性试验(AST)、快速荧光碘化丙啶染料基于膜完整性的检测试验(RFDMIA)和扫描电子显微镜(SEM)比较这些 CHX 耐药基因的表型。AST 结果表明,与匹配对照相比,CHXR1、ΔacrB、ΔompCF 和转化体 pCA24N-aceI 和 pCA24N-mlaA 导致 MIC 变化更大(两倍至四倍)。使用 CHX RFDMIA 检查这些突变体/转化体发现,孔蛋白双重缺失(ΔompCF)和 mlaA 改变(ΔmlaA;pCA24N-mlaA,CHXR1)与对照可区分。用碘化丙啶无法区分过度表达(pMS119EH-aceI)和缺失(ΔacrB)外排泵 RFDMIA 的结果,只能用溴化乙锭区分,这表明碘化丙啶更适合检测与孔蛋白和 mlaA 相关的 CHX 耐药机制。暴露于递增 CHX 浓度的 CHXR1 和未适应的大肠杆菌细胞的 SEM 显示,CHX 在任何测试浓度下都不会明显损坏细胞包膜完整性,但确实识别出了伸长的 CHXR1 细胞。ΔmlaA 赋予与外排泵过度表达和孔蛋白缺失相似水平的 CHX 耐药性,但是,只有外膜改变的孔蛋白和 mlaA 缺失可以使用 RFDMIA 可靠地区分。