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插入序列 IS 介导的荚膜多糖生物合成基因中断导致 ST11 K64 碳青霉烯类耐药肺炎克雷伯菌对裂解噬菌体产生耐药性。

Interruption of Capsular Polysaccharide Biosynthesis Gene by Insertion Sequence IS Mediates Resistance to a Lytic Phage against ST11 K64 Carbapenem-Resistant Klebsiella pneumoniae.

机构信息

Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

Division of Infectious Diseases, State Key Laboratory of Biotherapy, Chengdu, People's Republic of China.

出版信息

mSphere. 2022 Dec 21;7(6):e0051822. doi: 10.1128/msphere.00518-22. Epub 2022 Nov 15.

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major challenge for clinical management worldwide with limited antimicrobial options. Phages are considered an alternative option. Here, we isolated and identified a phage able to lyse ST11-K64 CRKP, the major type in China. This phage has a narrow host range, only lysing ST11-K64 CRKP, and inhibits the growth of host strains for 3 h forming large clear plaques (3.0 to 6.0 mm in diameter) with a surrounding halo. This phage exhibited excellent stability in different temperatures and pH and did not contain any virulence, lysogenic, antimicrobial resistance genes nor tRNA, meeting the criteria for phage therapy. Genomic analysis revealed that it represents a novel species of the genus according to ICTV standards. However, phage-resistant bacterial mutants emerged after 4-h exposure. Compared to the parental strain, phage-resistant mutants showed nonmucoid appearance and exhibited significantly reduced virulence for Galleria mellonella larva. Three randomly selected phage-resistant mutants were genome sequenced. Interruption of capsular polysaccharide biosynthesis-associated gene or by IS alone or an IS-formed composite transposon was identified. Interruption of is a known phage resistant mechanism, while that of is not. By complementing the intact , the phage susceptibility was restored, confirming the role of interruption in phage resistance. This highlights that alteration in the capsular polysaccharide biosynthesis gene cluster, which could be due to transposable elements, is a major mechanism for resistance to phages in CRKP. Noncapsule-targeting phages may be combined for improving phage therapy against CRKP. Phage therapy is an alternative approach against multidrug resistant microorganisms such as carbapenem-resistant Klebsiella pneumoniae (CRKP), which represents a major challenge for treatment due to very limited options of antimicrobial agents. For optimizing phage therapy, more new lytic phages are needed. Here, we isolated and characterized a phage of a novel species able to rapidly lyse a major type of CRKP without carrying any virulence, lysogenic, antimicrobial resistance genes. This phage is therefore suitable for clinical treatment. However, phage-resistant mutants of CRKP strains were observed after exposure. We found a new mechanism, i.e., interruption of a capsular polysaccharide biosynthesis gene by an insertion sequence-formed composite transposon. Our study demonstrates the capsular polysaccharide biosynthesis gene cluster as a major source of resistance to certain lytic phages in CRKP. This requires more studies to counter phage resistance. Our studies also highlight the critical role of insertion sequences in phage resistance.

摘要

耐碳青霉烯类肺炎克雷伯菌 (CRKP) 是全球临床管理的主要挑战,可用的抗菌药物选择有限。噬菌体被认为是一种替代选择。在这里,我们分离并鉴定了一种能够裂解中国主要类型 ST11-K64 CRKP 的噬菌体。该噬菌体宿主范围狭窄,仅裂解 ST11-K64 CRKP,并且在 3 小时内抑制宿主菌株的生长,形成直径为 3.0 至 6.0 毫米的大清晰噬菌斑(clear plaque),周围有晕圈。该噬菌体在不同温度和 pH 值下表现出极好的稳定性,并且不含任何毒力、溶原性、抗微生物耐药性基因或 tRNA,符合噬菌体治疗的标准。基因组分析表明,根据 ICTV 标准,它代表了一个新的属种。然而,在 4 小时暴露后出现了噬菌体抗性细菌突变体。与亲本菌株相比,噬菌体抗性突变体表现出非黏液外观,并且对家蚕幼虫的毒力显著降低。随机选择了三个噬菌体抗性突变体进行基因组测序。发现单独的插入序列(IS)或由 IS 形成的复合转座子中断了荚膜多糖生物合成相关基因 或 。中断 是已知的噬菌体抗性机制,而中断 则不然。通过互补完整的 ,恢复了噬菌体敏感性,证实了 中断在噬菌体抗性中的作用。这突出表明,由于转座元件,荚膜多糖生物合成基因簇的改变是 CRKP 对噬菌体产生抗性的主要机制。非囊靶向噬菌体可能会结合使用,以提高针对 CRKP 的噬菌体治疗效果。噬菌体治疗是一种针对多重耐药微生物(如耐碳青霉烯类肺炎克雷伯菌(CRKP))的替代方法,由于抗菌药物选择非常有限,因此对这种微生物的治疗是一个主要挑战。为了优化噬菌体治疗,需要更多新的裂解噬菌体。在这里,我们分离并表征了一种能够快速裂解主要类型 CRKP 的新型噬菌体,该噬菌体不携带任何毒力、溶原性、抗微生物耐药性基因。因此,该噬菌体适合临床治疗。然而,在暴露后观察到 CRKP 菌株的噬菌体抗性突变体。我们发现了一种新的机制,即插入序列形成的复合转座子中断了荚膜多糖生物合成基因 。我们的研究表明,荚膜多糖生物合成基因簇是 CRKP 中某些裂解噬菌体产生抗性的主要来源。这需要更多的研究来对抗噬菌体的耐药性。我们的研究还强调了插入序列在噬菌体耐药性中的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b39/9769513/86de9db2b377/msphere.00518-22-f001.jpg

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