Kupke Johannes, Brombach Julian, Fang Yuwen, Wolf Silver A, Thrukonda Lakshmipriya, Ghazisaeedi Fereshteh, Kuropka Benno, Hanke Dennis, Semmler Torsten, Nordholt Niclas, Schreiber Frank, Tedin Karsten, Lübke-Becker Antina, Steiner Ulrich K, Fulde Marcus
Department of Veterinary Medicine, Institute of Microbiology and Epizootics, Centre for Infection Medicine, Freie Universität Berlin, Berlin, Germany.
Robert Koch Institute (RKI), MF1-Genome Competence Centre, Berlin, Germany.
NPJ Antimicrob Resist. 2025 Feb 22;3(1):13. doi: 10.1038/s44259-025-00082-7.
Heteroresistance (HR) in bacteria describes a subpopulational phenomenon of antibiotic resistant cells of a generally susceptible population. Here, we investigated the molecular mechanisms and phenotypic characteristics underlying HR to ceftazidime (CAZ) in a clinical Enterobacter cloacae complex strain (ECC). We identified a plasmid-borne gene duplication-amplification (GDA) event of a region harbouring an ampC gene encoding a β-lactamase bla as the key determinant of HR. Individual colonies exhibited variations in the copy number of the genes resulting in resistance level variation which correlated with growth onset (lag times) and growth rates in the presence of CAZ. GDA copy number heterogeneity occurred within single resistant colonies, demonstrating heterogeneity of GDA on the single-cell level. The interdependence between GDA, lag time and antibiotic treatment and the strong plasticity underlying HR underlines the high risk for misdetection of antimicrobial HR and subsequent treatment failure.
细菌中的异质性耐药(HR)描述了一般敏感群体中抗生素耐药细胞的亚群现象。在此,我们研究了临床阴沟肠杆菌复合菌(ECC)菌株中对头孢他啶(CAZ)产生HR的分子机制和表型特征。我们确定了一个携带编码β-内酰胺酶bla的ampC基因区域的质粒介导的基因重复扩增(GDA)事件,这是HR的关键决定因素。单个菌落显示出基因拷贝数的变化,导致耐药水平的差异,这与在CAZ存在下的生长起始(滞后时间)和生长速率相关。GDA拷贝数异质性发生在单个耐药菌落内,表明在单细胞水平上GDA的异质性。GDA、滞后时间和抗生素治疗之间的相互依赖性以及HR背后的强大可塑性强调了抗菌HR误检测和随后治疗失败的高风险。