Rasmussen B A, Yang Y, Jacobus N, Bush K
Medical Research Division, American Cyanamid Company, Pearl River, New York 10965.
Antimicrob Agents Chemother. 1994 Sep;38(9):2116-20. doi: 10.1128/AAC.38.9.2116.
The metallo-beta-lactamase gene, ccrA, has been cloned from three clinical isolates of Bacteroides fragilis, TAL3636, QMCN3, and QMCN4. Although all three isolates harbored a gene encoding a potent beta-lactamase, the MICs of benzylpenicillin, piperacillin, cefotaxime, ceftazidime, imipenem, and biapenem for the three isolates varied from 4- to > 128-fold. QMCN4 was the most susceptible of the three isolates, followed by QMCN3. TAL3636 was resistant to all of the beta-lactams. Previous DNA sequence analysis of the three ccrA genes revealed that the enzymes differed at 5 amino acid residues (B. A. Rasmussen, Y. Gluzman, and F. P. Tally, Mol. Microbiol. 5:1211-1219, 1991). Biochemical characterization of the three enzymes revealed only small differences in kcat and Km values for the majority of beta-lactams tested. Thus, the 5 amino acid substitutions affected the hydrolyzing activity of the enzymes only modestly. Crypticity differences between the three isolates showed that QMCN4 was the least permeable of the isolates to cephaloridine, followed by TAL3636, and that QMCN3 was highly permeable to cephaloridine. Therefore, neither catalytic activity nor permeability was a major contributor to the dramatic differences in the MICs. Instead, microbiological susceptibility was closely related to the level of metallo-beta-lactamase present in each isolate. Both biochemical and physical studies indicated that TAL3636 produced 5- to 10-fold and 50- to 100-fold more metallo-beta-lactamase than QMCN3 and QMCN4, respectively. Therefore, the level of CcrA enzyme production is the dominant contributing factor to high-level resistance among strains harboring a ccrA gene.
金属β-内酰胺酶基因ccrA已从脆弱拟杆菌的三株临床分离株TAL3636、QMCN3和QMCN4中克隆出来。尽管这三株分离株都含有一个编码强效β-内酰胺酶的基因,但这三株分离株对苄青霉素、哌拉西林、头孢噻肟、头孢他啶、亚胺培南和美罗培南的最低抑菌浓度(MIC)相差4至>128倍。QMCN4是这三株分离株中最敏感的,其次是QMCN3。TAL3636对所有β-内酰胺类药物均耐药。先前对这三个ccrA基因的DNA序列分析表明,这些酶在5个氨基酸残基处存在差异(B.A.拉斯穆森、Y.格鲁兹曼和F.P.塔利,《分子微生物学》5:1211 - 1219,1991年)。对这三种酶的生化特性分析表明,对于大多数测试的β-内酰胺类药物,其催化常数(kcat)和米氏常数(Km)值仅有微小差异。因此,这5个氨基酸替换对酶的水解活性影响不大。这三株分离株之间的隐蔽性差异表明,QMCN4对头孢菌素的通透性在分离株中最低,其次是TAL3636,而QMCN3对头孢菌素具有高度通透性。因此,催化活性和通透性都不是MIC显著差异的主要原因。相反,微生物敏感性与每个分离株中金属β-内酰胺酶的水平密切相关。生化和物理研究均表明,TAL3636产生的金属β-内酰胺酶分别比QMCN3和QMCN4多5至10倍和50至100倍。因此,CcrA酶的产生水平是携带ccrA基因菌株高水平耐药的主要影响因素。