Chlorhexidine leads to the evolution of antibiotic-resistant Pseudomonas aeruginosa.

Antimicrobial resistance is a major public-health concern. We evaluate chlorhexidine role in selection of resistant Pseudomonas aeruginosa mutants and their antibiotic cross-resistance. Mutation frequency and mutation rate after short-term exposure to sub-inhibitory concentrations of chlorhexidine were compared to those after spontaneous chlorhexidine-exposure, in P. aeruginosa PAO1 strain. Chlorhexidine-resistant mutants were generated, either by serial passage in increasing chlorhexidine concentrations or by single exposure to lethal chlorhexidine concentration. The generated mutants were tested for cross-resistance to different antibiotics, by determination of minimum inhibitory concentrations (MIC). The accompanied phenotypic changes in membrane permeability, outer membrane proteins (OMP), and efflux function were evaluated. The effect of exposure to chlorhexidine on MexAB-OprM, MexEF-oprN, and MexXY efflux pumps expression was investigated. No significant change was recorded between the mutation frequencies and mutation rates after short-term exposure to sub-inhibitory concentrations of chlorhexidine and after spontaneous chlorhexidine-exposure, in P. aeruginosa PAO1 strain. Twelve stable mutants, with ≥ eight-fold increase in chlorhexidine MIC, were generated. Several mutants showed increase in the MIC of colistin, cefepime, ceftazidime, meropenem, ciprofloxacin, and amikacin; seven mutants expressed meropenem cross-resistance. This was accompanied by decreased outer membrane permeability and changes in OMP. Using efflux pump inhibitor, chlorhexidine resistance was reverted in most isolates. Exposure to sub-inhibitory concentration of chlorhexidine induced the expression of MexXY efflux pump. Some resistant mutants had overexpressed MexXY efflux pump. Chlorhexidine can select P. aeruginosa strains with antibiotic cross-resistance. This necessitates implementing special protocols for chlorhexidine use and re-evaluation of its benefit versus risk in personal-care products.

The secretome of Acinetobacter baumannii ATCC 17978 type II secretion system reveals a novel plasmid encoded phospholipase that could be implicated in lung colonization.

Acinetobacter baumannii infections are compounded with a striking lack of treatment options. In many Gram-negative bacteria, secreted proteins play an important early role in avoiding host defences. Typically, these proteins are targeted to the external environment or into host cells using dedicated transport systems. Despite the fact that medically relevant species of Acinetobacter possess a type II secretion system (T2SS), only recently, its significance as an important pathway for delivering virulence factors has gained attention. Using in silico analysis to characterize the genetic determinants of the T2SS, which are found clustered in other organisms, in Acinetobacter species, they appear to have a unique genetic organization and are distributed throughout the genome. When compared to other T2SS orthologs, individual components of the T2SS apparatus showed the highest similarity to those of Pseudomonas aeruginosa. A mutant of Acinetobacter baumannii strain ATCC 17978 lacking the secretin component of the T2SS (ΔgspD), together with a trans-complemented mutant, were tested in a series of in vitro and in vivo assays to determine the role of T2SS in pathogenicity. The ΔgspD mutant displayed decreased lipolytic activity, associated with attenuated colonization ability in a murine pneumonia model. These phenotypes are linked to LipAN, a novel plasmid-encoded phospholipase, identified through mass spectroscopy as a T2SS substrate. Recombinant LipAN showed specific phospholipase activity in vitro. Proteomics on the T2-dependent secretome of ATCC 17978 strain revealed its potential dedication to the secretion of a number of lipolytic enzymes, among others which could contribute to its virulence. This study highlights the role of T2SS as an active contributor to the virulence of A. baumannii potentially through secretion of a newly identified phospholipase.

'Supermutators' found amongst highly levofloxacin-resistant E. coli isolates: a rapid protocol for the detection of mutation sites.

Fluoroquinolone resistance is gradually acquired through several mechanisms. In particular, chromosomal mutations in the genes encoding topoisomerases II and IV and increased expression of the multidrug efflux pump AcrAB-TolC are the most common mechanisms. In this study, multiplex polymerase chain reaction (PCR) protocols were designed for high-throughput sequencing of the quinolone resistance determining regions of topoisomerases genes (gyrA, parC and parE) and/or the expression regulation systems of multidrug efflux pump AcrAB (acrRAB, marRAB and soxSR). These protocols were applied to sequence samples from five subpopulations of 103 clinical Escherichia coli isolates. These subpopulations were classified according to their levofloxacin susceptibility pattern as follows: highly resistant (HR), resistant (R), intermediate (I), reduced susceptibility (RS) and susceptible (S). All HR isolates had mutations in the six genes surveyed, with two 'supermutator' isolates harboring 13 mutations in these six genes. Strong associations were observed between mutations in acrR and HR isolates, parE and R/HR isolates and parC and I/R/HR isolates, whereas surprisingly, gyrA mutations were common in RS/I/R/HR isolates. Further investigation revealed that strong associations were limited to the triple mutations gyrA-S83L/D87N/R237H and HR isolates and the double mutations S83L/D87N and I/R/HR isolates, whereas the single mutation S83L was common in RS/I/R/HR isolates. Interestingly, two novel mutations (gyrA-R237H and acrR-V29G) were located and found to strongly associate with HR isolates. To the best of our knowledge, the gyrA-R237H and acrR-V29G mutations have never been reported and require further investigation to determine their exact role in resistance or 'fitness' as defined by their ability to compensate for the organismal cost of gaining resistance.

Kinetics and metabolic versatility of highly tolerant phenol degrading Alcaligenes strain TW1.

A bacterium that could completely metabolize phenol in batch culture supplied with up to 1200 mg phenol l(-1) at room temperature (25 degrees C) was isolated from the activated sludge of the industrial wastewater treatment plant of a Coke company (Cairo, Egypt). Morphological and physiological characterization showed strain TW1 was a motile, strictly aerobic, gram negative and short-rod occurring singly or in clusters. Partial 16S rRNA gene sequence analysis revealed strain TW1 belonged to the beta group of Proteobacteria, showing 100% identity to Alcaligenes SCTI. Strain TW1 aerobically grew on a number of monocyclic aromatic compounds (hydroquinone, catechol and o-cresol) as well as polycyclic aromatic compounds (pyrene, phenanthrene and naphthalene). The growth of Alcaligenes TW1 on phenol as sole carbon and energy source (25 degrees C) was well described by the Haldane kinetics model with a maximal specific growth rate of 0.58 h(-1), a half-saturation constant of 10 mg l(-1), and a substrate inhibition constant of 152-550 mg l(-1). The biomass yield coefficient ranged from 0.55 to 0.64 mg dry cell mass/mg phenol. Due to its high tolerance to phenol and high metabolic versatility, Alcaligenes sp. TW1 is considered an excellent candidate for the biotreatment of high strength phenol-laden industrial wastewaters.

Solar-based detoxification of phenol and p-nitrophenol by sequential TiO2 photocatalysis and photosynthetically aerated biological treatment.

Simulated solar UV/TiO(2) photocatalysis was efficient to detoxify a mixture of 100 mgphenoll(-1) and 50 mgp-nitrophenol (PNP) l(-1) and allow the subsequent biodegradation of the remaining pollutants and their photocatalytic products under photosynthetic aeration with Chlorella vulgaris. Photocatalytic degradation of phenol and PNP was well described by pseudo-first order kinetics (r(2)>0.98) with removal rate constants of 1.9x10(-4) and 2.8x10(-4)min(-1), respectively, when the pollutants were provided together and 5.7x10(-4) and 9.7x10(-4)min(-1), respectively, when they were provided individually. Photocatalytic pre-treatment of the mixture during 60 h removed 50+/-1% and 62+/-2% of the phenol and PNP initially present but only 11+/-3% of the initial COD. Hydroquinone, nitrate and catechol were identified as PNP photocatalytic products and catechol and hydroquinone as phenol photocatalytic products. Subsequent biological treatment of the pre-treated samples removed the remaining contaminants and their photocatalytic products as well as 81-83% of the initial COD, allowing complete detoxification of the mixture to C. vulgaris. Similar detoxification efficiencies were recorded after biological treatment of the irradiated mixture with activated sludge microflora or with an acclimated consortia composed of a phenol-degrading Alcaligenes sp. and a PNP-degrading Arthrobacter sp., although the acclimated strains biodegraded the remaining pollutants faster. Biological treatment of the non-irradiated mixture was inefficient due to C. vulgaris inhibition.

Sequential photochemical-biological degradation of chlorophenols.

UV/TiO2/H2O2, UV/TiO2 and UV/H2O2 were compared as pre-treatment processes for the detoxification of mixtures of 4-chlorophenol (4CP), 2,4-dichlorophenol (DCP), 2,4,6-trichlorophenol (TCP) and pentachlorophenol (PCP) prior to their biological treatment. When each chlorophenol was initially supplied at 50 mg l(-1), UV/TiO2/H2O2 treatment supported the highest pollutant removal, COD removal, and dechlorination efficiencies followed by UV/TiO2 and UV/H2O2. The remaining toxicity to Lipedium sativum was similar after all pre-treatments. Chlorophenol photodegradation was always well described by a first order model kinetic (r2>0.94) and the shortest 4CP, DCP, TCP and PCP half-lives of 8.7, 7.1, 4.5 and 3.3 h, respectively, were achieved during UV/TiO2/H2O2 treatment. No pollutant removal was observed in the controls conducted with H2O2 or TiO2 only. Inoculation of all the photochemically pre-treated mixtures with activated sludge microflora was followed by complete removal of the remaining pollutants. Combined UV/TiO2/H2O2-biological supported the highest detoxification, dechlorination (99%) and COD removal (88%) efficiencies. Similar results were achieved when each chlorophenol was supplied at 100 mg l(-1). COD and Cl mass balances indicated UV, UV/H2O2, and UV/TiO2 treatments lead to the formation of recalcitrant photoproducts, some of which were chlorinated.