Occurrence of endemic plasmids causing beta-lactam resistance in Enterobacteriaceae in children's university hospital in Munich.

Susceptibility of 62 clinical isolates of Enterobacteriaceae to 15 aminoglycosides, beta-lactams and fluoroquinolones was determined. The isolates originating from 3 intensive care units (neonatal, pediatric, and surgical) and the Department of Infant Internal Medicine of the Children's University Hospital City Center in Munich (Germany) were collected in August 1999, and March and October 2000. Transferability of antibiotic resistance from donors to their E. coli transconjugants was also demonstrated. The majority of isolates were resistant to ampicillin, cefoxitin, ceftriaxone, cefotaxime, ceftazidime and azthreonam but they were susceptible to cefepime, meropenem, aminoglycosides and fluoroquinolones. The occurrence of beta-lactamases and extended-spectrum beta-lactamases (ESBL) was also shown. In August 1999 75% of isolates produced beta-lactamases and 15% ESBL, in March 2000 95% of isolates produced beta-lactamases and 9% ESBL; in October 2000 all isolates produced beta-lactamases and only 5% produced ESBL. Plasmid DNA analysis in randomly chosen isolates and their transconjugants revealed the presence of plasmids ranging from 19 to 136 kb; in the majority of isolates a 120-kb plasmid was observed. Further analysis using restriction endonuclease suggested a dissemination and persistence of an endemic plasmid at all 4 wards of the large pediatric hospital in the City Center of Munich which may be responsible for resistance to beta-lactams among Enterobacteriaceae isolates.

[Occurrence and mechanisms of resistance to beta-lactam antibiotics in clinically important species of Enterobacter]. / Výskyt a mechanizmy rezistencie proti beta-laktámovým antibiotikám u klinicky významných druhov rodu Enterobacter.

Extended-spectrum beta-lactam antibiotics have found great medical importance, but their wide use in clinical practice leads to increasing resistance to them. The more frequent occurrence of infections caused by Bush group 1 beta-lactamase producing organisms, including species of the genus Enterobacter, is a serious problem in this field. Resistance to beta-lactams in this important nosocomial pathogens can be due to 1) reduction in outer membrane permeability to antibiotics caused by alterations in outer membrane lipopolysacharides or proteins (porins); 2) production of beta-lactamases, which inactivate beta-lactams and can also lead to resistance by non-hydrolytic mechanism called trapping. Production of plasmid-mediated extended-spectrum beta-lactamases, but especially chromosomally-mediated inducible cephalosporinase AmpC, which can be synthesized constitutively in large amounts as consequence of spontaneous chromosomal mutations, are of great clinical importance. Fourth-generation cephalosporins and carbapenems are the most effective in the treatment of infections caused by species belonging to the genus Enterobacter, but combination of high level beta-lactamase production and decreased outer membrane permeability, which is not rare in Enterobacter spp., leads to resistance even to these drugs.

Occurrence and transferability of beta-lactam resistance in Enterobacteriaceae isolated in Children's University Hospital in Bratislava.

Occurrence and transferability of beta-lactam resistance in 30 multi-resistant Escherichia coli, Klebsiella spp., Enterobacter spp., Pantoea agglomerans, Citrobacter freundii and Serratia marcescens strains isolated from children between 0 and 3 years of age is presented. The strains were resistant to ampicillin (30), cefoxitin (22), cefotaxime (30), ceftriaxone (30), ceftazidime (30) and aztreonam (28), but susceptible to cefepime (30) and imipenem (26). Twenty-eight of 30 isolates possessed a transferable resistance confirmed by conjugation and isolation of 79-89-kb plasmids. The beta-lactam resistance was due to production of beta-lactamases and ceftazidime proved to be stronger beta-lactamase inductor than ceftriaxone. Twenty-five clinical isolates expressed transferable extended spectrum beta-lactamases, and chromosomally encoded AmpC beta-lactamase.

Spectrum and transferability of beta-lactam resistance in hospital strains of Enterobacter isolated in Bratislava and Innsbruck.

The transferability and expression of beta-lactam resistance were compared in multiresistant clinical isolates of Enterobacter spp. collected from different hospitals in Bratislava, Slovakia (n = 15) and Innsbruck, Austria (n = 19) during 1996-1997. The strains from Bratislava were resistant to ampicillin, cefoxitin, cefotaxime, ceftazidime and ceftriaxone. All strains from Innsbruck were resistant to ampicillin and cefoxitin; 17 were also resistant to ceftazidime and aztreonam but the majority remained susceptible to cefotaxime and ceftriaxone. All strains were susceptible to cefepime and imipenem. The majority of the tested strains transferred resistance determinants to E. coli recipient by conjugation. Production of beta-lactamase including ESBL was the major mechanism of beta-lactam resistance. Large plasmids of 77-88 and 91 kb were confirmed in clinical isolates from Bratislava and Innsbruck.

Role of the PDR gene network in yeast susceptibility to the antifungal antibiotic mucidin.

Yeast strains disrupted in the PDR1, PDR3, or PDR5 gene, but not in SNQ2, exhibited higher sensitivity to mucidin (strobilurin A) than did the isogenic wild-type strains. Different gain-of-function mutations in the PDR1 and PDR3 genes rendered yeast mutants resistant to this antibiotic. Mucidin induced PDR5 expression, but the changes in the expression of SNQ2 were only barely detectable. The results indicate that PDR5 provides the link between transcriptional regulation by PDR1 and PDR3 and mucidin resistance of yeast.

Isolation and molecular characterization of the carboxy-terminal pdr3 mutants in Saccharomyces cerevisiae.

Multidrug resistance in Saccharomyces cerevisiae mainly results from the overexpression of genes coding for the membrane efflux pumps, the major facilitators and the ABC binding cassette transporters, under the control of key transcription regulators encoded by the PDR1 and PDR3 genes. Pdr3p transcriptional activator contains a weak activation domain near the N-terminal zinc finger, a central regulatory domain, and a strong activation domain near the carboxyl terminus. Here we report the results of the mutational analysis of the C-terminal region of Pdr3p. After in vitro mutagenesis of the PDR3 gene six single amino acid substitutions were identified and resulted in resistance to cycloheximide, sulfomethuron methyl, 4-nitroquinoline oxide, fluconazole, mucidin, chloramphenicol and oligomycin. All the C-terminal pdr3 mutant alleles also conferred multidrug resistance in the presence of the wild-type PDR3 gene. The pdr3 mutations resulted in overexpression of both the PDR3 and PDR5 genes as revealed by transactivation experiments involving the PDR3-lacZ and PDR5-lacZ fusion genes and Western blot analyses using antibodies against Pdr5p. Most of the C-terminal pdr3 mutations were found in two sequence stretches exhibiting a high degree of amino acid identity with Pdr1p indicating that they might play a significant role in protein-protein interactions during the initiation of transcription of genes involved in multidrug resistance.