1
|
Barceló IM, Escobar-Salom M, Cabot G, Perelló-Bauzà P, Jordana-Lluch E, Taltavull B, Torrens G, Rojo-Molinero E, Zamorano L, Pérez A, Oliver A, Juan C. Transferable AmpCs in Klebsiella pneumoniae: interplay with peptidoglycan recycling, mechanisms of hyperproduction, and virulence implications. Antimicrob Agents Chemother 2024; 68:e0131523. [PMID: 38517189 PMCID: PMC11064642 DOI: 10.1128/aac.01315-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
Chromosomal and transferable AmpC β-lactamases represent top resistance mechanisms in different gram-negatives, but knowledge regarding the latter, mostly concerning regulation and virulence-related implications, is far from being complete. To fill this gap, we used Klebsiella pneumoniae (KP) and two different plasmid-encoded AmpCs [DHA-1 (AmpR regulator linked, inducible) and CMY-2 (constitutive)] as models to perform a study in which we show that blockade of peptidoglycan recycling through AmpG permease inactivation abolished DHA-1 inducibility but did not affect CMY-2 production and neither did it alter KP pathogenic behavior. Moreover, whereas regular production of both AmpC-type enzymes did not attenuate KP virulence, when blaDHA-1 was expressed in an ampG-defective mutant, Galleria mellonella killing was significantly (but not drastically) attenuated. Spontaneous DHA-1 hyperproducer mutants were readily obtained in vitro, showing slight or insignificant virulence attenuations together with high-level resistance to β-lactams only mildly affected by basal production (e.g., ceftazidime, ceftolozane/tazobactam). By analyzing diverse DHA-1-harboring clinical KP strains, we demonstrate that the natural selection of these hyperproducers is not exceptional (>10% of the collection), whereas mutational inactivation of the typical AmpC hyperproduction-related gene mpl was the most frequent underlying mechanism. The potential silent dissemination of this kind of strains, for which an important fitness cost-related contention barrier does not seem to exist, is envisaged as a neglected threat for most β-lactams effectiveness, including recently introduced combinations. Analyzing whether this phenomenon is applicable to other transferable β-lactamases and species as well as determining the levels of conferred resistance poses an essential topic to be addressed.IMPORTANCEAlthough there is solid knowledge about the regulation of transferable and especially chromosomal AmpC β-lactamases in Enterobacterales, there are still gaps to fill, mainly related to regulatory mechanisms and virulence interplays of the former. This work addresses them using Klebsiella pneumoniae as model, delving into a barely explored conception: the acquisition of a plasmid-encoded inducible AmpC-type enzyme whose production can be increased through selection of chromosomal mutations, entailing dramatically increased resistance compared to basal expression but minor associated virulence costs. Accordingly, we demonstrate that clinical K. pneumoniae DHA-1 hyperproducer strains are not exceptional. Through this study, we warn for the first time that this phenomenon may be a neglected new threat for β-lactams effectiveness (including some recently introduced ones) silently spreading in the clinical context, not only in K. pneumoniae but potentially also in other pathogens. These facts must be carefully considered in order to design future resistance-preventive strategies.
Collapse
Affiliation(s)
- Isabel M. Barceló
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Maria Escobar-Salom
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Gabriel Cabot
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Pau Perelló-Bauzà
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Elena Jordana-Lluch
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Biel Taltavull
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Gabriel Torrens
- Department of Molecular Biology and Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå Centre for Microbial Research (UCMR), Umeå University, Umeå, Sweden
| | - Estrella Rojo-Molinero
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Laura Zamorano
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Astrid Pérez
- National Center for Microbiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Antonio Oliver
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Carlos Juan
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| |
Collapse
|
2
|
Barceló IM, Escobar-Salom M, Jordana-Lluch E, Torrens G, Oliver A, Juan C. Filling knowledge gaps related to AmpC-dependent β-lactam resistance in Enterobacter cloacae. Sci Rep 2024; 14:189. [PMID: 38167986 PMCID: PMC10762043 DOI: 10.1038/s41598-023-50685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
Enterobacter cloacae starred different pioneer studies that enabled the development of a widely accepted model for the peptidoglycan metabolism-linked regulation of intrinsic class C cephalosporinases, highly conserved in different Gram-negatives. However, some mechanistic and fitness/virulence-related aspects of E. cloacae choromosomal AmpC-dependent resistance are not completely understood. The present study including knockout mutants, β-lactamase cloning, gene expression analysis, characterization of resistance phenotypes, and the Galleria mellonella infection model fills these gaps demonstrating that: (i) AmpC enzyme does not show any collateral activity impacting fitness/virulence; (ii) AmpC hyperproduction mediated by ampD inactivation does not entail any biological cost; (iii) alteration of peptidoglycan recycling alone or combined with AmpC hyperproduction causes no attenuation of E. cloacae virulence in contrast to other species; (iv) derepression of E. cloacae AmpC does not follow a stepwise dynamics linked to the sequential inactivation of AmpD amidase homologues as happens in Pseudomonas aeruginosa; (v) the enigmatic additional putative AmpC-type β-lactamase generally present in E. cloacae does not contribute to the classical cephalosporinase hyperproduction-based resistance, having a negligible impact on phenotypes even when hyperproduced from multicopy vector. This study reveals interesting particularities in the chromosomal AmpC-related behavior of E. cloacae that complete the knowledge on this top resistance mechanism.
Collapse
Affiliation(s)
- Isabel M Barceló
- Health Research Institute of the Balearic Islands (IdISBa), 07010, Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), 07010, Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - María Escobar-Salom
- Health Research Institute of the Balearic Islands (IdISBa), 07010, Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), 07010, Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Elena Jordana-Lluch
- Health Research Institute of the Balearic Islands (IdISBa), 07010, Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), 07010, Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Gabriel Torrens
- Department of Molecular Biology and Laboratory for Molecular Infection Medicine Sweden (MIMS), Umeå Centre for Microbial Research (UCMR), Umeå University, 901 87, Umeå, Sweden
| | - Antonio Oliver
- Health Research Institute of the Balearic Islands (IdISBa), 07010, Palma, Spain
- Microbiology Department, University Hospital Son Espases (HUSE), 07010, Palma, Spain
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Carlos Juan
- Health Research Institute of the Balearic Islands (IdISBa), 07010, Palma, Spain.
- Microbiology Department, University Hospital Son Espases (HUSE), 07010, Palma, Spain.
- Centro de Investigación Biomédica en Red, Área Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| |
Collapse
|
3
|
Barceló IM, Jordana-Lluch E, Escobar-Salom M, Torrens G, Fraile-Ribot PA, Cabot G, Mulet X, Zamorano L, Juan C, Oliver A. Role of Enzymatic Activity in the Biological Cost Associated with the Production of AmpC β-Lactamases in Pseudomonas aeruginosa. Microbiol Spectr 2022; 10:e0270022. [PMID: 36214681 PMCID: PMC9604156 DOI: 10.1128/spectrum.02700-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/22/2022] [Indexed: 01/04/2023] Open
Abstract
In the current scenario of growing antibiotic resistance, understanding the interplay between resistance mechanisms and biological costs is crucial for designing therapeutic strategies. In this regard, intrinsic AmpC β-lactamase hyperproduction is probably the most important resistance mechanism of Pseudomonas aeruginosa, proven to entail important biological burdens that attenuate virulence mostly under peptidoglycan recycling alterations. P. aeruginosa can acquire resistance to new β-lactam-β-lactamase inhibitor combinations (ceftazidime-avibactam and ceftolozane-tazobactam) through mutations affecting ampC and its regulatory genes, but the impact of these mutations on the associated biological cost and the role that β-lactamase activity plays per se in contributing to the above-mentioned virulence attenuation are unknown. The same questions remain unsolved for plasmid-encoded AmpC-type β-lactamases such as FOX enzymes, some of which also provide resistance to new β-lactam-β-lactamase inhibitor combinations. Here, we assessed from different perspectives the effects of changes in the active center and, thus, in the hydrolytic spectrum resistance to inhibitors of AmpC-type β-lactamases on the fitness and virulence of P. aeruginosa, using site-directed mutagenesis; the previously described AmpC variants T96I, G183D, and ΔG229-E247; and, finally, blaFOX-4 versus blaFOX-8. Our results indicate the essential role of AmpC activity per se in causing the reported full virulence attenuation (in terms of growth, motility, cytotoxicity, and Galleria mellonella larvae killing), although the biological cost of the above-mentioned AmpC-type variants was similar to that of the wild-type enzymes. This suggests that there is not an important biological burden that may limit the selection/spread of these variants, which could progressively compromise the future effectiveness of the above-mentioned drug combinations. IMPORTANCE The growing antibiotic resistance of the top nosocomial pathogen Pseudomonas aeruginosa pushes research to explore new therapeutic strategies, for which the resistance-versus-virulence balance is a promising source of targets. While resistance often entails significant biological costs, little is known about the bases of the virulence attenuations associated with a resistance mechanism as extraordinarily relevant as β-lactamase production. We demonstrate that besides potential energy and cell wall alterations, the enzymatic activity of the P. aeruginosa cephalosporinase AmpC is essential for causing the full attenuation associated with its hyperproduction by affecting different features related to pathogenesis, a fact exploitable from the antivirulence perspective. Less encouraging, we also show that the production of different chromosomal/plasmid-encoded AmpC derivatives conferring resistance to some of the newest antibiotic combinations causes no significantly increased biological burdens, which suggests a free way for the selection/spread of these types of variants, potentially compromising the future effectiveness of these antipseudomonal therapies.
Collapse
Affiliation(s)
- Isabel M. Barceló
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| | - Elena Jordana-Lluch
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
| | - María Escobar-Salom
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| | - Gabriel Torrens
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
- Department of Molecular Biology, Umeå Centre for Microbial Research (UCMR), Umeå University, Umeå, Sweden
- Laboratory for Molecular Infection Medicine Sweden, Umeå Centre for Microbial Research (UCMR), Umeå University, Umeå, Sweden
| | - Pablo A. Fraile-Ribot
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| | - Gabriel Cabot
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| | - Xavier Mulet
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| | - Laura Zamorano
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| | - Carlos Juan
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| | - Antonio Oliver
- Research Unit, University Hospital Son Espases-Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Microbiology Department, University Hospital Son Espases, Palma, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Infecciosas, Madrid, Spain
| |
Collapse
|
4
|
Cerón-Pisa N, Shafiek H, Martín-Medina A, Verdú J, Jordana-Lluch E, Escobar-Salom M, Barceló IM, López-Causapé C, Oliver A, Juan C, Iglesias A, Cosío BG. Effects of Inhaled Corticosteroids on the Innate Immunological Response to Pseudomonas aeruginosa Infection in Patients with COPD. Int J Mol Sci 2022; 23:ijms23158127. [PMID: 35897707 PMCID: PMC9332726 DOI: 10.3390/ijms23158127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/16/2022] Open
Abstract
Inhaled corticosteroids (ICS) use is associated with an increased risk of Pseudomonas aeruginosa (PA) infection in patients with COPD. We aimed to evaluate the effects of ICS on alveolar macrophages in response to PA in COPD patients with and without baseline ICS treatment (COPD and COPD + ICS, respectively) as well as smoker and nonsmoker controls. To do so, cells were infected with PA and cotreated with budesonide (BUD) or fluticasone propionate (FLU). The analysis of NF-κB and c-jun activity revealed a significant increase in both factors in response to PA cotreated with BUD/FLU in smokers but not in COPD or COPD + ICS patients when compared with PA infection alone. The expression of Toll-like receptor 2 (TLR2) and the transcription factor c-jun were induced upon PA infection in nonsmokers only. Moreover, in the smoker and COPD groups, there was a significant increase in TLR2 and a decrease in c-jun expression when treated with BUD/FLU after PA infection, which were not observed in COPD + ICS patients. Therefore, the chronic use of ICS seemingly makes the macrophages tolerant to BUD/FLU stimulation compared with those from patients not treated with ICS, promoting an impaired recognition of PA and activity of alveolar macrophages in terms of altered expression of TLR2 and cytokine production, which could explain the increased risk of PA infection in COPD patients under ICS treatment.
Collapse
Affiliation(s)
- Noemi Cerón-Pisa
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
| | - Hanaa Shafiek
- Chest Diseases Department, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt;
| | - Aina Martín-Medina
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
| | - Javier Verdú
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Department of Respiratory Medicine, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Elena Jordana-Lluch
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC), 28029 Madrid, Spain
- Department of Microbiology, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Maria Escobar-Salom
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC), 28029 Madrid, Spain
- Department of Microbiology, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Isabel M. Barceló
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC), 28029 Madrid, Spain
- Department of Microbiology, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Carla López-Causapé
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC), 28029 Madrid, Spain
- Department of Microbiology, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Antonio Oliver
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC), 28029 Madrid, Spain
- Department of Microbiology, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Carlos Juan
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III (CIBERINFEC), 28029 Madrid, Spain
- Department of Microbiology, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
| | - Amanda Iglesias
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES), 28029 Madrid, Spain
- Correspondence: (A.I.); (B.G.C.); Tel.: +34-871-205-050 (ext. 64521) (A.I. & B.G.C.)
| | - Borja G. Cosío
- Instituto de Investigación Sanitaria de Les Illes Balears (IdISBa), Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain; (N.C.-P.); (A.M.-M.); (J.V.); (E.J.-L.); (M.E.-S.); (I.M.B.); (C.L.-C.); (A.O.); (C.J.)
- Department of Respiratory Medicine, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES), 28029 Madrid, Spain
- Correspondence: (A.I.); (B.G.C.); Tel.: +34-871-205-050 (ext. 64521) (A.I. & B.G.C.)
| |
Collapse
|
5
|
Barceló IM, Torrens G, Escobar-Salom M, Jordana-Lluch E, Capó-Bauzá MM, Ramón-Pallín C, García-Cuaresma D, Fraile-Ribot PA, Mulet X, Oliver A, Juan C. Impact of Peptidoglycan Recycling Blockade and Expression of Horizontally Acquired β-Lactamases on Pseudomonas aeruginosa Virulence. Microbiol Spectr 2022; 10:e0201921. [PMID: 35171032 PMCID: PMC8849096 DOI: 10.1128/spectrum.02019-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/24/2022] [Indexed: 01/02/2023] Open
Abstract
In the current scenario of antibiotic resistance magnification, new weapons against top nosocomial pathogens like Pseudomonas aeruginosa are urgently needed. The interplay between β-lactam resistance and virulence is considered a promising source of targets to be attacked by antivirulence therapies, and in this regard, we previously showed that a peptidoglycan recycling blockade dramatically attenuated the pathogenic power of P. aeruginosa strains hyperproducing the chromosomal β-lactamase AmpC. Here, we sought to ascertain whether this observation could be applicable to other β-lactamases. To do so, P. aeruginosa wild-type or peptidoglycan recycling-defective strains (ΔampG and ΔnagZ) harboring different cloned β-lactamases (transferable GES, VIM, and OXA types) were used to assess their virulence in Galleria mellonella larvae by determining 50% lethal doses (LD50s). A mild yet significant LD50 increase was observed after peptidoglycan recycling disruption per se, whereas the expression of class A and B enzymes did not impact virulence. While the production of the narrow-spectrum class D OXA-2 entailed a slight attenuation, its extended-spectrum derivatives OXA-226 (W159R [bearing a change of W to R at position 159]), OXA-161 (N148D), and principally, OXA-539 (D149 duplication) were associated with outstanding virulence impairments, especially in recycling-defective backgrounds (with some LD50s being >1,000-fold that of the wild type). Although their exact molecular bases remain to be deciphered, these results suggest that mutations affecting the catalytic center and, therefore, the hydrolytic spectrum of OXA-2-derived enzymes also drastically impact the pathogenic power of P. aeruginosa. This work provides new and relevant knowledge to the complex topic of the interplay between the production of β-lactamases and virulence that could be useful to build future therapeutic strategies against P. aeruginosa. IMPORTANCE Pseudomonas aeruginosa is one of the leading nosocomial pathogens whose growing resistance makes the development of therapeutic options extremely urgent. The resistance-virulence interplay has classically aroused researchers' interest as a source of therapeutic targets. In this regard, we describe a wide array of virulence attenuations associated with different transferable β-lactamases, among which the production of OXA-2-derived extended-spectrum β-lactamases stood out as a dramatic handicap for pathogenesis, likely as a side effect of mutations causing the expansion of their hydrolytic spectrums. Moreover, our results confirm the validity of disturbing peptidoglycan recycling as a weapon to attenuate P. aeruginosa virulence in class C and D β-lactamase production backgrounds. In the current scenario of dissemination of horizontally acquired β-lactamases, this work brings out new data on the complex interplay between the production of specific enzymes and virulence attenuation that, if complemented with the characterization of the underlying mechanisms, will likely be exploitable to develop future virulence-targeting antipseudomonal strategies.
Collapse
Affiliation(s)
- Isabel M. Barceló
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Gabriel Torrens
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - María Escobar-Salom
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Elena Jordana-Lluch
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - María Magdalena Capó-Bauzá
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Carlos Ramón-Pallín
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Daniel García-Cuaresma
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Pablo A. Fraile-Ribot
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Xavier Mulet
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Antonio Oliver
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Carlos Juan
- Microbiology Department and Research Unit, University Hospital Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- CIBER de Enfermedades Infecciosas, Madrid, Spain
| |
Collapse
|
6
|
Torrens G, Barceló IM, Pérez-Gallego M, Escobar-Salom M, Tur-Gracia S, Munar-Bestard M, González-Nicolau MDM, Cabrera-Venegas YJ, Rigo-Rumbos EN, Cabot G, López-Causapé C, Rojo-Molinero E, Oliver A, Juan C. Publisher Correction: Profiling the susceptibility of Pseudomonas aeruginosa strains from acute and chronic infections to cell-wall-targeting immune proteins. Sci Rep 2020; 10:4356. [PMID: 32132557 PMCID: PMC7055294 DOI: 10.1038/s41598-020-60494-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Gabriel Torrens
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Isabel M Barceló
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Marcelo Pérez-Gallego
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Maria Escobar-Salom
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Sara Tur-Gracia
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Marta Munar-Bestard
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - María Del Mar González-Nicolau
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Yoandy José Cabrera-Venegas
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Estefany Nayarith Rigo-Rumbos
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Gabriel Cabot
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Carla López-Causapé
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Estrella Rojo-Molinero
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Antonio Oliver
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Carlos Juan
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain.
| |
Collapse
|
7
|
Torrens G, Barceló IM, Pérez-Gallego M, Escobar-Salom M, Tur-Gracia S, Munar-Bestard M, González-Nicolau MDM, Cabrera-Venegas YJ, Rigo-Rumbos EN, Cabot G, López-Causapé C, Rojo-Molinero E, Oliver A, Juan C. Profiling the susceptibility of Pseudomonas aeruginosa strains from acute and chronic infections to cell-wall-targeting immune proteins. Sci Rep 2019; 9:3575. [PMID: 30837659 PMCID: PMC6401076 DOI: 10.1038/s41598-019-40440-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 02/06/2019] [Indexed: 02/06/2023] Open
Abstract
In the current scenario of high antibiotic resistance, the search for therapeutic options against Pseudomonas aeruginosa must be approached from different perspectives: cell-wall biology as source of bacterial weak points and our immune system as source of weapons. Our recent study suggests that once the permeability barrier has been overcome, the activity of our cell-wall-targeting immune proteins is notably enhanced, more in mutants with impaired peptidoglycan recycling. The present work aims at analyzing the activity of these proteins [lysozyme and Peptidoglycan-Recognition-Proteins (PGLYRPs)], alone or with a permeabilizer (subinhibitory colistin) in clinical strains, along with other features related to the cell-wall. We compared the most relevant and complementary scenarios: acute (bacteremia) and chronic infections [early/late isolates from lungs of cystic fibrosis (CF) patients]. Although a low activity of lysozyme/PGLYRPs per se (except punctual highly susceptible strains) was found, the colistin addition significantly increased their activity regardless of the strains’ colistin resistance levels. Our results show increased susceptibility in late CF isolates, suggesting that CF adaptation renders P. aeruginosa more vulnerable to proteins targeting the cell-wall. Thus, our work suggests that attacking some P. aeruginosa cell-wall biology-related elements to increase the activity of our innate weapons could be a promising therapeutic strategy.
Collapse
Affiliation(s)
- Gabriel Torrens
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Isabel M Barceló
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Marcelo Pérez-Gallego
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Maria Escobar-Salom
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Sara Tur-Gracia
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Marta Munar-Bestard
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - María Del Mar González-Nicolau
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Yoandy José Cabrera-Venegas
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Estefany Nayarith Rigo-Rumbos
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Gabriel Cabot
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Carla López-Causapé
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Estrella Rojo-Molinero
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Antonio Oliver
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain
| | - Carlos Juan
- Servicio de Microbiología and Unidad de Investigación, Hospital Universitari Son Espases-Institut de Investigació Sanitària de Balears (IdISBa), Palma, Spain.
| |
Collapse
|