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Kidd TJ, Mills G, Sá-Pessoa J, Dumigan A, Frank CG, Insua JL, Ingram R, Hobley L, Bengoechea JA. A Klebsiella pneumoniae antibiotic resistance mechanism that subdues host defences and promotes virulence. EMBO Mol Med 2017; 9:430-447. [PMID: 28202493 PMCID: PMC5376759 DOI: 10.15252/emmm.201607336] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Klebsiella pneumoniae is an important cause of multidrug‐resistant infections worldwide. Recent studies highlight the emergence of multidrug‐resistant K. pneumoniae strains which show resistance to colistin, a last‐line antibiotic, arising from mutational inactivation of the mgrB regulatory gene. However, the precise molecular resistance mechanisms of mgrB‐associated colistin resistance and its impact on virulence remain unclear. Here, we constructed an mgrB gene K. pneumoniae mutant and performed characterisation of its lipid A structure, polymyxin and antimicrobial peptide resistance, virulence and inflammatory responses upon infection. Our data reveal that mgrB mutation induces PhoPQ‐governed lipid A remodelling which confers not only resistance to polymyxins, but also enhances K. pneumoniae virulence by decreasing antimicrobial peptide susceptibility and attenuating early host defence response activation. Overall, our findings have important implications for patient management and antimicrobial stewardship, while also stressing antibiotic resistance development is not inexorably linked with subdued bacterial fitness and virulence.
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Affiliation(s)
- Timothy J Kidd
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK.,School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Qld, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Grant Mills
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Joana Sá-Pessoa
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Amy Dumigan
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Christian G Frank
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - José L Insua
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Rebecca Ingram
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - Laura Hobley
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - José A Bengoechea
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
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