Abstract
Clinical isolates of enterococci (Streptococcus faecalis) with high-level resistance to both streptomycin and kanamycin (minimal inhibitory concentration >2,000 μg/ml), and resistant to synergism with penicillin and streptomycin or kanamycin were examined for aminoglycoside-inactivating enzymes. All of the 10 strains studied had streptomycin adenylyltransferase and neomycin phosphotransferase activities; the latter enzyme phosphorylated amikacin as well as its normal substrates, such as kanamycin. Substrate profiles of the neomycin phosphotransferase activity suggested that phosphorylation occurred at the 3′-hydroxyl position, i.e., aminoglycoside 3′-phosphotransferase. A transconjugant strain, which acquired high-level aminoglycoside resistance and resistance to antibiotic synergism after mating with a resistant clinical isolate, also acquired both enzyme activities. Quantitative phosphorylation of amikacin in vitro by a sonicate of the transconjugant strain inactivated the antibiotic, as measured by bioassay, and the phosphorylated drug failed to produce synergism when combined with penicillin against a strain sensitive to penicillin-amikacin synergism.
No differences were found in the sensitivity of ribosomes from a sensitive and resistant strain when examined in vitro using polyuridylic acid directed [14C]-phenylalanine incorporation in the presence of streptomycin, kanamycin, or amikacin. Therefore, we conclude that aminoglycoside-inactivating enzymes are responsible for the aminoglycoside resistance, and resistance to antibiotic synergism observed in these strains.
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- Benveniste R., Davies J. Mechanisms of antibiotic resistance in bacteria. Annu Rev Biochem. 1973;42:471–506. doi: 10.1146/annurev.bi.42.070173.002351. [DOI] [PubMed] [Google Scholar]
- Bryan L. E., Van Den Elzen H. M. Effects of membrane-energy mutations and cations on streptomycin and gentamicin accumulation by bacteria: a model for entry of streptomycin and gentamicin in susceptible and resistant bacteria. Antimicrob Agents Chemother. 1977 Aug;12(2):163–177. doi: 10.1128/aac.12.2.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Calderwood S. A., Wennersten C., Moellering R. C., Jr, Kunz L. J., Krogstad D. J. Resistance to six aminoglycosidic aminocyclitol antibiotics among enterococci: prevalence, evolution, and relationship to synergism with penicillin. Antimicrob Agents Chemother. 1977 Sep;12(3):401–405. doi: 10.1128/aac.12.3.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Courvalin P., Davies J. Plasmid-medicated aminoglycoside phosphotransferase of broad substrate range that phosphorylates amikacin. Antimicrob Agents Chemother. 1977 Apr;11(4):619–624. doi: 10.1128/aac.11.4.619. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Iannini P. B., Ehret J., Eickhoff T. C. Effects of ampicillin-amikacin and ampicillin-rifampin on enterococci. Antimicrob Agents Chemother. 1976 Mar;9(3):448–451. doi: 10.1128/aac.9.3.448. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jacob A. E., Hobbs S. J. Conjugal transfer of plasmid-borne multiple antibiotic resistance in Streptococcus faecalis var. zymogenes. J Bacteriol. 1974 Feb;117(2):360–372. doi: 10.1128/jb.117.2.360-372.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jawetz E., Gunnison J. B., Coleman V. R. The Combined Action of Penicillin with Streptomycin or Chloromycetin on Enterococci in Vitro. Science. 1950 Mar 10;111(2880):254–256. doi: 10.1126/science.111.2880.254. [DOI] [PubMed] [Google Scholar]
- Krogstad D. J., Korfhagen T. R., Moellering R. C., Jr, Wennersten C., Swartz M. N. Plasmid-mediated resistance to antibiotic synergism in enterococci. J Clin Invest. 1978 Jun;61(6):1645–1653. doi: 10.1172/JCI109085. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moellering R. C., Jr, Watson B. K., Kunz L. J. Endocarditis due to group D streptococci. Comparison of disease caused by streptococcus bovis with that produced by the enterococci. Am J Med. 1974 Aug;57(2):239–250. doi: 10.1016/0002-9343(74)90448-3. [DOI] [PubMed] [Google Scholar]
- Ozanne B., Benveniste R., Tipper D., Davies J. Aminoglycoside antibiotics: inactivation by phosphorylation in Escherichia coli carrying R factors. J Bacteriol. 1969 Nov;100(2):1144–1146. doi: 10.1128/jb.100.2.1144-1146.1969. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ruhen R. W., Darrell J. H. Antibiotic synergism against group D streptococci in the treatment of endocarditis. Med J Aust. 1973 Jul 21;2(3):114–116. doi: 10.5694/j.1326-5377.1973.tb128693.x. [DOI] [PubMed] [Google Scholar]
- Smith D. H. R factors for aminoglycoside antibiotics. J Infect Dis. 1969 Apr-May;119(4):378–380. doi: 10.1093/infdis/119.4-5.378. [DOI] [PubMed] [Google Scholar]
- Standiford H. D., De Maine J. B., Kirby W. M. Antibiotic synergism of enterococci. Relation to inhibitory concentrations. Arch Intern Med. 1970 Aug;126(2):255–259. [PubMed] [Google Scholar]
- Umezawa H., Okanishi M., Kondo S., Hamana K., Utahara R., Maeda K., Mitsuhashi S. Phosphorylative inactivation of aminoglycosidic antibiotics by Escherichia coli carrying R factor. Science. 1967 Sep 29;157(3796):1559–1561. [PubMed] [Google Scholar]
- Umezawa H., Yamamoto H., Yagisawa M., Kondo S., Takeuchi T. Letter: Kanamycin phosphotransferase. I. Mechanism of cross resistance between kanamycin and lividomycin. J Antibiot (Tokyo) 1973 Jul;26(7):407–411. doi: 10.7164/antibiotics.26.407. [DOI] [PubMed] [Google Scholar]
- Umezawa Y., Yagisawa M., Sawa T., Takeuchi T., Umezawa H. Aminoglycoside 3'-phosphotransferase III, a new phosphotransferase. Resistance mechanism. J Antibiot (Tokyo) 1975 Nov;28(11):845–853. doi: 10.7164/antibiotics.28.845. [DOI] [PubMed] [Google Scholar]
- Winters R. E., Litwack K. D., Hewitt W. L. Relation between dose and levels of gentamicin in blood. J Infect Dis. 1971 Dec;124 (Suppl):S90–S95. doi: 10.1093/infdis/124.supplement_1.s90. [DOI] [PubMed] [Google Scholar]
- Yamada T., Tipper D., Davies J. Enzymatic inactivation of streptomycin by R factor-resistant Escherichia coli. Nature. 1968 Jul 20;219(5151):288–291. doi: 10.1038/219288a0. [DOI] [PubMed] [Google Scholar]
- Zimmermann R. A., Moellering R. C., Jr, Weinberg A. N. Mechanism of resistance to antibiotic synergism in enterococci. J Bacteriol. 1971 Mar;105(3):873–879. doi: 10.1128/jb.105.3.873-879.1971. [DOI] [PMC free article] [PubMed] [Google Scholar]