Search PubMed⌕ Search

Biomedical subjects

C E Rubens

Publications and source records attributed to C E Rubens.

62 records · Page 4Linked to original sources

Cloning and expression in Escherichia coli of a gene encoding nonenzymatic chloramphenicol resistance from Pseudomonas aeruginosa.

High-level chloramphenicol resistance in Pseudomonas aeruginosa may be due to enzymatic inactivation, ribosomal mutation, or a permeability barrier. We investigated the nonenzymatic resistance mechanism encoded by Tn1696, a transposon found in P. aeruginosa. A 1-megadalton DNA fragment from Tn1696 was cloned which mediated expression of chloramphenicol resistance in Escherichia coli. Comparison of the effects of chloramphenicol on in vitro translation revealed no difference between the susceptible recipient strain and the resistant transformant containing the cloned gene. The rate of chloramphenicol uptake was slower in the resistant strain, suggesting a permeability barrier to the antibiotic. In addition, sodium dodecyl sulfate-polyacrylamide gel electrophoresis of outer membranes demonstrated the absence of a 50,000-dalton protein in the resistant strain. DNA homology was evident between Tn1696 and chloramphenicol-resistant isolates of Haemophilus influenzae possessing altered outer membrane permeability. We conclude that chloramphenicol resistance encoded by Tn1696 is due to a permeability barrier and hypothesize that the gene from P. aeruginosa may share a common ancestral origin with these genes from other gram-negative organisms.

Chloramphenicol↗

Characterization of non-beta-lactamase-mediated ampicillin resistance in Haemophilus influenzae.

Ampicillin resistance in Haemophilus influenzae is most often due to the plasmid-mediated production of TEM beta-lactamase. We studied four strains with high-level ampicillin resistance (MIC of 32 micrograms/ml with an inoculum of 10(5) CFU on solid media) which did not produce detectable beta-lactamase activity with two different detection methods. Two of the four strains contained extrachromosomal DNA by agarose gel electrophoresis. Conjugation failed to transfer ampicillin resistance; in contrast, transformation yielded ampicillin-resistant transformants in three of the four strains. These transformants did not contain detectable extrachromosomal DNA. In addition, mobilization of the resistance determinant by transformation to, or conjugation with, recombination-deficient strains was unsuccessful. DNA-DNA hybridization experiments revealed no homology of the DNA of these strains with two R plasmids (one coding for ampicillin resistance, the other for chloramphenicol and tetracycline resistance). We conclude that the genetic basis of the non-beta-lactamase ampicillin resistance in these strains appears to be chromosomally mediated. We investigated the mechanism of resistance in these strains. Enzymatic modification of penicillin was not detected by autoradiography of a thin-layer chromatogram of cell sonic extracts of three ampicillin-resistant transformant strains incubated with [14C]penicillin. To assess changes in permeability of the cell envelope, a plasmid coding for beta-lactamase was conjugated into these strains, and the hydrolysis of penicillin by intact cells and cell sonic extracts was compared. Only one of three transformant strains had significantly diminished permeability. Outer membrane proteins of these strains analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed apparent differences in comparison with the isogenic ampicillin-susceptible recipient strain. Autofluorography of a sodium dodecyl sulfate-polyacrylamide gel electrophoresis of Sarkosyl-solubilized crude membrane (the putative inner membranes) from these ampicillin-resistant transformant strains incubated with [3H]penicillin compared with the isogenic ampicillin-susceptible recipient strain revealed reduced binding to PBP 3 and 6, 3 and 4, or 4. In addition, affinity binding studies revealed decreased affinity of PBP 4 for ampicillin of all four transformants tested. We conclude that the major mechanism of resistance in these strains is altered penicillin-binding proteins; however, other mechanisms, including permeability, may also play a role.

Ampicillin↗

Evolution of antimicrobial resistance and nosocomial infection. Lessons from the Vanderbilt experience.

The development of antimicrobial resistance by bacteria has had profound effects of the clinical use of antibiotics, especially in hospital-acquired infections. In 1973, a large outbreak of nosocomial infections due to Serratia marcescens began at the Vanderbilt University medical complex, a major characteristic of which was high-level resistance to gentamicin and carbenicillin. Investigation of the outbreak and subsequent in vitro studies have shown that the evolution and epidemiology of this high-level resistance operated at three levels of organizations: (1) dissemination of individual strains, (2) dissemination of a plasmid among different strains and (3) movement of a discrete genetic element, or transposon, between plasmids. The investigations of this outbreak and other studies reviewed support the concept that resistant strains can evoke as a result of R-plasmid exchange within the hospital environment, providing an opportunity for control of this exchange can be interrupted.

Carbenicillin↗

Evolution of a plasmid mediating resistance to multiple antimicrobial agents during a prolonged epidemic of nosocomial infections.

At the Vanderbilt University Medical Center, Nashville, Tennessee, resistance to gentamicin was encountered with increasing frequency among several species of gram-negative bacilli between 1973 and 1977. Representative strains were screened for plasmid DNA content using agarose gel electrophoresis. In strains of Pseudomonas aeruginosa and Serrati marcescens isolated early in the outbreak, gentamicin resistance was mediated by a common 9.8-megadalton nonconjugative plasmid. Either an 80- or a 100-megadalton transferable plasmid coexisted with the nonconjugative plasmid in the isolates of Serratia. Transposition between the 100- and 9.8-megadalton plasmids in this species resulted in the formation of a 105-megadalton conjugative plasmid that mediated gentamicin resistance; this was observed in strains of Serratia and Klebsiella isolated in 1976-1977. Thus, during this five-year investigation separate outbreaks of nosocomial infections that were caused by different bacterial species were shown to be related by the presence of plasmids that contained a common transposable DNA sequence.

Bacteria↗

Loss of an aminoglycoside resistance plasmid by Serratia marcescens during treatment of meningitis with amikacin.

During prophylaxis with gentamicin and amoxicillin following surgical repair of a meningomyelocele in a newborn infant, a cerebrospinal fluid leak occurred and fever ensued. Cultures of ventricular fluid yielded Serratia marcescens resistant to several antibiotics, including gentamicin and tobramycin, but sensitive to amikacin. When therapy with amikacin was substituted for that with gentamicin and amoxicillin, cultures yielded an additional colony type of S. marcescens, which was antibiotic-sensitive but of the same serotype as the original isolate, that eventually replaced the original resistant organism. The resistant S. marcescens was shown to possess a 105 X 10(6)-dalton plasmid not observed in the sensitive variant. The sensitive variant may have originated by loss of the plasmid from the resistant organism, possibly by removal of the selection pressure of antibiotics, which favored the emergence of a bacterial population that did not harbor resistance plasmids during clinical therapy.

Amikacin↗

Transposable plasmid deoxyribonucleic acid sequence in Pseudomonas aeruginosa which mediates resistance to gentamicin and four other antimicrobial agents.

A 9.1 x 10(6)-dalton transposable deoxyribonucleic acid sequence resides within Pseudomonas aeruginosa plasmid R1033 and mediates resistance to gentamicin, streptomycin, sulfamethoxazole, chloramphenicol, and mercuric chloride. Transposability was demonstrated in Escherichia coli when this sequence, designated Tn1696, excised from R1033 and integrated into plasmid pMB8. Excision and insertion of Tn1696 occurred independently of the host Rec phenotype and may involve the 140-base pair, inverted deoxyribonucleic acid repeated region that flanks this sequence. Occurrence of a multiresistance transposon on a transferrable plasmid that has a broad host range may have serious epidemiological and therapeutic consequences.

Anti-Bacterial Agents↗

Evolution of multiple-antibiotic-resistance plasmids mediated by transposable plasmid deoxyribonucleic acid sequences.

Two plasmid deoxyribonucleic acid sequences mediating multiple antibiotic resistance transposed in vivo between coexisting plasmids in clinical isolates of Serratia marcescens. This event resulted in the evolution of a transferable multiresistance plasmid. Both sequences, designated in Tn1699 and Tn1700, were flanked by inverted deoxyribonucleic acid repetitions and could transpose between replicons independently of the Excherichia coli recA gene function. Tn1699 and Tn1700 mediated ampicillin, carbenicillin, kanamycin, and gentamicin resistance but differed in the type of gentamicin-acetyltransferase enzymes that they encoded. The structural genes for these enzymes share a great deal of polynucleotide sequence similarity despite their phenotypic differences. The transposition of Tn1699 and Tn1700 to coresident transferable plasmids has contributed to the dissemination of antibiotic resistance among other gram-negative bacteria. These organisms have recently caused nosocomial infections in epidemic proportions.

Anti-Bacterial Agents↗

Characteristics of gentamicin resistance in nosocomial infections.

Characteristics of gentamicin resistance were studied in gram-negative bacilli from 50 consecutive patients with nosocomial infection, during a time when gentamicin resistance had recently become prevalent at Medical University Hospital. Burns, decubitus ulcers, and cystic fibrosis were common precipitating factors for acquisition of gentamicin-resistant organisms. Pseudomonas aeruginosa accounted for 76% and Enterobacteriaceae for 24% of isolates. There was high prevalence of cross-resistance to amikacin (61%) and tobramycin (58%). Of the P aeruginosa strains 36% possessed plasmids which were rapidly detected by agarose gel electrophoresis. None of the isolates transferred gentamicin resistance. Representative isolates failed to elaborate aminoglycoside-modifying enzymes or to take up labelled amikacin. Multiple immunotypes of P aeruginosa were identified. These data suggest that a nonplasmid mediated resistance mechanism such as impermeability was responsible for the emergence of gentamicin resistance.

Amikacin↗