Origins and Evolution of Antibiotic Resistance

Summary: Antibiotics have always been considered one of the wonder discoveries of the 20th century. This is true, but the real wonder is the rise of antibiotic resistance in hospitals, communities, and the environment concomitant with their use. The extraordinary genetic capacities of microbes have benefitted from man''s overuse of antibiotics to exploit every source of resistance genes and every means of horizontal gene transmission to develop multiple mechanisms of resistance for each and every antibiotic introduced into practice clinically, agriculturally, or otherwise. This review presents the salient aspects of antibiotic resistance development over the past half-century, with the oft-restated conclusion that it is time to act. To achieve complete restitution of therapeutic applications of antibiotics, there is a need for more information on the role of environmental microbiomes in the rise of antibiotic resistance. In particular, creative approaches to the discovery of novel antibiotics and their expedited and controlled introduction to therapy are obligatory.     

Modeling Non-inherited Antibiotic Resistance

A mathematical model is presented for the increase and decrease of non-inherited antibiotic resistance levels in bacteria. The model is applied to experimental data on E. coli exposed to amoxicillin or tetracyclin in different concentrations. The parameters of the model are estimated using a Monte Carlo Markov Chain method. The model accurately describes build-up and decline of antibiotic resistance caused by physiological adaptations as long as no genetic changes have occurred. The main conclusion of the analysis is that short time periods are sufficient to re-obtain low MIC-values after long-lasting exposure to these antibiotics.     

Biosynthesis of Sibiromycin,a Potent Antitumor Antibiotic

Pyrrolobenzodiazepines, a class of natural products produced by actinomycetes, are sequence selective DNA alkylating compounds with significant antitumor properties. Among the pyrrolo[1,4]benzodiazepines (PBDs) sibiromycin, one of two identified glycosylated PBDs, displays the highest affinity for DNA and the most potent antitumor properties. Despite the promising antitumor properties clinical trials of sibiromycin were precluded by the cardiotoxicity effect in animals attributed to the presence of the C-9 hydroxyl group. As a first step toward the development of sibiromycin analogs, we have cloned and localized the sibiromycin gene cluster to a 32.7-kb contiguous DNA region. Cluster boundaries tentatively assigned by comparative genomics were verified by gene replacement experiments. The sibiromycin gene cluster consisting of 26 open reading frames reveals a “modular” strategy in which the synthesis of the anthranilic and dihydropyrrole moieties is completed before assembly by the nonribosomal peptide synthetase enzymes. In addition, the gene cluster identified includes open reading frames encoding enzymes involved in sibirosamine biosynthesis, as well as regulatory and resistance proteins. Gene replacement and chemical complementation studies are reported to support the proposed biosynthetic pathway.Pyrrolo[1,4]benzodiazepines (PBDs) are a class of natural products found in actinomycetes (Fig. ​(Fig.1)1) and defined by a common pyrrolo[1,4]benzodiazepine ring system (41). They are sequence-selective DNA alkylating agents with significant antitumor properties (21). Once in the minor groove of DNA an aminal bond is formed between the electrophilic C-11 of a PBD and the exocyclic N-2 of a guanine base in a double-stranded DNA (20). Formation of the PBD-DNA complex causes very little distortion of the double-helical structure of DNA (20), and as such this complex is less readily repaired by DNA repair proteins compared to DNA adducts with other alkylating agents (4), significantly contributing to the potency of PBDs. Successful syntheses of PBD analogs have been reported, but synthetic procedures for the more chemically diverse PBDs are laborious and have modest yields (1, 44). In addition, a chemical synthesis for glycosylated PBDs has not yet been accomplished. Structure-activity relationship studies on the synthetically and naturally produced PBDs showed that the C-9 hydroxylation present in anthramycin is the source of the cardiotoxic properties of this compound (Fig. ​(Fig.1)1) (3, 17, 26, 38). These studies also showed that O glycosylation at C7 significantly enhanced DNA-binding affinity (Fig. ​(Fig.1)1) (17). The only known glycosylated PBDs are sibiromycin and sibanomicin produced by Streptosporangium sibiricum and Micromonospora sp., respectively, both containing a sibirosamine moiety (16, 35). Only the producer of sibiromycin is commercially available. A loose correlation between DNA binding affinity and cytotoxicity has been shown with naturally and synthetically produced PBDs (42). Sibiromycin has the highest DNA binding affinity and cytotoxicity with 50% inhibitory concentrations varying from 4 to 1.7 pM in leukemia, plasmacytoma, and ovarian cancer cell lines (42). Despite its potency, further testing of sibiromycin is precluded due to the presence of C-9 hydroxyl group responsible for the cardiotoxic properties. In order to generate analogs of glycosylated PBDs by combinatorial biosynthesis and to exploit their potency, we chose to characterize the sibiromycin gene cluster.Open in a separate windowFIG. 1.(A) Pyrrolobenzodiazepine common ring system. (B) Metabolic precursors and chemical structures of sibiromycin, anthramycin, tomaymycin, and lincomycin A.The metabolic precursors of the pyrrolobenzodiazepine ring of three PBDs (anthramycin, sibiromycin, and tomaymycin) were identified by feeding experiments to be l-tryptophan via the kynurenine pathway for the anthranilate moiety and l-tyrosine for the hydropyrrole moiety (11), suggesting a common biosynthetic pathway for these moieties in PBDs. The tyrosine-to-hydropyrrole transformation has been also identified by feeding studies in the biosynthesis of lincomycin, a lincosamide antibiotic (2) (Fig. ​(Fig.1B).1B). Despite the sequencing of the biosynthetic gene clusters of anthramycin (10) and lincomycin (37), limited functional assignment of open reading frames (ORFs) and elucidation of the biosynthetic pathways were reported partly due to the presence of several gene products with no significant similarities to functionally characterized enzymes. We reasoned that we could take advantage of the identification of the sibiromycin gene cluster not only to try to lay the groundwork for the production of analogs of sibiromycin by combinatorial biosynthesis but also to establish the biosynthetic pathways of the anthranilate and the hydropyrrole moieties by a comparative analysis of the PBDs and lincomycin gene clusters. To help in this analysis, we have also utilized the gene cluster of another PBD, tomaymycin, whose characterization is reported in the accompanying study (24a). The comparative analysis takes advantage of the presence of similarity and differences at the anthranilate and hydropyrrole moieties among these natural products (Fig. ​(Fig.1).1). For example, both anthramycin and sibiromycin contain C-8 methyl and C-9 hydroxyl substituents not present in tomaymycin. However, tomaymycin shares with sibiromycin a C-7 hydroxyl substituent. Therefore, homologous proteins involved in C-9 hydroxylation are expected to be present in the anthramycin and sibiromycin gene cluster but absent in the tomaymycin gene cluster. We applied a similar approach for the biosynthesis of the hydropyrrole moiety using also the lincomycin gene cluster.In the present study, we describe the cloning and sequencing of the sibiromycin gene cluster, the first biosynthetic gene cluster for a glycosylated PBD. Gene replacement experiments were used to confirm that the identified gene cluster was involved in sibiromycin biosynthesis, to define the boundaries of the sibiromycin gene cluster, and to elucidate the biosynthesis of the anthranilate moiety. Using the comparative approach, we were able not only to elucidate the sibiromycin biosynthetic pathway with a certain degree of confidence but also to assign ORFs in the anthramycin gene cluster contributing to the determination of the anthramycin biosynthetic pathway. The proposed biosynthetic pathway for the anthranilic moiety was supported by gene replacement and chemical complementation studies. The data reported here provide the basis for future studies on the enzymes involved in the biochemistry present in these pathways and for combinatorial biosynthetic experiments for the production of glycosylated PBDs.     

Reservoirs of Antibiotic Resistance Genes

A potential concern about the use of antibiotics in animal husbundary is that, as antibiotic resistant bacteria move from the farm into the human diet, they may pass antibiotic resistance genes to bacteria that normally reside in a the human intestinal tract and from there to bacteria that cause human disease (reservoir hypothesis). In this article various approaches to evaluating the risk of agricultural use of antibiotics are assessed critically. In addition, the potential benefits of applying new technology and using new insights from the field of microbial ecology are explained.     

Antibiotic Resistance in Bacteria and Its Future for Novel Antibiotic Development

Since the first introduction of the sulfa drugs and penicillin into clinical use, large numbers of antibiotics have been developed and hence contributed to human health. But extensive use of antibiotics has raised a serious public health problem due to multiantibiotic resistant bacterial pathogens that inevitably develop resistance to every new drug launched in the clinic. Consequently, there is a pressing need to develop new antibiotics to keep pace with bacterial resistance. Recent advances in microbial genomics and X-ray crystallography provide opportunities to identify novel antibacterial targets for the development of new classes of antibiotics and to design more potent antimicrobial compounds derived from existing antibiotics respectively. To prevent and control infectious diseases caused by multiantibiotic resistant bacteria, we need to understand more about the molecular aspects of the pathogens’ physiology and to pursue ways to prolong the life of precious antibiotics.     

Riboswitch Control of Aminoglycoside Antibiotic Resistance

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Highlights? The 5′ leader RNA of aminoglycoside antibiotic-resistance genes is conserved ? Aminoglycosides induce reporter gene expression by interacting with the leader RNA ? The aminoglycosides bind to the leader RNA and induce a change in the RNA structure ? Induction is independent of leader peptide stalling or drug-ribosome interactions     

Inhibiting the Evolution of Antibiotic Resistance

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Gonococcal Antibiotic Resistance in Los Angeles

One hundred and thirty-five gonococcal isolates collected from Los Angeles in 1972 were studied for antibiotic susceptibility to penicillin, ampicillin, carbenicillin, tetracycline, minocycline, doxycycline and spectinomycin. Only 12 percent of the isolates were sensitive to 0.05 μg per ml of penicillin while 35 percent required at least 0.5 μg per ml for inhibition of growth. The results were slightly better with ampicillin and nearly the same with carbenicillin. Nineteen percent of the isolates required at least 1.0 μg per ml of tetracycline for inhibition of growth and the results were similar with either minocycline or doxycycline. Forty-nine percent were sensitive to 2.0 μg per ml spectinomycin, but 37 percent required at least 8.0 μg per ml for inhibition of growth.In this study nine of eleven isolates resistant to 1.0 μg per ml of tetracycline were also resistant to both penicillin and spectinomycin. Six came from endocervical sites of female patients who contributed only 37 percent of the total number of isolates studied.Correlation between the agar dilution and disc diffusion methods was satisfactory with penicillin but not with ether tetracycline or spectinomycin.     

Silent Genes: Antimicrobial Resistance and Antibiotic Production

Silent genes are DNA sequences that are generally not expressed or expressed at a very low level. These genes become active as a result of mutation, recombination, or insertion. Silent genes can also be activated in laboratory conditions using pleiotropic, targeted genome-wide, or biosynthetic gene cluster approaches. Like every other gene, silent genes can spread through horizontal gene transfer. Most studies have focused on strains with phenotypic resistance, which is the most common subject. However, to fully understand the mechanism behind the spreading of antibiotic resistance, it is reasonable to study the whole resistome, including silent genes. Open in a separate window