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Overproduction of a low-affinity penicillin-binding protein and high-level ampicillin resistance in Enterococcus

R Fontana1, M Aldegheri, M Ligozzi

  • 1Instituto di Microbiologia, Università di Verona, Italy.

Insights

Ampicillin resistance in Enterococcus faecium correlates with overproduction of penicillin-binding protein 5 (PBP 5). Highly resistant strains show modified PBP 5, suggesting altered penicillin-binding capabilities.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Antibiotic Resistance

Background:

  • Enterococcus faecium is a significant cause of nosocomial infections.
  • Ampicillin resistance in E. faecium is a growing clinical concern.
  • Penicillin-binding proteins (PBPs) are key targets for beta-lactam antibiotics.

Purpose of the Study:

  • To investigate the correlation between ampicillin resistance levels and the overproduction of low-affinity penicillin-binding protein 5 (PBP 5) in clinical isolates of Enterococcus faecium.
  • To compare PBP 5 levels in ampicillin-susceptible and resistant strains, including laboratory-derived resistant mutants.

Main Methods:

  • Analysis of five ampicillin-resistant clinical isolates of Enterococcus faecium.
  • Comparison with one susceptible isolate and its ampicillin-resistant derivative.
  • Use of polyclonal antibodies specific to low-affinity PBP to quantify PBP 5 levels in E. faecium isolates.

Main Results:

  • Overproduction of low-affinity PBP was observed in moderately resistant strains (MIC, 32 µg/mL).
  • Highly resistant strains (MIC, 128 µg/mL) also showed significant amounts of PBP 5, suggesting overproduction.
  • Antibody reactions confirmed the presence of a membrane protein identical in mass to PBP 5 in all strains, with varying amounts.

Conclusions:

  • Overproduction of low-affinity PBP 5 is associated with ampicillin resistance in Enterococcus faecium.
  • Highly resistant strains may possess a modified PBP 5 with altered penicillin-binding capabilities compared to moderately resistant strains.
  • These findings highlight the role of PBP 5 alterations in the development of high-level ampicillin resistance in E. faecium.

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