eTransposon mutagenesis was used to identify novel determinants of intrinsic â¤-lactam resistance in Acinetobacter baumannii. An EZ-Tn5 transposon insertion in a gene corresponding to the A1S_0225 sequence resulted in a 4-fold decrease in resistance to ampicillin, cefotaxime, imipenem, and ceftriaxone but did not alter resistance to other classes of antibiotics. Based on this phenotype, the gene was designated blhA (â¤-lactam hypersusceptibility). The blhA::EZ-Tn5 mutation conferred a similar phenotype in A. baumannii strain ATCC 17978. The wild-type blhA gene complemented the blhA::EZTn5 insertion and restored â¤-lactam resistance levels back to wild-type levels. The blhA mutation also increased â¤-lactam susceptibility in an adeB adeJ double mutant, indicating that the blhA mutation acted independently of these efflux systems to mediate susceptibility. In addition, mRNA levels for the bla OXA and bla ADC â¤-lactamase genes were not altered by the blhA mutation. The blhA mutation resulted in a prominent cell division and morphological defect, with cells exhibiting a highly elongated phenotype, combined with large bulges in some cells. The blhA gene is unique to Acinetobacter and likely represents a novel gene involved in cell division. Three additional mutations, in zipA, zapA, and ftsK, each of which encode predicted cell division proteins, also conferred increased â¤-lactam susceptibility, indicating a common link between cell division and intrinsic â¤-lactam resistance in A. baumannii.
The Gram-negative bacterium Acinetobacter baumannii is rapidly becoming an important human pathogen and is associated with infections of the lungs, skin and soft tissues, bloodstream, and urinary tract (1-5). Infections due to this bacterium are primarily health care associated, but the incidence of community-acquired infections is on the rise and may reflect the increased virulence of some strains (6-8). The importance of this bacterium has been recognized by the Infectious Diseases Society of America, who classified it as a member of the ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens due to the extensive antibiotic resistances that are present (9, 10). Treatment of this bacterium with antibiotics is becoming increasingly problematic, with decreasing therapeutic options, and in some cases isolates are resistant to all commonly used antibiotics.Intrinsic resistance to the â¤-lactam class of antibiotics in A. baumannii is mediated by a number of mechanisms, including (i) chromosomally encoded â¤-lactamases; (ii) alterations in penicillin binding proteins (PBPs); (iii) efflux via members of the resistance-nodulation-division (RND) family, such as AdeABC and AdeIJK; and (iv) changes in outer membrane permeability (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The chromosomally encoded â¤-lactamases include those encoded by the bla ADC and bla OXA genes (17-22). Resistance conferred by the bla ADC and bla OXA genes typically ...