Chromosomal resistance

The molecular basis of acquired chromosomal resistance for specific antibiotics is discussed later in this chapter. 

Two mechanisms of chromosomal resistance have been identified. A mutation of dihydropteroate synthetase (DHPS) in Strep, pneumoniae produces an altered enzyme with reduced affinity for sulphonamides. Hyperproduction of p-aminobenzoic acid (PABA) overcomes the block imposed by inhibition ofDHPS. The specific cause of PABA hyperproduction is unknown, though chromosomal mutation is the probable cause. 

Various mechanisms can be responsible for the development of resistance. Chromosomal resistance... 

Chromosomal resistance develops as a result of spontaneous mutation in a locus that controls susceptibility to a given antimicrobial drug the presence of the drug serves as a selecting mechanism to suppress susceptible organisms and favor the growth of drug-resistant mutants. In addition, extrachromosomal resis-... 

Chromosomal resistance Drug resistance of a micro-organism due to a mutation in chromosomal DNA. 

Resistance to the toxic effects of mercury is quite commonly found in bacteria (Silver and Walderhaug 1992 Misra 1992). Since most bacteria are rarely exposed to toxic levels of mercury, the resistance mechanism is inducible and is frequently found on plasmids and/or transposons. Many of the multi-antibiotic resistance plasmids that are frequently found in clinical collections have determinants of mercury resistance as well. Furthermore, mercury resistance is a consistent component of the chromosomal resistance determinant of MRS A (methicillin-resistant Staphylococcus aureus), a current clinical problem and one with no apparent connection to the use of mercurials. If the mercury resistance system is present, the expression of the detoxifying activities is tightly regulated and turned on only when needed. The MerR regulatory protein turns on mRNA synthesis by a positive activator mechanism (for primary references, see Silver and Walderhaug 1992 Misra 1992). 

Most plasmids are topologically closed circles of DNA. They can be separated from the bulk of the chromosomal DNA by virtue of their resistance to alkaline solution. The double-stranded stmcture of DNA is denatured at high pH, but because the two strands of the plasmid are topologically joined they are more readily renatured. This property is exploited in rapid procedures for the isolation of plasmid DNA from recombinant microorganisms (5,6). 

Bacteria produce chromosomady and R-plasmid (resistance factor) mediated P-lactamases. The plasmid-mediated enzymes can cross interspecific and intergeneric boundaries. This transfer of resistance via plasmid transfer between strains and even species has enhanced the problems of P-lactam antibiotic resistance. Many species previously controded by P-lactam antibiotics are now resistant. The chromosomal P-lactamases are species specific, but can be broadly classified by substrate profile, sensitivity to inhibitors, analytical isoelectric focusing, immunological studies, and molecular weight deterrnination. Individual enzymes may inactivate primarily penicillins, cephalosporins, or both, and the substrate specificity predeterrnines the antibiotic resistance of the producing strain. Some P-lactamases are produced only in the presence of the P-lactam antibiotic (inducible) and others are produced continuously (constitutive). 

Clinically resistant bacteria, vktuaUy 100% of the Enterobacteriaceae produce a low level of chromosomal enzyme that can clinically be selected for higher levels. 

To achieve overproduction of phenylalanine, the micro-organism should be derepressed at the pheA level and free of inhibition at the arcG level. Both genes are located on the chromosomal DNA of the micro-organism and, by means of amino add analogues such as p-fluoro-DL-phenylalanine, it is possible to make (phenylalanine) feedback resistant mutants of E.cdi (pheA and oroF mutants). The following procedure can be used ... 

Antibiotic Resistance. Figure 1 According to Bush, Jacoby and Medeiros [2] four molecular classes of (3-lactamases can be discriminated based upon biochemical and molecular features. Classes 1, 2, and 4 included serine-proteases, while metallo enzymes are included in class 3. The substrate spectrum varies between different subclasses and the corresponding genes can be part of an R-plasmid leading to a wider distribution or are encoded chromosomally in cells of specific species. 

Bacteria can develop resistance to antimicrobial agents as a result of mutational changes in the chromosome or via the acquisition of genetic material (resistance genes carried on plasmids or transposons or the recombination of foreign DNA into the chromosome) (Fig. 2). 

Overproduction of the chromosomal genes for the dihydrofolate reductase (DHFR) and the dihydroptero-ate synthase (DHPS) leads to a decreased susceptibility to trimethoprim and sulfamethoxazol, respectively. This is thought to be the effect of titrating out the antibiotics. However, clinically significant resistance is always associated with amino acid changes within the target enzymes leading to a decreased affinity of the antibiotics. 

Resistance to trimethoprim can be due to the acquisition of plasmid encoded non-allelic variants of the chromosomal DHFR enzyme that are antibiotic unsusceptible. The genes may be part of transposons that then insert into the chromosome. For instance, in gram-negative bacteria the most widespread gene is dhfrl on transposon Tn7. 

Transposons are mobile DNA elements (sizes 2.5-23 kbp) that move from one place to another in the chromosome or onto extrachromosomal genetic elements within the same cell. They are flanked by inverted repeats at then-ends and encode among other proteins a transposase that is needed for the transposition process. Resistance genes in the transposon are often parts of integrons. These are structures that cany an integrase responsible for the insertion of the resistance gene cassettes into the integron. 

Several groups of drugs that bind to tubulin at different sites interfere with its polymerization into microtubules. These drugs are of experimental and clinical importance (Bershadsky and Vasiliev, 1988). For example, colchicine, an alkaloid derived from the meadow saffron plant Colchicum autumnale or Colchicum speciosum), is the oldest and most widely studied of these drugs. It forms a molecular complex with tubulin in the cytosol pool and prevents its polymerization into microtubules. Other substances such as colcemid, podophyllotoxin, and noco-dazole bind to the tubulin molecule at the same site as colchicine and produce a similar effect, albeit with some kinetic differences. Mature ciliary microtubules are resistant to colchicine, whereas those of the mitotic spindle are very sensitive. Colchicine and colcemid block cell division in metaphase and are widely used in cytogenetic studies of cultured cells to enhance the yield of metaphase plate chromosomes. 

Acquired resistance. This occurs when bacteria which were previously susceptible become resistant, usually, but not always, after exposure to the antibiotic concerned. Intrirrsic resistance is always chromosomally mediated, whereas acquired resistance may occirr by mutations in the chromosome or by the acquisition of genes coding for resistance ftom an external source normally via a plasmid or transposon. Both types are clinically important and can result in treatment failure, although acquired resistance is more of a threat in the spread of antibiotic resistance (Russell Chopra 1996). 

Three genetic elements are responsible for acquired resistance chromosomes, plasmids and trarrsposons (Lewis 1989). Each of these will be considered in tiun. 

Resistance to certain antibiotics can arise as a consequence of mutations to chromosomal genes because of changes in the DNA sequence. Mutations can occin due to single base pair changes. Transitions involve the substitution of one purine (A or G) for another and therefore one pyrimidine (C or T) for another. Transversions involve a change from a pyrimidine to a purine and vice versa. Frameshift mutations occin when one or... 

Plasmids have the ability to transfer within and between species and can therefore be acquired from other bacteria as well as a consequence of cell division. This property makes plasmid-acquired resistance much more threatening in terms ofthe spread of antibiotic resistance than resistance acquired due to chromosomal mutation. Plasmids also harbour transposons (section 2.1.3), which enhances their ability to transfer antibiotic resistance genes. 

Chromosomally mediated resistance only Plasmid-mediated resistance Transposonst... 

Resistance may also be chromosomally mediated, t Multiple resistance genes may be carried on a transposon. 

Chromosomal and plasmid-mediated resistance to the sulphonamides has been described... 

Chromosomal mutations in E. coli result in overproduction of dihydrofolate reductase (DHFR). Higher concentrations of trimethoprim, which may not be therapeutically achievable, are therefore required to inhibit nucleotide metabolism. Other mutations lower the affinity of DHFR for trimethoprim. These two mechanisms of resistance may coexist in a single strain, effectively increasing the level of resistance to the antibiotic. 

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