title: A new high-level gentamicin resistance gene, aph(2'')-Id, in Enterococcus spp.
abstract: Enterococcus casseliflavus UC73 is a clinical blood isolate with high-level resistance to gentamicin. DNA preparations from UC73 failed to hybridize with intragenic probes for aac(6')-Ie-aph(2'')-Ia and aph(2'')-Ic. A 4-kb fragment from UC73 was cloned and found to confer resistance to gentamicin in Escherichia coli DH5alpha transformants. Nucleotide sequence analysis revealed the presence of a 906-bp open reading frame whose deduced amino acid sequence had a region with homology to the aminoglycoside-modifying enzyme APH(2'')-Ic and to the C-terminal domain of the bifunctional enzyme AAC(6')-APH(2''). The gene is designated aph(2'')-Id, and its observed phosphotransferase activity is designated APH(2'')-Id. A PCR-generated intragenic probe hybridized to the genomic DNA from 17 of 118 enterococcal clinical isolates (108 with high-level gentamicin resistance) from five hospitals. All 17 were vancomycin-resistant Enterococcus faecium isolates, and pulsed-field typing revealed three distinct clones. The combination of ampicillin plus either amikacin or neomycin exhibited synergistic killing against E. casseliflavus UC73. Screening and interpretation of high-level aminoglycoside resistance in enterococci may need to be modified to include detection of APH(2'')-Id.
authors.affiliation: Research and Medical Service, Department of Veterans' Affairs Medical Center, Detroit, Michigan 48201, USA.
authors.forename: S F
authors.initials: SF
authors.lastname: Tsai
authors.forename: M J
authors.initials: MJ
authors.lastname: Zervos
authors.forename: D B
authors.initials: DB
authors.lastname: Clewell
authors.forename: S M
authors.initials: SM
authors.lastname: Donabedian
authors.forename: D F
authors.initials: DF
authors.lastname: Sahm
authors.forename: J W
authors.initials: JW
authors.lastname: Chow
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins; D004352:Drug Resistance, Microbial / Q000235:genetics*; D016983:Enterococcus / Q000187:drug effects / Q000235:genetics*; D005798:Genes, Bacterial / Q000235:genetics*; D005839:Gentamicins / Q000494:pharmacology; D010770:Phosphotransferases / Q000378:metabolism; D017853:Phosphotransferases (Alcohol Group Acceptor) / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D005839:Gentamicins; D010770:Phosphotransferases; C112789:APH(2'')-Id protein, Enterococcus; D017853:Phosphotransferases (Alcohol Group Acceptor)