title: Non-target gene mutations in the development of fluoroquinolone resistance in Escherichia coli.
abstract: Mutations in loci other than genes for the target topoisomerases of fluoroquinolones, gyrA and parC, may play a role in the development of fluoroquinolone resistance in Escherichia coli. A series of mutants with increasing resistance to ofloxacin was obtained from an E. coli K-12 strain and five clinical isolates. First-step mutants acquired a gyrA mutation. Second-step mutants reproducibly acquired a phenotype of multiple antibiotic resistance (Mar) and organic solvent tolerance and showed enhanced fluoroquinolone efflux. None of the second-step mutants showed additional topoisomerase mutations. All second-step mutants showed constitutive expression of marA and/or overexpressed soxS. In some third-step mutants, fluoroquinolone efflux was further enhanced compared to that for second-step mutants, even when the mutant had acquired additional topoisomerase mutations. Attempts to circumvent the second-step Mar mutation by induction of the mar locus with sodium salicylate and thus to select for pure topoisomerase mutants at the second step were not successful. At least in vitro, non-target gene mutations accumulate in second- and third-step mutants upon exposure to a fluoroquinolone and typically include, but do not appear to be limited to, mutations in the mar or sox regulons with consequent increased drug efflux.
authors.affiliation: Section of Infectious Diseases and Clinical Immunology, Department of Medicine, University Hospital and Medical Center, D-89070 Ulm, Germany.winfried.kern@medizin.uni-ulm.de
authors.forename: W V
authors.initials: WV
authors.lastname: Kern
authors.forename: M
authors.initials: M
authors.lastname: Oethinger
authors.forename: A S
authors.initials: AS
authors.lastname: Jellen-Ritter
authors.forename: S B
authors.initials: SB
authors.lastname: Levy
mesh_terms: D000890:Anti-Infective Agents / Q000378:metabolism / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D015152:Blotting, Northern; D003510:Cyclohexanes / Q000633:toxicity; D027081:DNA Gyrase; D004250:DNA Topoisomerases, Type II / Q000235:genetics; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics* / Q000378:metabolism; D029968:Escherichia coli Proteins; D024841:Fluoroquinolones; D005798:Genes, Bacterial / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D009154:Mutation / Q000235:genetics*; D010641:Phenotype; D012329:RNA, Bacterial / Q000096:biosynthesis / Q000235:genetics; D012097:Repressor Proteins / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012980:Sodium Salicylate / Q000494:pharmacology; D012997:Solvents / Q000633:toxicity
chemical_list: D000890:Anti-Infective Agents; D001426:Bacterial Proteins; D003510:Cyclohexanes; D029968:Escherichia coli Proteins; D024841:Fluoroquinolones; C080004:MarR protein, E coli; D012329:RNA, Bacterial; D012097:Repressor Proteins; D012997:Solvents; D027081:DNA Gyrase; D004250:DNA Topoisomerases, Type II; D012980:Sodium Salicylate