title: Adaptation of Enterococcus faecalis to daptomycin reveals an ordered progression to resistance.
abstract: With increasing numbers of hospital-acquired antibiotic resistant infections each year and staggering health care costs, there is a clear need for new antimicrobial agents, as well as novel strategies to extend their clinical efficacy. While genomic studies have provided a wealth of information about the alleles associated with adaptation to antibiotics, they do not provide essential information about the relative importance of genomic changes, their order of appearance, or potential epistatic relationships between adaptive changes. Here we used quantitative experimental evolution of a single polymorphic population in continuous culture with whole-genome sequencing and allelic frequency measurements to study daptomycin (DAP) resistance in the vancomycin-resistant clinical pathogen Enterococcus faecalis S613. Importantly, we sustained both planktonic and nonplanktonic (i.e., biofilm) populations in coculture as the concentration of antibiotic was raised, facilitating the development of more ecological complexity than is typically observed in laboratory evolution. Quantitative experimental evolution revealed a clear order and hierarchy of genetic changes leading to resistance, the signaling and metabolic pathways responsible, and the relative importance of these mutations to the evolution of DAP resistance. Despite the relative simplicity of this ex vivo approach compared to the ecological complexity of the human body, we showed that experimental evolution allows for rapid identification of clinically relevant adaptive molecular pathways and new targets for drug design in pathogens.
authors: Department of Biochemistry and Cell Biology, Rice University, Houston, Texas, USA.
authors: Corwin
authors: C
authors: Miller
authors: Jiayi
authors: J
authors: Kong
authors: Truc T
authors: TT
authors: Tran
authors: Cesar A
authors: CA
authors: Arias
authors: Gerda
authors: G
authors: Saxer
authors: Yousif
authors: Y
authors: Shamoo
mesh_terms: D000222:Adaptation, Physiological / Q000187:drug effects / Q000235:genetics*; D000483:Alleles; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017576:Daptomycin / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000235:genetics*; D013293:Enterococcus faecalis / Q000187:drug effects / Q000235:genetics* / Q000378:metabolism; D004843:Epistasis, Genetic; D019143:Evolution, Molecular; D015964:Gene Expression Regulation, Bacterial; D005787:Gene Frequency; D016680:Genome, Bacterial; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D009154:Mutation; D015398:Signal Transduction; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D017576:Daptomycin
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