Novel mechanism of resistance to glycopeptide antibiotics in Enterococcus faecium

J Biol Chem. 2006 Oct 27;281(43):32254-62. doi: 10.1074/jbc.M606920200. Epub 2006 Aug 29.

Abstract

Glycopeptides and beta-lactams are the major antibiotics available for the treatment of infections due to Gram-positive bacteria. Emergence of cross-resistance to these drugs by a single mechanism has been considered as unlikely because they inhibit peptidoglycan polymerization by different mechanisms. The glycopeptides bind to the peptidyl-D-Ala(4)-D-Ala(5) extremity of peptidoglycan precursors and block by steric hindrance the essential glycosyltransferase and D,D-transpeptidase activities of the penicillin-binding proteins (PBPs). The beta-lactams are structural analogues of D-Ala(4)-D-Ala(5) and act as suicide substrates of the D,D-transpeptidase module of the PBPs. Here we have shown that bypass of the PBPs by the recently described beta-lactam-insensitive L,D-transpeptidase from Enterococcus faecium (Ldt(fm)) can lead to high level resistance to glycopeptides and beta-lactams. Cross-resistance was selected by glycopeptides alone or serially by beta-lactams and glycopeptides. In the corresponding mutants, UDP-MurNAc-pentapeptide was extensively converted to UDP-MurNAc-tetrapeptide following hydrolysis of D-Ala(5), thereby providing the substrate of Ldt(fm). Complete elimination of D-Ala(5), a residue essential for glycopeptide binding, was possible because Ldt(fm) uses the energy of the L-Lys(3)-D-Ala(4) peptide bond for cross-link formation in contrast to PBPs, which use the energy of the D-Ala(4)-D-Ala(5) bond. This novel mechanism of glycopeptide resistance was unrelated to the previously identified replacement of D-Ala(5) by D-Ser or D-lactate.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alanine / metabolism
  • Amino Acid Substitution
  • Anti-Bacterial Agents / pharmacology*
  • Cross-Linking Reagents / pharmacology
  • Cytoplasm / metabolism
  • Drug Resistance, Bacterial*
  • Enterococcus faecium / genetics
  • Enterococcus faecium / metabolism*
  • Glycopeptides / pharmacology*
  • Hydrolysis
  • Microbial Sensitivity Tests
  • Models, Biological
  • Muramoylpentapeptide Carboxypeptidase / metabolism
  • Peptide Fragments / chemistry
  • Peptidoglycan / biosynthesis
  • Peptidoglycan / chemistry
  • Peptidoglycan / metabolism
  • Substrate Specificity
  • beta-Lactams / metabolism

Substances

  • Anti-Bacterial Agents
  • Cross-Linking Reagents
  • Glycopeptides
  • Peptide Fragments
  • Peptidoglycan
  • beta-Lactams
  • Muramoylpentapeptide Carboxypeptidase
  • Alanine