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      Lack of AcrB Efflux Function Confers Loss of Virulence on Salmonella enterica Serovar Typhimurium

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          ABSTRACT

          AcrAB-TolC is the paradigm resistance-nodulation-division (RND) multidrug resistance efflux system in Gram-negative bacteria, with AcrB being the pump protein in this complex. We constructed a nonfunctional AcrB mutant by replacing D408, a highly conserved residue essential for proton translocation. Western blotting confirmed that the AcrB D408A mutant had the same native level of expression of AcrB as the parental strain. The mutant had no growth deficiencies in rich or minimal medium. However, compared with wild-type SL1344, the mutant had increased accumulation of Hoechst 33342 dye and decreased efflux of ethidium bromide and was multidrug hypersusceptible. The D408A mutant was attenuated in vivo in mouse and Galleria mellonella models and showed significantly reduced invasion into intestinal epithelial cells and macrophages in vitro. A dose-dependent inhibition of invasion was also observed when two different efflux pump inhibitors were added to the wild-type strain during infection of epithelial cells. RNA sequencing (RNA-seq) revealed downregulation of bacterial factors necessary for infection, including those in the Salmonella pathogenicity islands 1, 2, and 4; quorum sensing genes; and phoPQ. Several general stress response genes were upregulated, probably due to retention of noxious molecules inside the bacterium. Unlike loss of AcrB protein, loss of efflux function did not induce overexpression of other RND efflux pumps. Our data suggest that gene deletion mutants are unsuitable for studying membrane transporters and, importantly, that inhibitors of AcrB efflux function will not induce expression of other RND pumps.

          IMPORTANCE

          Antibiotic resistance is a major public health concern. In Gram-negative bacteria, overexpression of the AcrAB-TolC multidrug efflux system confers resistance to clinically useful drugs. Here, we show that loss of AcrB efflux function causes loss of virulence in Salmonella enterica serovar Typhimurium. This is due to the reduction of bacterial factors necessary for infection, which is likely to be caused by the retention of noxious molecules inside the bacterium. We also show that, in contrast to loss of AcrB protein, loss of efflux does not induce overexpression of other efflux pumps from the same family. This indicates that there are differences between loss of efflux protein and loss of efflux that make gene deletion mutants unsuitable for studying the biological function of membrane transporters. Understanding the biological role of AcrB will help to assess the risks of targeting efflux pumps as a strategy to combat antibiotic resistance.

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          Most cited references61

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          Multidrug-resistance efflux pumps - not just for resistance.

          It is well established that multidrug-resistance efflux pumps encoded by bacteria can confer clinically relevant resistance to antibiotics. It is now understood that these efflux pumps also have a physiological role(s). They can confer resistance to natural substances produced by the host, including bile, hormones and host-defence molecules. In addition, some efflux pumps of the resistance nodulation division (RND) family have been shown to have a role in the colonization and the persistence of bacteria in the host. Here, I present the accumulating evidence that multidrug-resistance efflux pumps have roles in bacterial pathogenicity and propose that these pumps therefore have greater clinical relevance than is usually attributed to them.
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            The relationship between antimicrobial resistance and patient outcomes: mortality, length of hospital stay, and health care costs.

            There is an association between the development of antimicrobial resistance in Staphylococcus aureus, enterococci, and gram-negative bacilli and increases in mortality, morbidity, length of hospitalization, and cost of health care. For many patients, inadequate or delayed therapy and severe underlying disease are primarily responsible for the adverse outcomes of infections caused by antimicrobial-resistant organisms. Patients with infections due to antimicrobial-resistant organisms have higher costs (approximately 6,000-30,000 dollars) than do patients with infections due to antimicrobial-susceptible organisms; the difference in cost is even greater when patients infected with antimicrobial-resistant organisms are compared with patients without infection. Strategies to prevent nosocomial emergence and spread of antimicrobial-resistant organisms are essential.
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              Galleria mellonella infection models for the study of bacterial diseases and for antimicrobial drug testing

              abstract Galleria mellonella (greater wax moth or honeycomb moth) has been introduced as an alternative model to study microbial infections. G. mellonella larvae can be easily and inexpensively obtained in large numbers and are simple to use as they don't require special lab equipment. There are no ethical constraints and their short life cycle makes them ideal for large-scale studies. Although insects lack an adaptive immune response, their innate immune response shows remarkable similarities with the immune response in vertebrates. This review gives a current update of what is known about the immune system of G. mellonella and provides an extensive overview of how G. mellonella is used to study the virulence of Gram-positive and Gram-negative bacteria. In addition, the use of G. mellonella to evaluate the efficacy of antimicrobial agents and experimental phage therapy are also discussed. The review concludes with a critical assessment of the current limitatons of G. mellonella infection models.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                mBio
                MBio
                mbio
                mbio
                mBio
                mBio
                American Society for Microbiology (1752 N St., N.W., Washington, DC )
                2150-7511
                18 July 2017
                Jul-Aug 2017
                : 8
                : 4
                : e00968-17
                Affiliations
                [a ]Institute of Microbiology and Infection, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, United Kingdom
                [b ]Unit of Prophylaxis and Control of Bacterial Zoonoses, Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, Rome, Italy
                [c ]School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
                [d ]Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom
                [e ]Microbiotix, Inc., Anti-Infectives R&D, Worcester, Massachusetts, USA
                University of British Columbia
                Author notes
                Address correspondence to Laura J. V. Piddock, l.j.v.piddock@ 123456bham.ac.uk .

                This article is a direct contribution from a Fellow of the American Academy of Microbiology. Solicited external reviewers: William Shafer, Emory University School of Medicine; Robert Bonomo, Louis Stokes Cleveland VA Medical Center.

                Author information
                http://orcid.org/0000-0001-6904-4253
                http://orcid.org/0000-0003-1460-473X
                Article
                mBio00968-17
                10.1128/mBio.00968-17
                5516257
                28720734
                507b733f-5c0f-4e84-bc8f-77815ec2ba13
                Copyright © 2017 Wang-Kan et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

                History
                : 8 June 2017
                : 16 June 2017
                Page count
                supplementary-material: 10, Figures: 7, Tables: 2, Equations: 0, References: 68, Pages: 14, Words: 9712
                Funding
                Funded by: Consejo Nacional de Ciencia y Tecnología (CONACYT) https://doi.org/10.13039/501100003141
                Award Recipient : Xuan Wang-Kan
                Categories
                Research Article
                Custom metadata
                July/August 2017

                Life sciences
                acrb,spi,salmonella,salmonella pathogenicity island,efflux,motility,transcriptome,virulence
                Life sciences
                acrb, spi, salmonella, salmonella pathogenicity island, efflux, motility, transcriptome, virulence

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