Molecular, Genetic, and Biochemical Characterization of OXA-484 Carbapenemase, a Difficult-to-Detect R214G Variant of OXA-181

oleh: Camille Gonzalez, Saoussen Oueslati, Mariam Rima, Réva Nermont, Laurent Dortet, Katie L. Hopkins, Bogdan I. Iorga, Rémy A. Bonnin, Thierry Naas

Format: Article
Diterbitkan: MDPI AG 2024-07-01

Deskripsi

OXA-244, an R214G variant of OXA-48, is silently spreading worldwide likely because of difficulties in detection using classical screening media. Here, we characterized two clinical isolates of <i>Escherichia coli</i> and <i>Citrobacter youngae</i> that displayed reduced susceptibility to carbapenems but were lacking significant carbapenemase activity as revealed by negative Carba NP test results. However, positive test results were seen for OXA-48-like enzymes by lateral flow immunoassays. WGS revealed the presence of a <i>bla</i>OXA-181-like gene that codes for OXA-484, an R214G variant of OXA-181. <i>Bla</i>OXA-484 gene was located on a 58.4-kb IncP1-like plasmid (pN-OXA-484), that upon transfer into <i>E. coli</i> HB4 with impaired permeability, conferred carbapenem and temocillin resistance (MICs > 32 mg/L). <i>E. coli</i> TOP10 (pTOPO-OXA-484) revealed reduced MICs in most substrates as compared to <i>E. coli</i> TOP10 (pTOPO-OXA-181), especially for imipenem (0.25 mg/L versus 0.75 mg/L) and temocillin (16 mg/L versus 1028 mg/L). Catalytic efficiencies of OXA-484 were reduced as compared to OXA-181 for most ß-lactams including imipenem and temocillin with 27.5- and 21.7-fold reduction, respectively. Molecular modeling confirmed that the salt bridges between R214, D159, and the R1 substituent’s carboxylate group of temocillin were not possible with G214 in OXA-484, explaining the reduced affinity for temocillin. In addition, changes in active site’s water network may explain the decrease in hydrolysis rate of carbapenems. OXA-484 has weak imipenem and temocillin hydrolytic activities, which may lead to silent spread due to underdetection using selective screening media or biochemical imipenem hydrolysis confirmatory tests.