The Spx stress regulator confers high-level β-lactam resistance and decreases susceptibility to last-line antibiotics in methicillin-resistant Staphylococcus aureus

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  • Tobias Krogh Nielsen
  • Ida Birkjær Petersen
  • Xu, Lijuan
  • Maria Disen Barbuti
  • Viktor Mebus
  • Anni Justh
  • Abdulelah Ahmed Alqarzaee
  • Nicolas Jacques
  • Cécile Oury
  • Vinai Thomas
  • Morten Kjos
  • Camilla Henriksen
  • Frees, Dorte

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are a leading cause of mortality worldwide. MRSA has acquired resistance to next-generation β-lactam antibiotics through the horizontal acquisition of the mecA resistance gene. Development of high resistance is, however, often associated with additional mutations in a set of chromosomal core genes, known as potentiators, which, through poorly described mechanisms, enhance resistance. The yjbH gene was recently identifiedas a hot spot for adaptive mutations during severe infections. Here, we show that inactivation of yjbH increased β-lactam MICs up to 16-fold and transformed MRSA cells with low levels of resistance to being homogenously highly resistant to β-lactams. The yjbH gene encodes an adaptor protein that targets the transcriptional stress regulator Spx for degradation by the ClpXP protease. Using CRISPR interference (CRISPRi) to knock down spx transcription, we unambiguously linked hyper-resistance to the accumulation of Spx. Spx was previously proposed to be essential; however, our data suggest that Spx is dispensable for growth at 37°C but becomes essential in the presence of antibiotics with various targets. On the other hand, high Spx levels bypassed the role of PBP4 in β-lactam resistance and broadly decreased MRSA susceptibility to compounds targeting the cell wall or the cell membrane, including vancomycin, daptomycin, and nisin. Strikingly, Spx potentiated resistance independently of its redox-sensing switch. Collectively, our study identifiesa general stress pathway that, in addition to promoting the development of high-level, broad-spectrum β-lactam resistance, also decreases MRSA susceptibility to critical antibiotics of last resort.

OriginalsprogEngelsk
TidsskriftAntimicrobial Agents and Chemotherapy
Vol/bind68
Udgave nummer6
Antal sider18
ISSN0066-4804
DOI
StatusUdgivet - 2024

Bibliografisk note

Publisher Copyright:
© 2024 American Society for Microbiology.

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