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Antibiotic resistance (AR) in microorganisms has become a crucial challenge to global public health security. The acquirement of AR in microorganisms is often accompanied by a fitness cost. Typically, in an environment without antibiotics, the bacterial community with AR shows weaker competitiveness than susceptible bacteria, which makes antibiotic resistance genes (ARGs) a burden for bacteria. This article elaborates on the mechanisms underlying the generation of fitness costs and the corresponding measurement methods, provides examples to illustrate the fitness costs mediated by ARGs under different acquisition methods, and introduces the differences in fitness costs between chromosome-mediated and plasmid-mediated ARGs as well as their molecular mechanisms. Finally, it proposes prevention and control strategies for antibiotic resistant bacteria (ARB) based on fitness costs. This article reveals the biological law of the trade-off between antibiotic resistance and bacterial fitness and provides ideas for preventing and controlling the global public health security issues caused by ARB and ARGs.
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微生物的抗生素抗性(antibiotic resistance, AR)问题已成为全球公共卫生安全面临的重大挑战。微生物获得AR后常伴随适应性代价,通常在无抗生素环境中其群落竞争力弱于敏感菌,这使得抗生素抗性基因(antibiotic resistance genes, ARGs)成为细菌的负担。基于此,本文详细阐述了适应性代价的产生机制与测量方法,举例说明了不同获取方式下ARGs介导的适应性代价,着重介绍了染色体介导和质粒介导的ARGs在适应性代价方面的差异及分子机制,最后提出了基于适应性代价的抗生素抗性菌(antibiotic resistance bacteria, ARB)防控策略。本文揭示了抗生素抗性与细菌适应性之间的权衡生物学规律,为解决由ARB及ARGs引发的全球公共卫生安全问题提供了防控思路。
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作者贡献声明
罗裔宵:数据收集与分析和完成呈现;陈洁蓉:数据分析和撰写文章;罗智聪:提供资源和数据分析;郑昕晨:数据收集和撰写文章;罗俊金:数据收集;黎玥:撰写文章;温馨:提供资源和监督管理;陈涛:方法论和监督管理;吴银宝:提出概念,获取基金和方法论。
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Methods for measuring fitness cost., figureFileSmall=8VUcQlEPVjokB52r2dc8Zg==, figureFileBig=TJSMCwA5HjMlTiBSJycDVQ==, tableContent=null), ArticleFig(id=1226195556029084053, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136785005232278, language=CN, label=图1, caption=
适应性代价的测量方法, figureFileSmall=8VUcQlEPVjokB52r2dc8Zg==, figureFileBig=TJSMCwA5HjMlTiBSJycDVQ==, tableContent=null), ArticleFig(id=1226195556188467617, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136785005232278, language=EN, label=Figure 2, caption=
Prevention and control strategies for ARB., figureFileSmall=r3RlTNQJW3IpEMsFGv/2Kw==, figureFileBig=H+7Jmn4Ie0xEpBECWBXKpA==, tableContent=null), ArticleFig(id=1226195556314296743, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136785005232278, language=CN, label=图2, caption=
ARB的防控策略, figureFileSmall=r3RlTNQJW3IpEMsFGv/2Kw==, figureFileBig=H+7Jmn4Ie0xEpBECWBXKpA==, tableContent=null), ArticleFig(id=1226195556427542960, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136785005232278, language=EN, label=Table 1, caption=
The fitness cost of ARGs under different acquisition methods
, figureFileSmall=null, figureFileBig=null, tableContent=
| Access method of ARGs | Species | ARGs | Resistance mechanism | Characteristics | Fitness cost | Reference |
|---|
| Genetic mutation | Staphylococcus epidermidis | rpoB | Prevent the interaction between rifampicin and the β-subunit of RNA polymerase | The growth rate decreases | RF: <1.0 | [27] |
| Pseudomonas aeruginosa | nfxB | Regulators of multidrug efflux pumps | A large amount of energy is consumed, and the growth rate decreases | Growth curves:P<0.000 1 | [28] |
gyrA, gyrB | Prevent fluoroquinolones from binding to DNA-modifying subunits of DNA gyrases | No fitness cost | RF: 1.012 (gyrA),1.003 (gyrB) |
| Mycolicibacterium smegmatis | rv2752c | Encoding a bifunctional RNase J protein with β-lactamase and ribonuclease activities | Decreased transcription efficiency and reduced growth rate | RF: 0.87 | [29] |
| Conjugation | Escherichia coli | blaCTX-M-14 | Enzymes that hydrolyze penicillin and third-generation cephalosporins | Some bacteria lose their conjugative ability | RF: 0.985 | [30] |
| blaNDM | Enzymes that hydrolyze carbapenem drugs | Decreased virulence and loss of plasmids | RF: 0.813 006 | [31] |
qnrA, qnrB, qnrS | Protect DNA gyrase and topoisomerase IV from inhibition by quinolone drugs | No fitness cost | RF: 1.030 (qnrA), 1.056 (qnrB), 1.016 (qnrS) | [32] |
| Salmonella | fosA7 | Produce fosfomycin-modifying enzymes | The growth rate is not affected | Growth curves:P=0.844 1 | [33] |
| Transposon | Escherichia coli | sul1,sul2,sul3 | Dihydropteroate synthase with low affinity for sulfonamide drugs | The motility is decreased, and the growth rate is reduced (sul3) | S: 0.021>0 (sul1), 0.019>0 (sul2), -0.087<0 (sul3) | [34] |
| Enterococcus faecium | vanA | The encoded protein alters the synthesis of cell wall peptidoglycan precursors | The growth rate decreases | Growth curves:P<0.001 | [35] |
| Integrator | Escherichia coli | dfrA1-sat2-aadA1 | Type II integrons carry gene cassettes with a multi-resistance pattern | The growth rate decreases | S: -0.068<0 | [36] |
| Transduction | Streptococcus suis | mef(A), tet(O) | Efflux pump proteins and ribosome protection proteins | The growth rate increases | Growth curves: the logarithmic phase (2 hours earlier) and the OD690 peak (3 hours earlier and being 0.25 higher) | [37] |
| Escherichia coli | blaCTX-M-55 | Enzymes for multiple β-lactam drugs | The growth rate and elevated plasmid loss rate increases (P1) | RF: <1 (No P1), >1 (P1) | [38] |
), ArticleFig(id=1226195556549177786, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136785005232278, language=CN, label=表1, caption=
不同获得方式下ARGs介导的适应性代价
, figureFileSmall=null, figureFileBig=null, tableContent=
| Access method of ARGs | Species | ARGs | Resistance mechanism | Characteristics | Fitness cost | Reference |
|---|
| Genetic mutation | Staphylococcus epidermidis | rpoB | Prevent the interaction between rifampicin and the β-subunit of RNA polymerase | The growth rate decreases | RF: <1.0 | [27] |
| Pseudomonas aeruginosa | nfxB | Regulators of multidrug efflux pumps | A large amount of energy is consumed, and the growth rate decreases | Growth curves:P<0.000 1 | [28] |
gyrA, gyrB | Prevent fluoroquinolones from binding to DNA-modifying subunits of DNA gyrases | No fitness cost | RF: 1.012 (gyrA),1.003 (gyrB) |
| Mycolicibacterium smegmatis | rv2752c | Encoding a bifunctional RNase J protein with β-lactamase and ribonuclease activities | Decreased transcription efficiency and reduced growth rate | RF: 0.87 | [29] |
| Conjugation | Escherichia coli | blaCTX-M-14 | Enzymes that hydrolyze penicillin and third-generation cephalosporins | Some bacteria lose their conjugative ability | RF: 0.985 | [30] |
| blaNDM | Enzymes that hydrolyze carbapenem drugs | Decreased virulence and loss of plasmids | RF: 0.813 006 | [31] |
qnrA, qnrB, qnrS | Protect DNA gyrase and topoisomerase IV from inhibition by quinolone drugs | No fitness cost | RF: 1.030 (qnrA), 1.056 (qnrB), 1.016 (qnrS) | [32] |
| Salmonella | fosA7 | Produce fosfomycin-modifying enzymes | The growth rate is not affected | Growth curves:P=0.844 1 | [33] |
| Transposon | Escherichia coli | sul1,sul2,sul3 | Dihydropteroate synthase with low affinity for sulfonamide drugs | The motility is decreased, and the growth rate is reduced (sul3) | S: 0.021>0 (sul1), 0.019>0 (sul2), -0.087<0 (sul3) | [34] |
| Enterococcus faecium | vanA | The encoded protein alters the synthesis of cell wall peptidoglycan precursors | The growth rate decreases | Growth curves:P<0.001 | [35] |
| Integrator | Escherichia coli | dfrA1-sat2-aadA1 | Type II integrons carry gene cassettes with a multi-resistance pattern | The growth rate decreases | S: -0.068<0 | [36] |
| Transduction | Streptococcus suis | mef(A), tet(O) | Efflux pump proteins and ribosome protection proteins | The growth rate increases | Growth curves: the logarithmic phase (2 hours earlier) and the OD690 peak (3 hours earlier and being 0.25 higher) | [37] |
| Escherichia coli | blaCTX-M-55 | Enzymes for multiple β-lactam drugs | The growth rate and elevated plasmid loss rate increases (P1) | RF: <1 (No P1), >1 (P1) | [38] |
), ArticleFig(id=1226195556729532868, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136785005232278, language=EN, label=Table 2, caption=
Molecular mechanisms of chromosome- and plasmid-mediated fitness cost
, figureFileSmall=null, figureFileBig=null, tableContent=
| Vector | Mechanism | Drug | ARGs | Impacted cost pathway | Fitness cost | Reference |
|---|
| Chromosome | Reduced permeability | The extended-spectrum | ompC/F | Impaired nutrient absorption→DNA methylation→DNA binding to proteins | Arrested the growth and replication of bacteria | [40-41] |
| ompC/F | Decreased expression of csgA/B→impaired curli synthesis | Decreased biofilm formation | [42-43] |
| Active transport of antibiotics | The extended-spectrum | — | Overexpression of efflux pumps | High energy burden | [15] |
mexABOprM, mexCDOprJ | Impact on the rhl QS system→reduced phenazine synthesis; lack of MexA | Decreased virulence | [44] |
| mexEFOprN | Pumping out PQS precursors→delayed production of PQS signaling molecules | Impaired initiation of PQS function, decreased virulence | [45] |
| mexEFOprN | H+ antiport→intracellular H+ accumulation | Imbalance of pH homeostasis | [46] |
| ade group | Downregulated expression of pili and membrane structural proteins | Decreased biofilm formation | [47] |
| acrABTolC | Promotion of QS signal AHL efflux→binding to membrane receptor SdiA | Promotion of biofilm formation | [48] |
| Target modification | Aminoglycosides | rrs | A1408G mutation in 16S rRNA gene→no impact on the ON/OFF switching of the A site | No fitness cost | [49] |
| rrs | A1408C/U mutations in 16S rRNA gene→affect the ON/OFF switching of the A site | Bacterial death | [49] |
| Rifampicin | ropB | Alteration of the conserved β subunit of RNA polymerase | Decreased transcription efficiency | [6,50] |
| Plasmid | Inactivation and modification of the drug | β-lactams | blaKPC-2 | Downregulated expression of virulence genes iucA, magA, and rmpA2 | Decreased virulence | [51] |
| blaFOX-4/8 | Overexpression of AmpC enzyme→abnormal peptidoglycan metabolism→interference with cell wall integrity | Decreased virulence | [52] |
| blaNDM | Downregulation of locomotion, ATP synthesis, and DNA replication | Decreased motility and replicative capacity | [11] |
| Tetracyclines | tet(X4) | Downregulated expression of atlR→inability to inhibit the copy number of plasmids | Decreased biofilm formation and virulence | [53] |
| tetX | Increased ATPase activity and protein synthesis | Increased metabolic burden | [54] |
| tet(X4) | Encoded the H-NS protein→inhibits tet(X4) expression | No fitness cost | [55] |
| Active transport of antibiotics | Tetracyclines | tetH | Downregulated expression of fimbrial genes fimA and fimC | Decreased motility | [56] |
| tetA | Decreased K+ uptake efficiency of the Trk system | High energy consumption | [57] |
| Quinolones | qepA2,oqxAB | gyrA/B mutations that induce the target modification mechanism | Enhanced fitness | [58-59] |
| Target modification | Glycopeptides | van | Modification of peptidoglycan→defect in sporulation | Decreased infectivity | [60] |
| Aminoglycosides | armA | Resistant methylation of A1405 in 16S rRNA gene | No fitness cost | [61] |
| armA | Interference with the endogenous methylation of C1402 by RsmI | Affects ribosome function | [61] |
| npmA | Resistant methylation of A1408 in 16S rRNA gene | No fitness cost | [61] |
| npmA | Block the activity of RsmF on C1407 | Reduces the accuracy of translation | [61] |
| Macrolides | cfr | Expression of cfr→resistant methylation of A2503 in 16S rRNA gene | No fitness cost | [62] |
| cfr | Co-expression of ermB and cfr→dimethylation of A2508 | Obstruction of the export tunnel for nascent peptide synthesis | [62] |
| Polymyxins | mcr-1 | Modification of lipid A→obstruction of LPS synthesis | Decreased virulence | [63] |
| mcr-1 | Modification of LPS→downregulation of waa and rml→downregulation of LPS core and O-antigen synthesis | Increased membrane permeability and membrane depolarization | [64] |
), ArticleFig(id=1226195556859556297, tenantId=1146029695717560320, journalId=1192105938417971205, articleId=1226136785005232278, language=CN, label=表2, caption=
染色体和质粒介导的ARGs的适应性代价分子机制
, figureFileSmall=null, figureFileBig=null, tableContent=
| Vector | Mechanism | Drug | ARGs | Impacted cost pathway | Fitness cost | Reference |
|---|
| Chromosome | Reduced permeability | The extended-spectrum | ompC/F | Impaired nutrient absorption→DNA methylation→DNA binding to proteins | Arrested the growth and replication of bacteria | [40-41] |
| ompC/F | Decreased expression of csgA/B→impaired curli synthesis | Decreased biofilm formation | [42-43] |
| Active transport of antibiotics | The extended-spectrum | — | Overexpression of efflux pumps | High energy burden | [15] |
mexABOprM, mexCDOprJ | Impact on the rhl QS system→reduced phenazine synthesis; lack of MexA | Decreased virulence | [44] |
| mexEFOprN | Pumping out PQS precursors→delayed production of PQS signaling molecules | Impaired initiation of PQS function, decreased virulence | [45] |
| mexEFOprN | H+ antiport→intracellular H+ accumulation | Imbalance of pH homeostasis | [46] |
| ade group | Downregulated expression of pili and membrane structural proteins | Decreased biofilm formation | [47] |
| acrABTolC | Promotion of QS signal AHL efflux→binding to membrane receptor SdiA | Promotion of biofilm formation | [48] |
| Target modification | Aminoglycosides | rrs | A1408G mutation in 16S rRNA gene→no impact on the ON/OFF switching of the A site | No fitness cost | [49] |
| rrs | A1408C/U mutations in 16S rRNA gene→affect the ON/OFF switching of the A site | Bacterial death | [49] |
| Rifampicin | ropB | Alteration of the conserved β subunit of RNA polymerase | Decreased transcription efficiency | [6,50] |
| Plasmid | Inactivation and modification of the drug | β-lactams | blaKPC-2 | Downregulated expression of virulence genes iucA, magA, and rmpA2 | Decreased virulence | [51] |
| blaFOX-4/8 | Overexpression of AmpC enzyme→abnormal peptidoglycan metabolism→interference with cell wall integrity | Decreased virulence | [52] |
| blaNDM | Downregulation of locomotion, ATP synthesis, and DNA replication | Decreased motility and replicative capacity | [11] |
| Tetracyclines | tet(X4) | Downregulated expression of atlR→inability to inhibit the copy number of plasmids | Decreased biofilm formation and virulence | [53] |
| tetX | Increased ATPase activity and protein synthesis | Increased metabolic burden | [54] |
| tet(X4) | Encoded the H-NS protein→inhibits tet(X4) expression | No fitness cost | [55] |
| Active transport of antibiotics | Tetracyclines | tetH | Downregulated expression of fimbrial genes fimA and fimC | Decreased motility | [56] |
| tetA | Decreased K+ uptake efficiency of the Trk system | High energy consumption | [57] |
| Quinolones | qepA2,oqxAB | gyrA/B mutations that induce the target modification mechanism | Enhanced fitness | [58-59] |
| Target modification | Glycopeptides | van | Modification of peptidoglycan→defect in sporulation | Decreased infectivity | [60] |
| Aminoglycosides | armA | Resistant methylation of A1405 in 16S rRNA gene | No fitness cost | [61] |
| armA | Interference with the endogenous methylation of C1402 by RsmI | Affects ribosome function | [61] |
| npmA | Resistant methylation of A1408 in 16S rRNA gene | No fitness cost | [61] |
| npmA | Block the activity of RsmF on C1407 | Reduces the accuracy of translation | [61] |
| Macrolides | cfr | Expression of cfr→resistant methylation of A2503 in 16S rRNA gene | No fitness cost | [62] |
| cfr | Co-expression of ermB and cfr→dimethylation of A2508 | Obstruction of the export tunnel for nascent peptide synthesis | [62] |
| Polymyxins | mcr-1 | Modification of lipid A→obstruction of LPS synthesis | Decreased virulence | [63] |
| mcr-1 | Modification of LPS→downregulation of waa and rml→downregulation of LPS core and O-antigen synthesis | Increased membrane permeability and membrane depolarization | [64] |
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