The Asp20-to-Asn Substitution in the Response Regulator AdeR Leads to Enhanced Efflux Activity of AdeB in Acinetobacter baumannii
ABSTRACTOverexpression of the resistance-nodulation-cell division-type efflux pump AdeABC is often associated with multidrug resistance inAcinetobacter baumanniiand has been linked to mutations in the genes encoding the AdeRS two-component system. In a previous study, we reported that the Asp20→Asn amino acid substitution in the response regulator AdeR is associated withadeBoverexpression and reduced susceptibility to the antimicrobials levofloxacin, tigecycline, and trimethoprim-sulfamethoxazole. To further characterize the effect of the Asp20→Asn substitution on antimicrobial susceptibility, the expression of the efflux genesadeB,adeJ, andadeG, and substrate accumulation, four plasmid constructs [containingadeR(Asp20)S,adeR(Asn20)S,adeR(Asp20)SABC, andadeR(Asn20)SABC] were introduced into theadeRSABC-deficientA. baumanniiisolate NIPH 60. NeitheradeRSconstruct induced changes in antimicrobial susceptibility or substrate accumulation from that for the vector-only control. TheadeR(Asp20)SABCtransformant showed reduced susceptibility to 6 antimicrobials and accumulated 12% less ethidium than the control, whereas the Asn20 variant showed reduced susceptibility to 6 of 8 antimicrobial classes tested, and its ethidium accumulation was only 72% of that observed for the vector-only construct.adeBexpression was 7-fold higher in theadeR(Asn20)SABCtransformant than in its Asp20 variant. No changes inadeGoradeJexpression or in acriflavine or rhodamine 6G accumulation were detected. The antimicrobial susceptibility data suggest that AdeRS does not regulate any resistance determinants other than AdeABC. Furthermore, the characterization of the Asp20→Asn20 substitution proves that the reduced antimicrobial susceptibility previously associated with this substitution was indeed caused by enhanced efflux activity of AdeB.