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JAC Advance Access originally published online on February 6, 2008
Journal of Antimicrobial Chemotherapy 2008 61(5):1053-1056; doi:10.1093/jac/dkn044
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Increased mutability of Pseudomonas aeruginosa in biofilms

K. Driffield{dagger}, K. Miller, J. M. Bostock, A. J. O'Neill and I. Chopra*

Antimicrobial Research Centre and Institute of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, UK


* Corresponding author. Tel: +44-113-343-5604; Fax: +44-113-343-1407; E-mail: i.chopra{at}leeds.ac.uk

Received 21 November 2007; returned 4 January 2008; revised 15 January 2008; accepted 16 January 2008


    Abstract
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Objectives: Isolates of Pseudomonas aeruginosa from cystic fibrosis (CF) patients are frequently hypermutable due to selection of mutants with defects in DNA repair genes such as mutS. Since P. aeruginosa grows as a biofilm within the infected CF lung, it is possible that this mode of growth enhances the mutability of the organism thereby increasing the opportunity to derive permanent hypermutators through mutation in DNA repair genes. We have now conducted experiments to examine this possibility.

Methods: Using established procedures, we examined the mutability of P. aeruginosa PA01 in planktonic cultures and in biofilm cultures generated by growth in a Sorbarod system. Transcriptional profiling by DNA microarray was used to compare gene expression in planktonic and biofilm cells.

Results: Mutation frequency determinations for resistance to rifampicin and ciprofloxacin demonstrated that biofilm cultures of P. aeruginosa displayed up to a 105-fold increase in mutability compared with planktonic cultures. Several genes (ahpC, katA, sodB and PA3529, a probable peroxidase) that encode enzymes conferring protection against oxidative DNA damage were down-regulated in biofilm cells. In particular, katA, which encodes the major pseudomonal antioxidant catalase, was down-regulated 7.7-fold.

Conclusions: Down-regulation of antioxidant enzymes in P. aeruginosa biofilms may enhance the rate of mutagenic events due to the accumulation of DNA damage. Since P. aeruginosa forms biofilms in the CF lung, this mode of growth may enhance the direct selection of antibiotic-resistant organisms in CF patients and also increase the opportunity to derive permanent hypermutators thereby providing a further source of antibiotic-resistant mutants in the CF lung.

Keywords: mutation frequencies , microarrays , antibiotic resistance , hypermutators


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Hypermutable strains of Pseudomonas aeruginosa, with defects in the methyl-directed mismatch repair (MMR) system, are frequently isolated from the lungs of cystic fibrosis (CF) patients.1,2 In contrast, such strains are not readily recovered from other patients infected with this opportunistic pathogen.3 A strong relationship between antibiotic resistance and hypermutability has been observed in P. aeruginosa isolates from the CF lung, suggesting that hypermutability confers a selective advantage for the pathogen in this environment where the organism is often exposed to high doses of antibiotics for prolonged periods as part of the therapeutic regimen for CF patients.1,4

Although the CF lung appears to provide an environment that favours the development and selection of hypermutators in P. aeruginosa, the factors responsible are poorly understood. Infection of the CF lung results in a chronic inflammatory response with liberation of reactive oxygen species (ROS),5 which are capable of causing DNA damage and mutation in bacteria.6 Indeed, ROS-mediated mutagenesis has been implicated as a factor in the emergence of antibiotic-resistant hypermutable P. aeruginosa during infection of CF patients.7 However, in the CF lung, P. aeruginosa grows as a biofilm which is poorly penetrated by ROS.8 Consequently, it is possible that the mutagenic effect of ROS on P. aeruginosa in the CF lung is enhanced by the physiological status of the organism itself. We have now examined whether there is a relationship between the mutability of P. aeruginosa growing in biofilms and expression of genes involved in protection against ROS-mediated DNA damage, or its repair.


    Materials and methods
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Bacteria, growth media and chemicals

P. aeruginosa PA019 was obtained from Dr Raphael Canton, Hospital Universitario Ramón y Cajal, Madrid, Spain. This strain was routinely cultured at 37°C in Iso-Sensitest broth (ISB) or Iso-Sensitest agar (ISA), which were purchased from Oxoid (Basingstoke, UK). All chemicals, reagents and antibiotics were purchased from Sigma (Poole, UK) with the exception of ciprofloxacin, which was a gift from Bayer AG (Leverkusen, Germany).

Antibacterial susceptibility testing

MIC determinations were performed on planktonic cultures of P. aeruginosa PAO1 by agar dilution, using inocula of 104 cfu/spot. MICs were defined as the lowest antibiotic concentration preventing visible bacterial growth after 18 h of incubation at 37°C.

Biofilm culture

P. aeruginosa biofilms were created using a modified Sorbarod apparatus.1012 Sorbarod filters (Ilacon Ltd, Tonbridge, UK) were inoculated with 0.5 mL saturated bacterial cultures in ISB (~109 organisms/mL) and then perfused with ISB at a flow rate of 1 mL/min for 72 h at 37°C. Bacteria were harvested from Sorbarod filters by splitting the paper sleeve to release the fibres, followed by vigorous vortexing (30 s), sonication (5 min) in an ultrasonic water bath and further vortexing (30 s).

Determination of mutation frequencies for resistance to antibiotics

Mutation frequencies for resistance to rifampicin and ciprofloxacin were determined for planktonic and biofilm cultures. Bacterial cells were recovered from biofilms as described above and planktonic cultures were grown in the absence of antibiotic for 18 h prior to plating onto ISA selection plates containing antibiotic at 4x MIC to recover resistant mutants. To determine viable counts, aliquots of diluted culture were plated onto non-selective ISA. Colony counts were made after 24 h of incubation at 37°C on non-selective media and after 48 h of incubation on selective media. Mutation frequencies were expressed as the number of antibiotic-resistant mutants recovered as a fraction of the viable count. Where appropriate, cultures were concentrated by centrifugation to facilitate the recovery of resistant mutants.

Analysis of gene expression in planktonic and biofilm cultures by microarray profiling

Biofilm and planktonic P. aeruginosa cells were collected in RNAprotect (Qiagen, Crawley, UK), and RNA purified using the RNeasy mini kit (Qiagen) according to the manufacturer's instructions. RNA was submitted to GRI Ltd (Essex, UK) for labelling, hybridization and quantification of gene expression using a NimbleGen microarray and ArrayStarTM FirstLight software (DNASTAR). The NimbleGen array contained 5567 of the predicted 5570 open reading frames (ORFs) of P. aeruginosa PA01.9 Genes were considered to be differentially expressed in the biofilm if they exhibited a 2-fold increase or decrease in expression compared with planktonic cultures.13,14


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Growth of P. aeruginosa in biofilms results in elevated mutation frequencies

The frequency of selection of rifampicin- and ciprofloxacin-resistant mutants of P. aeruginosa PA01 increased ~15- and 105-fold, respectively, when the organism was grown as a biofilm (Table 1). No hypermutators, defined here as strains with permanent mutation frequencies elevated 10-fold or greater for resistance to two or more antibiotics, were observed among the resistant mutants recovered (data not shown). This suggests that the increased mutability observed in biofilm cultures was predominantly phenotypic rather than genotypic.


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Table 1. Mutation frequencies for selection of rifampicin- and ciprofloxacin-resistant mutants of P. aeruginosa PAO1 in planktonic and biofilm cultures

 
Comparison of gene expression in P. aeruginosa planktonic and biofilm cultures

To investigate further the enhanced mutability of biofilm cultures of P. aeruginosa (Table 1), we examined global gene expression profiles by microarray analysis. We were particularly interested in the expression of genes that mediate DNA repair (Table 2) and protect against ROS (Table 3).15,16 Genes involved in MMR (mutS, mutL and uvrD), repair of 8-oxo-dG (GO) lesions (mutM, mutT, mutY and micA) and replication fidelity (mutD and dnaE) were not differentially expressed in the biofilm compared with planktonic cultures (Table 2). Hence, the increased mutability observed in P. aeruginosa PA01 biofilm cells is not due to diminished transcription of these genes. We noted down-regulation of polA expression in biofilm cultures (Table 2). This may contribute to the enhanced mutability of P. aeruginosa in the biofilm (Table 1). Nevertheless, the contribution is likely to be modest since complete elimination of this gene in Escherichia coli only confers a very small increase in mutability.17


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Table 2. Transcription levels of P. aeruginosa genes involved in DNA repair and replication fidelity in Sorbarod biofilms versus planktonic cultures

 


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Table 3. Transcription levels of P. aeruginosa genes involved in oxidative protection in Sorbarod biofilms versus planktonic cultures

 
However, transcription of several genes involved in defence against ROS18 was down-regulated in the biofilm (Table 3). These genes included sodB, katA, ahpC and ORF PA3529, which encodes a probable peroxidase.9


    Discussion
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Production of antioxidant enzymes and the maintenance of efficient DNA repair systems are first-line defences against oxidative DNA damage in bacteria.19 We observed that four genes in P. aeruginosa that encode antioxidant enzymes are down-regulated in the biofilm (Table 3). This suggests that the organisms may be particularly susceptible to DNA damage from ROS derived from aerobic respiration. In particular, katA, the primary pseudomonal antioxidant catalase enzyme, was down-regulated 7.7-fold in biofilm cultures when compared with planktonic cultures. It has been demonstrated that KatA is crucial for oxidative and osmotic protection as well as adaptation to peroxide stress in P. aeruginosa in both planktonic cultures20 and biofilms.21 In contrast to our findings, a recent transcriptional analysis of gene expression in biofilms of P. aeruginosa PA01 demonstrated no alteration in expression of katA.22 The relationship of this observation to our findings is unclear. Unfortunately, the mutational status of the organisms in the biofilm was not determined in the previously published study,22 which makes further discussion of the apparent discrepancy difficult.

The frequently encountered GO DNA lesion, resulting from ROS attack, is removed and repaired by the GO system.23,24 However, expression of the GO system is not up-regulated in the biofilm compared with planktonic cells (Table 2), at least at the level of transcription. Therefore in the biofilm, the GO system may become saturated leading to incomplete removal of GO DNA lesions and increased occurrence of mutations.

In the chronically infected CF lung, there is a marked inflammatory response dominated by polymorphonuclear leukocytes (PMNs) that release ROS.5 These liberated ROS, together with the by-products of aerobic respiration, are therefore likely to increase oxidative damage of bacterial DNA.7 Consequently, we conclude that the biofilm mode of growth adopted by P. aeruginosa during infection of the CF lung, in which genes conferring protection against oxidative damage are down-regulated, may increase the mutability of the organism. This creates conditions for the emergence of antibiotic-resistant organisms, e.g. through point mutation in drug targets, and also enhances the opportunity to derive permanent hypermutators through mutation in DNA repair genes such as mutS, which is frequently found to be mutated in clinical hypermutator isolates.1,2


    Funding
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 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Funding
 Transparency declarations
 References
 
The research described here was supported by a BBSRC CASE PhD studentship for K. D. in conjunction with Smith and Nephew Research, York, awarded to I. C.


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None to declare.


    Footnotes
 
{dagger} Present address. Smith and Nephew Research Centre, York Science Park, Heslington, York YO10 5DF, UK. Back


    References
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 Abstract
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 Materials and methods
 Results
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 References
 
1 Oliver A, Canton R, Campo P, et al. High frequency of hypermutable Pseudomonas aeruginosa in cystic fibrosis lung infection. Science (2000) 288:1251–4.[Abstract/Free Full Text]

2 Chopra I, O'Neill AJ, Miller K. The role of mutators in the emergence of antibiotic-resistant bacteria. Drug Resist Updat (2003) 6:137–45.[CrossRef][Web of Science][Medline]

3 Gutierrez O, Juan C, Perez JL, et al. Lack of association between hypermutation and antibiotic resistance development in Pseudomonas aeruginosa isolates from intensive care unit patients. Antimicrob Agents Chemother (2004) 48:3573–5.[Abstract/Free Full Text]

4 Martinez JL, Baquero F. Mutation frequencies and antibiotic resistance. Antimicrob Agents Chemother (2000) 44:1771–7.[Free Full Text]

5 Brown RK, Kelly FJ. Evidence for increased oxidative damage in patients with cystic fibrosis. Pediatr Res (1994) 36:487–93.[Web of Science][Medline]

6 Sakai A, Nakanishi M, Yoshiyama K, et al. Impact of reactive oxygen species on spontaneous mutagenesis in Escherichia coli. Genes Cells (2006) 11:767–78.[Abstract/Free Full Text]

7 Ciofu O, Riis B, Pressler T, et al. Occurrence of hypermutable Pseudomonas aeruginosa in cystic fibrosis patients is associated with the oxidative stress caused by chronic lung inflammation. Antimicrob Agents Chemother (2005) 49:2276–82.[Abstract/Free Full Text]

8 Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science (1999) 284:1318–22.[Abstract/Free Full Text]

9 Stover CK, Pham XQ, Erwin AL, et al. Complete genome sequence of Pseudomonas aeruginosa PA01, an opportunistic pathogen. Nature (2000) 406:959–64.[CrossRef][Medline]

10 Budhani RK, Struthers JK. The use of Sorbarod biofilms to study the antimicrobial susceptibility of a strain of Streptococcus pneumoniae. J Antimicrob Chemother (1997) 40:601–2.[Free Full Text]

11 Gander S, Hayward K, Finch R. An investigation of the antimicrobial effects of linezolid on bacterial biofilms utilizing an in vitro pharmacokinetic model. J Antimicrob Chemother (2002) 49:301–8.[Abstract/Free Full Text]

12 Hodgson AE, Nelson SM, Brown MR, et al. A simple in vitro model for growth control of bacterial biofilms. J Appl Bacteriol (1995) 79:87–93.[Medline]

13 Whiteley M, Bangera MG, Bumgarner RE, et al. Gene expression in Pseudomonas aeruginosa biofilms. Nature (2001) 413:860–4.[CrossRef][Medline]

14 Bagge N, Schuster M, Hentzer M, et al. Pseudomonas aeruginosa biofilms exposed to imipenem exhibit changes in global gene expression and β-lactamase and alginate production. Antimicrob Agents Chemother (2004) 48:1175–87.[Abstract/Free Full Text]

15 Horst JP, Wu TH, Marinus MG. Escherichia coli mutator genes. Trends Microbiol (1999) 7:29–36.[CrossRef][Web of Science][Medline]

16 Sasaki M, Yonemura Y, Kurusu Y. Genetic analysis of Bacillus subtilis mutator genes. J Gen Appl Microbiol (2000) 46:183–7.[CrossRef][Medline]

17 Bates H, Randall SK, Rayssiguier C, et al. Spontaneous and UV-induced mutations in Escherichia coli K-12 strains with altered or absent DNA polymerase I. J Bacteriol (1989) 171:2480–4.[Abstract/Free Full Text]

18 Ochsner UA, Vasil ML, Alsabbagh E, et al. Role of the Pseudomonas aeruginosa oxyR-recG operon in oxidative stress defense and DNA repair: OxyR-dependent regulation of katB-ankB, ahpB, and ahpC-ahpF. J Bacteriol (2000) 182:4533–44.[Abstract/Free Full Text]

19 Ochsner UA, Wilderman PJ, Vasil AI, et al. GeneChip® expression analysis of the iron starvation response in Pseudomonas aeruginosa: identification of novel pyoverdine biosynthesis genes. Mol Microbiol (2002) 45:1277–87.[CrossRef][Web of Science][Medline]

20 Lee J-S, Heo Y-J, Lee JK, et al. KatA, the major catalase, is critical for osmoprotection and virulence in Pseudomonas aeruginosa PA14. Infect Immun (2005) 73:4399–403.[Abstract/Free Full Text]

21 Elkins JG, Hassett DJ, Stewart PS, et al. Protective role of catalase in Pseudomonas aeruginosa biofilm resistance to hydrogen peroxide. Appl Environ Microbiol (1999) 65:4594–600.[Abstract/Free Full Text]

22 Waite R, Paccanaro A, Papakonstantinopoulou A, et al. Clustering of Pseudomonas aeruginosa transcriptomes from planktonic cultures, developing and mature biofilms reveals distinct expression profiles. BMC Genomics (2006) 7:162.[CrossRef][Medline]

23 Miller JH. Spontaneous mutators in bacteria: insights into pathways of mutagenesis and repair. Annu Rev Microbiol (1996) 50:625–43.[CrossRef][Web of Science][Medline]

24 Oliver A, Sanchez JM, Blazquez J. Characterization of the GO system of Pseudomonas aeruginosa. FEMS Microbiol Lett (2002) 217:31–5.[CrossRef][Web of Science][Medline]


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