Seeking patterns of antibiotic resistance in ATLAS, an open, raw MIC database with patient metadata

This is the final version. Available on open access from Nature Research via the DOI in this recordData availability: ATLAS is available following website registration*. Data and further information can be downloaded from the following links: Project overview: https://amr.theodi.org/project-overview Project description: https://wellcome.ac.uk/sites/default/files/antimicrobial-resistance-surveillance-sharing-industry-data.pdf Data download*: https://www.synapse.org/#!Synapse:syn17009517/wiki/585653 The same dataset is available from this link: https://s3-eu-west-1.amazonaws.com/amr-prototype-data/Open+Atlas_Reuse_Data.xlsx Data was extracted from the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report from years 2013-2018. These were downloaded from the following UK government website: https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report ResistanceMap data is published by the Centre for Disease, Dynamics Economics and Policy28, it can be downloaded from https://github.com/gwenknight/empiricprescribing/tree/master/data, Data for the European Centre for Disease Prevention and Control (ECDC) can be downloaded from https://atlas.ecdc.europa.eu/public/index.aspx?Dataset=27#x00026;HealthTopic=4. The file we used in this paper can be downloaded from https://github.com/PabloCatalan/atlas/tree/master/data/europe_resistance_data.csv EUCAST data can only be obtained by contacting individuals named on their website https://www.eucast.org/mic_distributions_and_ecoffs/ and requesting access to MIC histograms, which we were granted.Code availability: Analysis codes66 written in Python 3.0 using pandas can be downloaded here: https://github.com/PabloCatalan/atlas or https://doi.org/10.5281/zenodo.6390565. Codes have been written to provide straightforward access to data so that figures from this manuscript can be reproduced and to help facilitate the development of new analyses. Interested readers are encouraged to seek assistance from corresponding authors in case it is not clear how those codes are used.Antibiotic resistance represents a growing medical concern where raw, clinical datasets are under-exploited as a means to track the scale of the problem. We therefore sought patterns of antibiotic resistance in the Antimicrobial Testing Leadership and Surveillance (ATLAS) database. ATLAS holds 6.5M minimal inhibitory concentrations (MICs) for 3,919 pathogen-antibiotic pairs isolated from 633k patients in 70 countries between 2004 and 2017. We show most pairs form coherent, although not stationary, timeseries whose frequencies of resistance are higher than other databases, although we identified no systematic bias towards including more resistant strains in ATLAS. We sought data anomalies whereby MICs could shift for methodological and not clinical or microbiological reasons and found artefacts in over 100 pathogen-antibiotic pairs. Using an information-optimal clustering methodology to classify pathogens into low and high antibiotic susceptibilities, we used ATLAS to predict changes in resistance. Dynamics of the latter exhibit complex patterns with MIC increases, and some decreases, whereby subpopulations' MICs can diverge. We also identify pathogens at risk of developing clinical resistance in the near future.Engineering and Physical Sciences Research Council (EPSRC)Ramón Areces Postdoctoral FellowshipMinisterio de Ciencia, Innovación y Universidades/FEDEREuropean Research Council (ERC)Biotechnology and Biological Sciences Research Council (BBSRC)David Phillips FellowshipNational Health and Medical Research Counci

Breaking antimicrobial resistance by disrupting extracytoplasmic protein folding

Data availability: All data generated during this study that support the findings are included in the manuscript or in the Supplementary Information.Copyright © 2022, Furniss et al. Antimicrobial resistance in Gram-negative bacteria is one of the greatest threats to global health. New antibacterial strategies are urgently needed, and the development of antibiotic adjuvants that either neutralize resistance proteins or compromise the integrity of the cell envelope is of ever-growing interest. Most available adjuvants are only effective against specific resistance proteins. Here we demonstrate that disruption of cell envelope protein homeostasis simultaneously compromises several classes of resistance determinants. In particular, we find that impairing DsbA-mediated disulfide bond formation incapacitates diverse β-lactamases and destabilizes mobile colistin resistance enzymes. Furthermore, we show that chemical inhibition of DsbA sensitizes multidrug-resistant clinical isolates to existing antibiotics and that the absence of DsbA, in combination with antibiotic treatment, substantially increases the survival of Galleria mellonella larvae infected with multidrug-resistant Pseudomonas aeruginosa. This work lays the foundation for the development of novel antibiotic adjuvants that function as broad-acting resistance breakers.MRC Career Development Award MR/M009505/1 (to D.A.I.M.); the institutional BBSRC-DTP studentships BB/M011178/1 (to N.K.) and BB/M01116X/1 (to H.L.P.); the BBSRC David Philips Fellowship BB/M02623X/1 (to J.M.A.B.); the ISSF Wellcome Trust grant 105603/Z/14/Z (to G.L.-M.); the Brunel Research Innovation and Enterprise Fund, Innovate UK and British Society for Antimicrobial Chemotherapy grants 2018-11143, 37800 and BSAC-2018-0095, respectively (to R.R.MC); the Swiss National Science Foundation Postdoc Mobility and Ambizione Fellowships P300PA_167703 and PZ00P3_180142, respectively (to D.G.)

Choice of Bacterial Growth Medium Alters the Transcriptome and Phenotype of Salmonella enterica Serovar Typhimurium

The type of bacterial culture medium is an important consideration during design of any experimental protocol. The aim of this study was to understand the impact of medium choice on bacterial gene expression and physiology by comparing the transcriptome of Salmonella enterica SL1344 after growth in the widely used LB broth or the rationally designed MOPS minimal medium. Transcriptomics showed that after growth in MOPS minimal media, compared to LB, there was increased expression of 42 genes involved in amino acid synthesis and 23 genes coding for ABC transporters. Seven flagellar genes had decreased expression after growth in MOPS minimal medium and this correlated with a decreased motility. In both MOPS minimal medium and MEM expression of genes from SPI-2 was increased and the adhesion of S. Typhimurium to intestinal epithelial cells was higher compared to the levels after growth in LB. However, SL1344 invasion was not significantly altered by growth in either MOPs minimal media or MEM. Expression of SPI-2 was also measured using chromosomal GFP reporter fusions followed by flow cytometry which showed, for the first time, that the reduction in SPI-2 transcript after growth in different media related to a reduction in the proportion of the bacterial population expressing SPI-2. These data highlight the profound differences in the global transcriptome after in vitro growth in different media and show that choice of medium should be considered carefully during experimental design, particularly when virulence related phenotypes are being measured

Adaptive modulation of antibiotic resistance through intragenomic coevolution

Bacteria gain antibiotic resistance genes by horizontal acquisition of mobile genetic elements (MGEs) from other lineages. Newly acquired MGEs are often poorly adapted causing intragenomic conflicts; these are resolved by either compensatory adaptation - of the chromosome or the MGE - or reciprocal coadaptation. The footprints of such intragenomic coevolution are present in bacterial genomes, suggesting an important role promoting genomic integration of horizontally acquired genes, but direct experimental evidence of the process is limited. Here we show adaptive modulation of tetracycline resistance via intragenomic coevolution between Escherichia coli and the multidrug resistant plasmid RK2. Tetracycline treatments, including monotherapy or combination therapies with ampicillin, favoured de novo chromosomal resistance mutations coupled with mutations on RK2 impairing the plasmid-encoded tetracycline efflux pump. These mutations together provided increased tetracycline resistance at reduced cost. Additionally, the chromosomal resistance mutations conferred cross-resistance to chloramphenicol. Reciprocal coadaptation was not observed under ampicillin-only or no antibiotic selection. Intragenomic coevolution can create genomes comprising multiple replicons that together provide high-level, low-cost resistance, but the resulting co-dependence may limit the spread of coadapted MGEs to other lineages

RNA-seq Analysis Reveals That an ECF σ Factor, AcsS, Regulates Achromobactin Biosynthesis in Pseudomonas syringae pv. syringae B728a

Iron is an essential micronutrient for Pseudomonas syringae pv. syringae strain B728a and many other microorganisms; therefore, B728a has evolved methods of iron acquirement including the use of iron-chelating siderophores. In this study an extracytoplasmic function (ECF) sigma factor, AcsS, encoded within the achromobactin gene cluster is shown to be a major regulator of genes involved in the biosynthesis and secretion of this siderophore. However, production of achromobactin was not completely abrogated in the deletion mutant, implying that other regulators may be involved such as PvdS, the sigma factor that regulates pyoverdine biosynthesis. RNA-seq analysis identified 287 genes that are differentially expressed between the AcsS deletion mutant and the wild type strain. These genes are involved in iron response, secretion, extracellular polysaccharide production, and cell motility. Thus, the transcriptome analysis supports a role for AcsS in the regulation of achromobactin production and the potential activity of both AcsS and achromobactin in the plant-associated lifestyle of strain B728a

Multiplexed identification, quantification and genotyping of infectious agents using a semiconductor biochip

The emergence of pathogens resistant to existing antimicrobial drugs is a growing worldwide health crisis that threatens a return to the pre-antibiotic era. To decrease the overuse of antibiotics, molecular diagnostics systems are needed that can rapidly identify pathogens in a clinical sample and determine the presence of mutations that confer drug resistance at the point of care. We developed a fully integrated, miniaturized semiconductor biochip and closed-tube detection chemistry that performs multiplex nucleic acid amplification and sequence analysis. The approach had a high dynamic range of quantification of microbial load and was able to perform comprehensive mutation analysis on up to 1,000 sequences or strands simultaneously in <2 h. We detected and quantified multiple DNA and RNA respiratory viruses in clinical samples with complete concordance to a commercially available test. We also identified 54 drug-resistance-associated mutations that were present in six genes of Mycobacterium tuberculosis, all of which were confirmed by next-generation sequencing