Jichao Zhu | PubMed Health

PubMed2026

EprX associates with concurrent shifts in antimicrobial resistance and virulence in clinical bloodstream E. coli: a putative adaptive node for bacterial fitness.

Bloodstream infections (BSIs) caused by E. coli represent a growing global threat, driven by escalating antimicrobial resistance (AMR) and sustained virulence. However, the regulatory mechanisms linking these two phenotypes remain poorly understood. Here, we identify EprX, a previously uncharacterized YjbI-type pentapeptide repeat protein (PRP), a locus that our data suggest may influence metabolic and transcriptional profiles in clinical BSI E. coli isolates. Genomic screening of 85 clinical BSI strains reveals that eprX is present in 21.2% of isolates, often within distinct genomic contexts suggestive of mobile acquisition. Using λ-Red recombineering, we constructed eprX knockout mutants. Loss of eprX is associated with altered antimicrobial resistance profiles, increasing susceptibility to gentamicin, ciprofloxacin, and levofloxacin. This phenotype is consistent with upregulation of outer membrane porin genes (ompC, ompF) and downregulation of multidrug efflux pump genes (macB, mdtC, emrB) and two-component regulatory system genes. eprX deficiency also appears to correlate with attenuated virulence in our assays, as evidenced by improved survival of Galleria mellonella larvae (65-95% at 72 h post-infection vs. 40-60% for wild-type strains) and reduced adhesion to and invasion of human HeLa cells. Transcriptomic profiling reveals that eprX carriage is associated with broad, coordinated shifts in the expression of genes involved in LPS transport (lptG/lptF), type ;II secretion system components (gspD/gspE/gspF), autotransporter adhesins (ag43), and flagellar assembly, suggesting potential disruptions in outer-membrane integrity, biofilm formation, and virulence programs. Our data suggests that eprX is a genetic locus whose presence correlates with concurrent shifts in resistance maintenance and virulence traits, representing a putative adaptive node within the E. coli fitness landscape.

Animals↗

PubMed2026

Emergence of ceftazidime-avibactam resistance mediated by KPC variants KPC-71 and KPC-78 in ST463 Pseudomonas aeruginosa.

UNLABELLED: Pseudomonas aeruginosa is a well-recognized opportunistic pathogen and a leading cause of healthcare-associated infections. The shrinking effectiveness of available antimicrobial therapies has intensified the global threat posed by carbapenem-resistant P. aeruginosa (CRPA). Here, we elucidate the mechanisms of ceftazidime-avibactam (CZA) resistance mediated by the rare KPC variants, KPC-71 and KPC-78, identified during the treatment of CRPA infections. Two CZA-resistant P. aeruginosa strains, SY-206885 and HZ-231016032, were isolated from critically ill male patients with severe pneumonia. Whole-genome sequencing assigned both isolates to the high-risk sequence type 463 (ST463). Isolate SY-206885 harbors the blaKPC-71 gene, while HZ-231016032 carries blaKPC-78. Cloning and expression of these genes in P. aeruginosa PAO1 conferred a marked increase in the CZA minimum inhibitory concentration. Notably, expression of KPC-71 or KPC-78 conferred CZA resistance while simultaneously reducing carbapenem hydrolytic activity, a trade-off previously described for some KPC variants but still rarely documented in P. aeruginosa. Structural analysis and kinetic profiling showed that, relative to wild-type KPC-2, both KPC-71 and KPC-78 exhibited reduced catalytic turnover but increased substrate affinity for ceftazidime, together with significantly weakened binding to avibactam. In addition, elevated expression of MexAB-OprM and AmpC-related determinants in the clinical isolates likely further enhanced the high-level CZA resistance phenotype. These findings highlight the capacity of the ST463 CRPA lineage to evolve CZA resistance through KPC structural diversification under antimicrobial pressure and underscore the need for close surveillance during therapy. IMPORTANCE: In this study, we report the detection of the uncommon KPC variants KPC-71 and KPC-78 in clinical sequence type 463 (ST463) carbapenem-resistant Pseudomonas aeruginosa isolates exhibiting resistance to ceftazidime-avibactam (CZA). We demonstrate that CZA resistance is driven by specific structural alterations-a serine insertion between residues 182 and 183 or a D179A substitution within the Ω-loop-that reshape the functional balance of the KPC enzyme. These changes appear to create an evolutionary trade-off by improving ceftazidime recognition while weakening avibactam-mediated inhibition. Given the widespread dissemination of the ST463 lineage in China, the emergence of these variants highlights the urgent need for clinicians to monitor for CZA resistance development during therapy. CLINICAL TRIALS: This study is registered with ClinicalTrials.gov as ChiCTR2500105846.

Ceftazidime↗