Exploring the Inhibition of CTX-M-9 by β-Lactamase Inhibitors and Carbapenems

Author:

Bethel Christopher R.1,Taracila Magdalena2,Shyr Teresa1,Thomson Jodi M.3,Distler Anne M.134,Hujer Kristine M.12,Hujer Andrea M.12,Endimiani Andrea12,Papp-Wallace Krisztina1,Bonnet Richard5,Bonomo Robert A.1236

Affiliation:

1. Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio

2. Departments of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

3. Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio

4. Cuyahoga Community College, Cleveland, Ohio

5. Centre Hospitalier Universitaire de Clermont-Ferrand, Laboratoire de Bactériologie, UFR Médecine, University Clermont, Clermont-Ferrand, France

6. Molecular Biology and Microbiology, Case Western Reserve University School of Medicine, Cleveland, Ohio

Abstract

ABSTRACT Currently, CTX-M β-lactamases are among the most prevalent and most heterogeneous extended-spectrum β-lactamases (ESBLs). In general, CTX-M enzymes are susceptible to inhibition by β-lactamase inhibitors. However, it is unknown if the pathway to inhibition by β-lactamase inhibitors for CTX-M ESBLs is similar to TEM and SHV β-lactamases and why bacteria possessing only CTX-M ESBLs are so susceptible to carbapenems. Here, we have performed a kinetic analysis and timed electrospray ionization mass spectrometry (ESI-MS) studies to reveal the intermediates of inhibition of CTX-M-9, an ESBL representative of this family of enzymes. CTX-M-9 β-lactamase was inactivated by sulbactam, tazobactam, clavulanate, meropenem, doripenem, ertapenem, and a 6-methylidene penem, penem 1. K i values ranged from 1.6 ± 0.3 μM (mean ± standard error) for tazobactam to 0.02 ± 0.01 μM for penem 1. Before and after tryptic digestion of the CTX-M-9 β-lactamase apo-enzyme and CTX-M-9 inactivation by inhibitors (meropenem, clavulanate, sulbactam, tazobactam, and penem 1), ESI-MS and matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) identified different adducts attached to the peptide containing the active site Ser70 (+52, 70, 88, and 156 ± 3 atomic mass units). This study shows that a multistep inhibition pathway results from modification or fragmentation with clavulanate, sulbactam, and tazobactam, while a single acyl enzyme intermediate is detected when meropenem and penem 1 inactivate CTX-M-9 β-lactamase. More generally, we propose that Arg276 in CTX-M-9 plays an essential role in the recognition of the C 3 carboxylate of inhibitors and that the localization of this positive charge to a “region of the active site” rather than a specific residue represents an important evolutionary strategy used by β-lactamases.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

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