Escape mutations circumvent a tradeoff between resistance to a beta-lactam and resistance to a beta-lactamase inhibitor

Nat Commun. 2020 Apr 24;11(1):2029. doi: 10.1038/s41467-020-15666-2.

Abstract

Beta-lactamase inhibitors are increasingly used to counteract antibiotic resistance mediated by beta-lactamase enzymes. These inhibitors compete with the beta-lactam antibiotic for the same binding site on the beta-lactamase, thus generating an evolutionary tradeoff: mutations that increase the enzyme's beta-lactamase activity tend to increase also its susceptibility to the inhibitor. Here, we investigate how common and accessible are mutants that escape this adaptive tradeoff. Screening a deep mutant library of the blaampC beta-lactamase gene of Escherichia coli, we identified mutations that allow growth at beta-lactam concentrations far exceeding those inhibiting growth of the wildtype strain, even in the presence of the enzyme inhibitor (avibactam). These escape mutations are rare and drug-specific, and some combinations of avibactam with beta-lactam drugs appear to prevent such escape phenotypes. Our results, showing differential adaptive potential of blaampC to combinations of avibactam and different beta-lactam antibiotics, suggest that it may be possible to identify treatments that are more resilient to evolution of resistance.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Substitution
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Azabicyclo Compounds / pharmacology
  • Bacterial Proteins / chemistry
  • Bacterial Proteins / genetics*
  • Binding Sites / genetics
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Escherichia coli / drug effects
  • Escherichia coli / genetics*
  • Evolution, Molecular
  • Inhibitory Concentration 50
  • Microbial Sensitivity Tests
  • Molecular Docking Simulation
  • Mutation
  • beta-Lactamase Inhibitors / pharmacology*
  • beta-Lactamases / chemistry
  • beta-Lactamases / genetics*
  • beta-Lactams / pharmacology

Substances

  • Anti-Bacterial Agents
  • Azabicyclo Compounds
  • Bacterial Proteins
  • beta-Lactamase Inhibitors
  • beta-Lactams
  • avibactam
  • AmpC beta-lactamases
  • beta-Lactamases