Background Information of Bacterial Integrons

During the past 20 years a significant amount of information related to the mechanism and spread of antibiotic resistance has become available.   Recently, the impact of horizontally transmitted genetic determinants

and the role of recombination in the recruitment of resistance genes have been highlighted.  Resistance genes can be exchanged among bacterial populations. Several mechanisms for the acquisition and dissemination of resistance determinants involve DNA exchange and in this way resistance genes can spread efficiently among bacterial populations from animals and humans .  The identification of specialised genetic structures responsible for the acquisition of resistance genes on horizontal gene vehicles represents an important discovery in our understanding of antibiotic resistance mechanisms. Naturally occurring gene expression elements, called integrons, have been described as a very efficient genetic mechanism by which bacteria can acquire resistance genes. Integrons promote the capture of one or more gene cassettes within the same attachment site, thereby forming composite clusters of antibiotic resistance genes.

Integrons are gene expression systems that incorporate ORFs (open reading frames) and convert them into functional genes. The essential components of an integron include the integrase gene (intI), the attachment site (attI) and the promoter, which promotes the expression of any suitably integrated gene(s).

The most common integrons are classified by classes 1-3:

Class 1 represents the most common structure and most of the elements belonging to this class are characterized by the presence of two conserved segments, the 5’-conserved segment (5’-CS) and 3’-conserved segment (3’-CS). The 5’-CS contains the intI gene, the attI site and the promoter, while the 3’-CS codes for the sul1 gene, conferring resistance to sulphonamides and the qacED1 gene, conferring resistance to quaternary ammonium compounds used

as disinfectants. In addition, the 3’-CS carries the ORF5 encoding a protein of unknown function.

Class 2 integrons have also been described and these are included in the Tn7 family of transposons. Tn7 contains three integrated gene cassettes (dhfrIsat- aadA1) adjacent to a defective integrase gene (intI2) located at 5’-CS. The Tn7 attI site is located between the intI2 gene and the first inserted resistance gene as described for class 1 integrons. Class 2 integrons do not contain the sul1 gene but in fact include genes whose function promotes Tn7 transposition. 

To date, only one class 3 integron has been reported, containing the blaIMP gene cassette that confers resistance to broadspectrum b-lactams including carbapenems, and part of the aacA4 gene, previously identified

as a gene cassette in class 1 integrons. The integrase gene (intI3) demonstrated an identity of 60.9% to the intI1 gene at the amino acid level, with the gene cassette boundaries showing atypical recombination sites.  It is noteworthy that despite the differences in the integrase and attI site sequences, the same gene cassettes are thought to be acquired by all three integron classes, as identical gene cassettes have been found in classes 1 and 2 and in classes 1 and 3. This observation suggests that the class-specific integrases work on an apparently common pool of resistance gene cassettes.

Summary of the review:

Carattoli A.  Importance of integrons in the diffusion of resistance. Vet Res. 2001 May-Aug;32(3-4):243-59. Review.

PMID: 11432416 [PubMed - indexed for MEDLINE]

Información de trasfondo sobre Integrones Bacterianos

Información de Trasfondo:

Las bacterias pueden transferir de unas a otras información genética, protegiéndose de múltiples antibióticos.  Esta resistencia se debe a la presencia de genes localizados en plásmidos y transposones.  Recientemente se ha descrito otro mecanismo que confiere resistencia: los integrones (Stokes HW. et al., 1989).  Los integrones, son elementos genéticos dinámicos en el que por un mecanismo de recombinación en un lugar específico, se acumula una combinación de genes estructurales organizados (Ploy et al., 2000). Los genes que se incorporan a los integrones se han denominado genes casete.  Tres elementos principales permiten la captura y expresión de los genes casetes en los integrones: uno que codifica una integrasa, (intI); el otro es el lugar de recombinación sitio-específico, (attI); y un promotor.  La clasificación de estos elementos se ha hecho en base a la secuencia de su integrasa. Las clases 1, 2 y 3 son las más estudiadas y están relacionadas a la resistencia de antibióticos.  Los integrones se encuentran ampliamente entre las especies de la familia Enterobacteriaceae (clase 2: Shigella sonnei y clase 3: Klebsiella pneumoniae) y en otras bacterias gramnegativas como Pseudomonas aeruginosa (clase 1) (Moraga R.M. et al., 2007).  

 Justificación y Relevancia:

La transmisión de genes que confieren resistencia a antibióticos entre enterobacterias y bacterias causantes de enfermedades nosocomiales, como Pseudomonas, ha ido en aumento (González et al., 2004). En cepas de Shigella se ha descrito un aumento progresivo de la resistencia a varios antibióticos, incluyendo a aquellos que son considerados de elección en el tratamiento de las infecciones que ellas producen. Destaca, por su importancia clínica y epidemiológica, la resistencia a ampicilina y sulfametoxazol-trimetoprim6 (Muñoz J, et al., 2003).  En  estudios realizados de genes casetes en integrones clase 3, se ha determinado que la especie Klebsiella pneumoniae es la bacteria que con más frecuencia aparece; resistente a aminoglucósidos y a cefalosporina de 3ra generación (Psichogiou M et al., 2007).  Cabe mencionar el reciente estudio en el que se aislaron 74 cepas de K. pneumoniae; se detectaron 13 genes casetes diferentes, en 11 tipos de combinaciones distintas (Yao F, et.al, 2007).  En Pseudomonas aeruginosa ha aumentado la resistencia a imipenem, ciprofloxacina, amicacina y ceftazidima (Cornejo-Juárez P et al., 2007).  La importancia de monitorear la entrada y salida de la planta de tratamiento de agua, es identificar la presencia de DNA y determinar si al final del proceso se encuentran presente los mismos genes casetes provenientes del ambiente hospitalario.  Esto resultaría en un posible aumento en el número de bacterias resistentes, debido a que los genes casetes libres en el ambiente, podrían insertarse en los integrones de bacterias no-resistentes.

Referencias:Cornejo-Juárez P, Velásquez-Acosta C, Sandoval S, Gordillo P, Volkow-  Fernández P.  (2007).  Antimicrobial resistance patterns of isolates  from urine cultures at an oncological center.  Salud Publica Mex. 49(5):330-6.    Flanagan JL, Brodie EL, Weng L, Lynch SV, Garcia O, Brown R,  Hugenholtz P, DeSantis TZ, Andersen GL, Wiener-Kronish JP, Bristow J.  (2007).  Loss of bacterial diversity during antibiotic treatment of intubated patients colonized with Pseudomonas aeruginosa.  J Clin Microbiol. 45(6):1954-62.      Flores X, Comas J, Roda IR, Jiménez L, Gernaey KV.  (2007).   Application  of multivariable statistical techniques in plant-wide WWTP control  strategies analysis.  Water Sci Technol. 56(6):75-  83.González G, Mella S, Zemelman R, Bello H, Domínguez M.  (2004).  Integrons and resistance gene cassettes: structure and role against antimicrobials.  Rev Med Chil.  132(5):619-26.Moura A, Henriques I, Ribeiro R, Correia A.  (2007).  Prevalence and characterization of integrons from bacteria isolated from a slaughterhouse wastewater treatment plant.  Antimicrob        Chemother.  2.Muñoz J, Bello H, Domínguez M, Mella S, Zemelman R, González G.  (2003).  Integrons and antimicrobial resistance gene cassettes in Shigella.  Rev Med Chil.  131(7):727-33.  Ploy MC, Lambert T, Couty JP, Denis F.  (2000).  Integrons: an antibiotic resistance gene capture and expression system.  Clin Chem Lab Med.  38(6):483-7.  Psichogiou M, Tassios PT, Avlamis A, Stefanou I, Kosmidis C, Platsouka E, Paniara O, Xanthaki A, Toutouza M, Daikos GL, Tzouvelekis LS.  (2007).  Ongoing epidemic of blaVIM-1-positive Klebsiella pneumoniae in Athens, Greece: a prospective survey.  J Antimicrob Chemother.  13Rubén Moraga M., Edgardo Santander P., Teresa Arias C. y Fermín Méndez A.  (2007).  Integrons and their relationship with resistance phenotype in Gram negative bacilli isolated in the Hospital Torres Galdames, Iquique, Chile.  24 (5): 384-390.Stokes HW, Hall RM.  (1989).  A novel family of potentially mobile DNA  elements encoding site-specific gene-integration functions:  integrons.  Mol Microbiol.  3(12):1669-83.

Stokes HW, Holmes AJ, Nield BS, Holley MP, Nevalainen KM, Mabbutt   BC, Gillings MR.  (2001).   Gene cassette PCR: sequence-independent recovery of entire genes from environmental DNA.  Appl Environ Microbiol. 67(11):5240-6.