<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">AiM</journal-id><journal-title-group><journal-title>Advances in Microbiology</journal-title></journal-title-group><issn pub-type="epub">2165-3402</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/aim.2019.912064</article-id><article-id pub-id-type="publisher-id">AiM-97012</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject></subj-group></article-categories><title-group><article-title>
 
 
  Mutational and Phylogenetic Analysis of &lt;i&gt;nfxB&lt;/i&gt; Gene in Multidrug-Resistant Clinical Isolates of &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; Hyperexpressing MexCD-OprJ Efflux Pump
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Manju</surname><given-names>Suresh</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Nithya</surname><given-names>Narayanan</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kollancheri</surname><given-names>Puthurath Vimal</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Pullampara</surname><given-names>Rajamma Jayasree</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Panickassery</surname><given-names>Ramakrishnan Manish Kumar</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff3"><addr-line>School of Health Sciences, University of Calicut, Malappuram, Kerala, India</addr-line></aff><aff id="aff1"><addr-line>Department of Biotechnology, University of Calicut, Malappuram, Kerala, India</addr-line></aff><aff id="aff2"><addr-line>Department of Botany, University of Calicut, Malappuram, Kerala, India</addr-line></aff><pub-date pub-type="epub"><day>26</day><month>11</month><year>2019</year></pub-date><volume>09</volume><issue>12</issue><fpage>993</fpage><lpage>999</lpage><history><date date-type="received"><day>25,</day>	<month>October</month>	<year>2019</year></date><date date-type="rev-recd"><day>8,</day>	<month>December</month>	<year>2019</year>	</date><date date-type="accepted"><day>11,</day>	<month>December</month>	<year>2019</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  The present study focused on MexCD-OprJ efflux pump and its regulatory gene 
  nfxB in multidrug resistant (MDR) clinical isolates of 
  Pseudomonas aeruginosa collected from Kerala, South India. Semi-quantitative reverse transcription-PCR technique was employed to detect hyperexpression of the efflux pump gene, 
  mexD. Amplicons from 
  nfxB gene of isolates hyperexpressing the efflux pump were sequenced for mutational and phylogenetic analysis. Among 29 isolates of MDR 
  P. aeruginosa, increased 
  mexD transcription was detected in 10.3% of the isolates when compared with 
  P. aeruginosa reference strain, PAO (MTCC-3541). Various synonymous and non-synonymous mutations in 
  nfxB regulatory gene sequences were detected. Notably, mutations detected in the strains designate Pa6 and Pa7 have been found to be novel and are hitherto unreported in GenBank data base. The genetic divergence and homogeneity of the 
  nfxB regulatory gene sequences of 
  mexCD-oprJ operon were clearly apparent in the phylogram generated employing similar sequences retrieved from the public database.
 
</p></abstract><kwd-group><kwd>Multidrug-Resistant</kwd><kwd> &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt;</kwd><kwd> Efflux Pump</kwd><kwd> Regulatory Gene</kwd><kwd> Mutational Variations</kwd><kwd> Phylogenetic Analysis</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>MexCD-OprJ efflux pump of resistance-nodulation-cell division superfamily, normally quiescent in wild-type strain of P. aeruginosa, does not contribute to intrinsic antimicrobial resistance. This pump is capable of extruding a variety of antimicrobial agents, biocides, organic solvents, dyes and detergents. The mexCD-oprJ operon is regulated by repressors such as NfxB and EsrC. The nfxB gene encoding repressor protein, NfxB, is located upstream of the structural genes mexCD-oprJ with an intergenic regulatory region facilitating divergent transcription. NfxB shows similarity to proteins of the LacI-GalR family. It binds to a site composed of two 39 bp repeats within the aforementioned intergenic sequences between nfxB and mexC which negatively regulates mexCD-oprJ as well as its own expression. Mutations within nfxB gene negatively impact NfxB repressor activity leading to hyperexpression of mexCD-oprJ, and strains harbouring such defects are known as nfxB-type mutants [<xref ref-type="bibr" rid="scirp.97012-ref1">1</xref>] [<xref ref-type="bibr" rid="scirp.97012-ref2">2</xref>]. EsrC, a second regulator of MexCD-OprJ, encoded by a gene PA4596, is located downstream of mexCD-oprJ operon. EsrC represses transcription of mexCD-oprJ only under “envelope stress” (membrane-damaged) condition and is dependent on NfxB [<xref ref-type="bibr" rid="scirp.97012-ref3">3</xref>]. The present study was undertaken to analyze mutational and phylogenetic relatedness of nfxB regulatory gene in MDR isolates of P. aeruginosa hyperexpressing MexCD-OprJ efflux pump.</p></sec><sec id="s2"><title>2. Materials and Methods</title><sec id="s2_1"><title>2.1. Bacterial Isolates</title><p>Of a total of 144 MDR gram-negative bacteria, collected during the period 2012-2016 from various clinical laboratories in Kerala, 29 isolates of P. aeruginosa (designated as Pa1 - Pa29) were included in this study along with a reference P. aeruginosa MTCC-3541 (Microbial Type Culture Collection) strain, PAO.</p></sec><sec id="s2_2"><title>2.2. Random Amplified Polymorphic DNA (RAPD)</title><p>Random Amplified Polymorphic DNA (RAPD) typing was performed with RBa-D5 primer (GenBank accession. no. AM911680) according to manufacturer’s instructions. Images of DNA banding patterns obtained after agarose gel electrophoresis were analyzed using the PyElph software [<xref ref-type="bibr" rid="scirp.97012-ref4">4</xref>] to prepare dendrograms using unweighed pair-group method arithmetic mean (UPGMA) method.</p></sec><sec id="s2_3"><title>2.3. Semi-Quantitative RT-PCR</title><p>Semi-quantitative RT-PCR using primers (Eurofins Genomics India Pvt. Ltd., Bangalore) for genes such as rpsL and mexD [<xref ref-type="bibr" rid="scirp.97012-ref5">5</xref>] [<xref ref-type="bibr" rid="scirp.97012-ref6">6</xref>] were performed as described by us in a related study [<xref ref-type="bibr" rid="scirp.97012-ref7">7</xref>]. The RT-PCR reactions were performed using a minicycler (MJ Research, USA) in a reaction volume of 25 μl containing 12.5 μl of 2x Emerald GT master mix (TaKaRa Inc., Japan), 0.25 μM of each primer and 0.5 μl of cDNA. Amplification products were analyzed on 1% (w/v) agarose gels to detect the presence of the expected amplicons and compare the band intensities with those from the reference strain P. aeruginosa MTCC-PAO.</p></sec><sec id="s2_4"><title>2.4. PCR Amplification and Sequencing of the nfxB Gene and Its Phylogenetic Analysis</title><p>The regulatory nfxB gene primer [<xref ref-type="bibr" rid="scirp.97012-ref8">8</xref>] was used for DNA amplifications and sequencing [<xref ref-type="bibr" rid="scirp.97012-ref7">7</xref>]. The ampliconic sequences were analyzed with NCBI BLAST tool (https://www.ncbi.nlm.nih.gov/) by comparison with sequences of the reference strain, P. aeruginosa PAO1, retrieved from the GenBank database. The phylogram construction, employing nfxB gene sequences obtained in this study in combination with similar sequences retrieved from public databases, was carried out by Bayesian inference using Markov Chain Monte Carlo method [<xref ref-type="bibr" rid="scirp.97012-ref9">9</xref>]. The jModelTest software [<xref ref-type="bibr" rid="scirp.97012-ref10">10</xref>] used for the analysis of nucleotide sequence evolution with respect to each gene was based on Akaike Information Criterion (AIC).</p></sec><sec id="s2_5"><title>2.5. Nucleotide Sequence Accession Numbers</title><p>The nfxB gene nucleotide sequences obtained in the present study were deposited in the GenBank database under the following accession numbers MH346508-MH346510.</p></sec></sec><sec id="s3"><title>3. Result and Discussion</title><p>The RAPD profiles generated in our study were found to be distinctive and reproducible (<xref ref-type="fig" rid="fig1">Figure 1</xref>). The dendrogram showed two major clusters—A and B, in which major cluster A was found to be subdivided into two sub-clusters A1 and A2 (<xref ref-type="fig" rid="fig2">Figure 2</xref>). The mexD was significantly overexpressed in three isolates such as Pa6, Pa7 and Pa13 (<xref ref-type="fig" rid="fig3">Figure 3</xref>). Isolates with efflux pump activity were found to be included in the sub-cluster A1 of RAPD dendrogram. Of them, Pa7 and Pa13 belonged to a single clade, whilst strain Pa6 was found grouped into another clade. Mutation analysis of nfxB gene revealed point mutations, T → C at 239<sup>th</sup> position in Pa6, T → C at 349<sup>th</sup> position in Pa7 and C → T at 14<sup>th</sup> position in Pa13 (<xref ref-type="table" rid="table1">Table 1</xref>). Notably, mutations detected in Pa6 and Pa7 isolates have been found to be novel and are hitherto unreported in GenBank data base, whilst the mutation detected in Pa13 has already been reported earlier [<xref ref-type="bibr" rid="scirp.97012-ref11">11</xref>]. Phylogram (<xref ref-type="fig" rid="fig4">Figure 4</xref>) was constructed using three nfxB gene sequences of MexCD-OprJ overproducers—Pa6, Pa7 and Pa13 and nine other selected sequences of P. aeruginosa isolate retrieved from the GenBank database including the reference strain, P. aeruginosa—PAO1 (GenBank accession no. AE004091. 2). For this analysis, Pseudomonas chlororaphis (GenBank accession no. CP011110.1) was taken as</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Summary of genetic analyses of mutations in nfxB gene of P. aeruginosa clinical isolates</title></caption><table><tbody><thead><tr><th align="center" valign="middle"  rowspan="2"  >Isolates</th><th align="center" valign="middle"  colspan="2"  >nfxB mutation<sup> </sup></th></tr></thead><tr><td align="center" valign="middle" >Nucleotide</td><td align="center" valign="middle" >Aminoacid</td></tr><tr><td align="center" valign="middle" >Pa6</td><td align="center" valign="middle" ><sup>239</sup>T → C <sup>555</sup>T → G</td><td align="center" valign="middle" ><sup>80</sup>Leucine → Serine −</td></tr><tr><td align="center" valign="middle" >Pa7</td><td align="center" valign="middle" ><sup>39</sup>G → A,<sup>183</sup>A → G,<sup>423</sup>G → A,<sup>480</sup>T → C,<sup>486</sup>A → T,<sup>537</sup>T → C,<sup>543</sup>C → T,<sup>555</sup>T → G<sup> </sup> <sup>349</sup>T → C</td><td align="center" valign="middle" >−<sup> </sup> <sup>117</sup>Serine → Proline</td></tr><tr><td align="center" valign="middle" >Pa13</td><td align="center" valign="middle" ><sup>14</sup>C → T <sup>135</sup>C → T,<sup>141</sup>G → A,<sup>555</sup>T → G</td><td align="center" valign="middle" ><sup>5</sup>Serine → Phenylalanine −</td></tr></tbody></table></table-wrap><p>“−” represents no amino acid change.</p><p>the outgroup as this sequence showed better sequence similarity with a higher query coverage. GTR was selected as the best fit model of sequence evolution on the basis of AIC. Potential scale reduction factor (PSRF) and estimated sample size (ESS) value were observed as 1.0 and above 100 respectively. Analysis was run for 1,000,000 generations and clade credibility values represented at each node were found to be &gt;0.5. Bayesian phylogenetic analysis revealed that the sequence from Pa6 exhibited similarity with isolates reported from Taiwan (GenBank accession no. CP004061.1), Mexico (GenBank accession no. CP021999.1) and Brazil (GenBank accession no. CP021380.1). Pa13 isolate showed similarity with that reported from Tamil Nadu with GenBank accession no. CP008739.2 [<xref ref-type="bibr" rid="scirp.97012-ref11">11</xref>] whilst Pa7 was found to be similar to P. aeruginosa sequences deposited from North America with GenBank accession no. CP012901.1 [<xref ref-type="bibr" rid="scirp.97012-ref12">12</xref>].</p></sec><sec id="s4"><title>4. Conclusion</title><p>Antibiotic resistance is a stark reality across the world including the Indian subcontinent. Antimicrobial selection pressure and spread of resistant organisms are the main leading factors for the emergence of resistance. The present study has been successful in unraveling vital information on the mutational variations of nfxB regulatory gene sequences of MexCD-OprJ efflux pump present in P. aeruginosa. Occurrence of genetic similarities of nfxB gene sequences among the isolates used in this study as well as with those previously reported from other countries warrants the need for implementation of strict control measures to prevent spread of resistance genes.</p></sec><sec id="s5"><title>Acknowledgements</title><p>This study was supported by the Government of India, DST (Department of Science and Technology)—INSPIRE fellowship (Grant No. IF120394) to MS.</p></sec><sec id="s6"><title>Conflicts of Interest</title><p>The authors declare no conflicts of interest regarding the publication of this paper.</p></sec><sec id="s7"><title>Cite this paper</title><p>Suresh, M., Narayanan, N., Vimal, K.P., Jayasree, P.R., Kumar, P.R.M. (2019) Mutational and Phylogenetic Analysis of nfxB Gene in Multidrug-Resistant Clinical Isolates of Pseudomonas aeruginosa Hyperexpressing MexCD-OprJ Efflux Pump. 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