@article{Wong:2022:10.1073/pnas.2203593119,
author = {Wong, JLC and David, S and Sanchez-Garrido, J and Woo, JZ and Low, WW and Morecchiato, F and Giani, T and Rossolini, GM and Beis, K and Brett, SJ and Clements, A and Aanensen, DM and Rouskin, S and Frankel, G},
doi = {10.1073/pnas.2203593119},
journal = {Proc Natl Acad Sci U S A},
title = {Recurrent emergence of Klebsiella pneumoniae carbapenem resistance mediated by an inhibitory ompK36 mRNA secondary structure.},
url = {http://dx.doi.org/10.1073/pnas.2203593119},
volume = {119},
year = {2022}
}

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TY  - JOUR
AB  - Outer membrane porins in Gram-negative bacteria facilitate antibiotic influx. In Klebsiella pneumoniae, modifications in the porin OmpK36 are implicated in increasing resistance to carbapenems. An analysis of large K. pneumoniae genome collections, encompassing major healthcare-associated clones, revealed the recurrent emergence of a synonymous cytosine-to-thymine transition at position 25 (25c > t) in ompK36. We show that the 25c > t transition increases carbapenem resistance through depletion of OmpK36 from the outer membrane. The mutation attenuates K. pneumoniae in a murine pneumonia model, which accounts for its limited clonal expansion observed by phylogenetic analysis. However, in the context of carbapenem treatment, the 25c > t transition tips the balance toward treatment failure, thus accounting for its recurrent emergence. Mechanistically, the 25c > t transition mediates an intramolecular messenger RNA (mRNA) interaction between a uracil encoded by 25t and the first adenine within the Shine-Dalgarno sequence. This specific interaction leads to the formation of an RNA stem structure, which obscures the ribosomal binding site thus disrupting translation. While mutations reducing OmpK36 expression via transcriptional silencing are known, we uniquely demonstrate the repeated selection of a synonymous ompK36 mutation mediating translational suppression in response to antibiotic pressure.
AU  - Wong,JLC
AU  - David,S
AU  - Sanchez-Garrido,J
AU  - Woo,JZ
AU  - Low,WW
AU  - Morecchiato,F
AU  - Giani,T
AU  - Rossolini,GM
AU  - Beis,K
AU  - Brett,SJ
AU  - Clements,A
AU  - Aanensen,DM
AU  - Rouskin,S
AU  - Frankel,G
DO  - 10.1073/pnas.2203593119
PY  - 2022///
TI  - Recurrent emergence of Klebsiella pneumoniae carbapenem resistance mediated by an inhibitory ompK36 mRNA secondary structure.
T2  - Proc Natl Acad Sci U S A
UR  - http://dx.doi.org/10.1073/pnas.2203593119
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36095213
VL  - 119
ER  - 

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