Streptomycin Accumulation Research Articles

HopE and HopD Porin-Mediated Drug Influx Contributes to Intrinsic Antimicrobial Susceptibility and Inhibits Streptomycin Resistance Acquisition by Natural Transformation in Helicobacter pylori.

ABSTRACTHelicobacter pylori is a human pathogen competent for natural transformation. Intrinsic and acquired antibiotic resistance contribute to the survival and multiplication of H. pylori under antibiotics. While drug-resistance dissemination by natural transformation (NT)-mediated horizontal gene transfer remains poorly understood in H. pylori. The purpose of the study was to investigate the role of H. pylori porins (HopA, HopB, HopC, HopD, and HopE) in the intrinsic antibiotic resistance and to preliminarily reveal the potential effect of HopE and HopD porins in streptomycin resistance acquisition after NT in the presence of antibiotics. Using traditional antibiotic susceptibility tests and growth curve analysis, we found the MIC values of metronidazole, clarithromycin, levofloxacin, tetracycline, rifampin, and streptomycin in mutants lacking HopE and/or HopD were significantly elevated compare to those in wild-type strain. The quantitative analysis of the tetramethyl rhodamine isothiocyanate (TRITC)-labeled streptomycin accumulation at the single-cell level showed reduced streptomycin intracellular fluorescence in ΔhopE and ΔhopD mutant cells. Furthermore, in the presence of translation-inhibiting antibiotic streptomycin, the resistance acquisition frequency was decreased in the wild-type strain, which could be reversed by mutants lacking HopE and HopD that restored relatively high resistance acquisition frequencies. By transforming a pUC19-rpsLmut-sfgfp linear plasmid carrying a streptomycin conferring mutation, we observed that the impaired ability of rpsLmut synthesis in the wild-type strain was restored in the ΔhopE and ΔhopD mutant transformants. Our study revealed that in the presence of streptomycin, resistance acquisition at least partially relied on the deletion of the hopE and hopD genes, because their loss reduced streptomycin concentration in the cell and thus restored the expression of the resistance-conferring gene, which was inhibited by streptomycin in wild-type strain. The loss of HopE and HopD influx activity may also preserve resistance acquisition by transformation in the presence of antibiotics with other modes of action.IMPORTANCE Helicobacter pylori is constitutively competent for natural transformation (NT) and possesses an efficient system for homologous recombination, which could be utilized to study the NT-mediated horizontal gene transfer induced antibiotic resistance acquisition. Bacterial porins have drawn renewed attention because of their crucial role in antibiotic susceptibility. From the perspective of porin-mediated influx in H. pylori, our study preliminarily revealed the important role of HopE and HopD porins not only in preserving the intrinsic susceptibility to specific antibiotic but also in evading acquired antibiotic resistance by NT in the presence of translation-inhibiting antimicrobial. Therefore, the loss of HopE or HopD porin in H. pylori genomes, combined with the large number of secreted or cell-free genetic elements carrying mutations conferring antibiotic resistance, may raise the possibility that this mechanism plays a potential role in the propagation of antibiotic resistance within H. pylori communities.

Characterization of RaeE-RaeF-RopN, a putative RND efflux pump system in Riemerella anatipestifer

Resistance-nodulation-division (RND) efflux systems are ubiquitous in Gram-negative bacteria and play a predominant role in antimicrobial resistance and other diverse phenotypes, but the knowledges of RND efflux systems are poorly understood so far in Riemerella anatipestifer. According to the sequence annotation, RIA_1117-RIA_1118-RIA_1119 operon in RA-GD strain encodes a putative tripartite RND efflux system. RIA_1117, RIA_1118 and RIA_1119 genes encode an outer member protein (OMP), an inner membrane pump protein (pump transporter), and a periplasmic membrane fusion protein (MFP), respectively. Furthermore, RIA_1119 protein is annotated as a MexE component. In this work, the biological functions of RIA_1117-RIA_1118-RIA_1119 proteins were studied. The antibiotic susceptibility testing showed that the inactivation of RIA_1117, RIA_1118 and RIA_1119 genes all raised susceptibility to amikacin, streptomycin and SDS. By induction with the above antimicrobial agents, the transcription levels of RIA_1117 and RIA_1118 genes were up-regulated significantly using qRT-PCR detection, but no significance difference was observed for the transcription level of RIA_1119 gene. CCCP inhibitor assay confirmed that RIA_1117, RIA_1118 and RIA_1119 proteins mediated amikacin, streptomycin and SDS resistance depending on proton motive force (PMF). Spot assay and streptomycin accumulation assay confirmed that RIA_1117, RIA_1118 and RIA_1119 proteins contributed to export streptomycin, and CCCP increased the accumulation of streptomycin. Furthermore, RIA_1117, RIA_1118 and RIA_1119 proteins also were involved in the fitness and virulence of RA-GD strain. These results showed that RIA_1117-RIA_1118-RIA_1119 operon encoded a RND efflux system, which has the substrate specificity for streptomycin, amikacin and SDS and contributed to the growth and virulence of RA-GD. RIA_1117-RIA_1118-RIA_1119 was designated RaeE-RaeF-RopN efflux system. Based on the above results and structural analysis, RIA_1117, RIA_1118 and RIA_1119 proteins corresponded to RopN (OMP), RaeF (pump transporter) and RaeE (MFP), respectively.

RanB, a putative ABC-type multidrug efflux transporter contributes to aminoglycosides resistance and organic solvents tolerance in Riemerella anatipestifer

Riemerella anatipestifer is a Gram-negative bacterium, which is an important pathogen infecting ducks and resistant to various antibiotics. The efflux pump is an important resistance mechanism of Gram-negative bacteria, but little research has been done in R. anatipestifer. In this study, the drug resistance mediated by RIA_1614 gene of R. anatipestifer RA-GD strain was studied, because the gene was presumed to be an efflux pump component of ABC. Firstly, the deletion strain RA-GD△RIA_1614 and complemented strain RA-GD△RIA_1614 pCPRA::RIA_1614 were constructed. Then, MICs of various antimicrobial agents to parent and deletion strains and the tolerance of the strains to organic solvents were detected to screen the substrates for RIA_1614 gene. Moreover, the transcription levels of RIA_1614 gene in the parent and the complemented strains exposed to the substrates were detected by quantitative real-time RT-PCR. Furthermore, the efflux abilities of parent, deletion and complemented strains to substrates were determined by antibiotic accumulation test. In addition, in vitro competition ability and virulence of the strains were also detected. The results showed that the deletion strain was more sensitive to aminoglycosides and organic solvents than parental strain RA-GD. When RA-GD and complemented strain were exposed to sub-repression levels of aminoglycosides and organic solvents, the transcription levels of RIA_1614 gene were significantly up-regulated. Sodium o-vanadate inhibitor assay confirmed that RIA_1614 protein contributed to amikacin and streptomycin resistance and organic solvent tolerance. Streptomycin accumulation test showed that the RIA_1614 protein was able to export streptomycin, and the addition of ATPase inhibitor sodium o-vanadate increased the accumulation of streptomycin, indicating that RIA_1614 protein was an ATP-dependent efflux transporter. Growth and competition experiments revealed that RIA_1614 protein had no significant effect on growth of RA-GD, but decreased in vitro competition ability of the strain. Furthermore, pathogenicity tests showed that RIA_1614 protein involved in the virulence of the strain. Based on the results and amino acid sequence analysis, it was determined that RIA_1614 protein was a member of ABC efflux pumps, and the protein was named RanB.

Autostimulation of Dihydrostreptomycin Uptake in Bacillus subtilis

In Bacillus subtilis it was shown that the membrane potential (delta psi) has to reach a threshold value of -180 to -190 mV for efficient uptake of dihydrostreptomycin to occur. The magnitude of delta psi is raised above this threshold, and dihydrostreptomycin uptake greatly enhanced, not only by dihydrostreptomycin itself (autostimulation) and by other miscoding aminoglycoside antibiotics, but also by puromycin, bacitracin and N,N'-dicyclohexylcarbodiimide. Stimulation of uptake by dihydrostreptomycin or puromycin was dependent on a specific interference with ongoing protein synthesis. Thus, chloramphenicol prevented the stimulating effect of puromycin by lowering the magnitude of delta psi. Although normally severely antagonizing streptomycin accumulation, K+, as well as spermidine and putrescine, which are known to stabilize ribosomes, consequently enhanced autostimulation of dihydrostreptomycin uptake in a K+-retention mutant with impaired protein synthesis. It is suggested that miscoding aminoglycosides and puromycin both enhance dihydrostreptomycin uptake by increasing delta psi due to ion fluxes, which are themselves caused by a dramatic stimulation of intracellular proteolysis of faulty proteins.

Bacteriostatic action of streptomycin on ribosomally resistant mutants (rpsL) of Salmonella typhimurium

Incubation of streptomycin-resistant (rpsL) mutants of Salmonella typhimurium in alkaline nutrient medium containing streptomycin brought about an inhibition of cell growth that was readily reversed by removing the antibiotic or neutralizing the medium. Growth inhibition was maximal at pH 8.2 and a streptomycin concentration of 800 micrograms/ml. A similar amount of dihydrostreptomycin had a negligible effect, and 10-times-higher concentrations of this antibiotic were required to reproduce the streptomycin action. Addition of streptomycin (400 micrograms/ml) to rpsL cells in alkaline (pH 8.2) nutrient medium caused inhibition of protein and DNA synthesis and also, but to a lower degree, of RNA synthesis. This effect on macromolecular synthesis was not due to ATP deprivation, since ATP content rose after addition of the antibiotic. At pH 8.2, the rate of entrance of streptomycin increased fourfold with respect to the rate at pH 7.0, leading to a large accumulation of streptomycin into rpsL cells. Uptake of the antibiotic was halted by addition of KCN or chloramphenicol. Equal uptake was obtained with 800 micrograms of dihydrostreptomycin or 400 micrograms of streptomycin per ml, yet the former did not affect cell growth at that concentration. It is concluded that high pH stimulates streptomycin and dihydrostreptomycin uptake by rpsL strains but only streptomycin accumulation causes growth inhibition in cells lacking the high-affinity ribosomal site.

Streptomycin accumulation by Bacillus subtilis requires both a membrane potential and cytochrome aa3

Cytochrome aa3 concentrations in the cytoplasmic membrane of Bacillus subtilis were altered by growth conditions, and the effects on the membrane potential (delta psi) in whole cells were measured. When cytochrome aa3 was absent, the magnitude of delta psi was not diminished by comparison with the delta psi measured in cells containing normal cytochrome aa3 concentrations. In addition, the energy-dependent uptake of proline and glutamate was comparable at both cytochrome aa3 concentrations. However, in the cytochrome aa3-deficient cell preparation, accumulation of the aminoglycoside antibiotic streptomycin was much lower than that of the cytochrome aa3-sufficient cells. When cells were cultured under conditions that stimulated higher than normal concentrations of cytochrome aa3, delta psi was also increased, and enhanced streptomycin accumulation was observed. Phenazine methosulfate-ascorbate was used both in delta psi measurements and in uptake studies to provide high rates of electron transport and maximal delta psi values. These results, taken together with those previously published (A. S. McEnroe and H. W. Taber, Antimicrob. Agents Chemother. 26:507-512, 1984) suggest that the uptake of streptomycin by B. subtilis requires adequate levels both of delta psi and cytochrome aa3.

Physiology of crop plants

Riemerella anatipestifer is a Gram-negative bacterium, which is an important pathogen infecting ducks and resistant to various antibiotics. The efflux pump is an important resistance mechanism of Gram-negative bacteria, but little research has been done in R. anatipestifer. In this study, the drug resistance mediated by RIA_1614 gene of R. anatipestifer RA-GD strain was studied, because the gene was presumed to be an efflux pump component of ABC. Firstly, the deletion strain RA-GD△RIA_1614 and complemented strain RA-GD△RIA_1614 pCPRA::RIA_1614 were constructed. Then, MICs of various antimicrobial agents to parent and deletion strains and the tolerance of the strains to organic solvents were detected to screen the substrates for RIA_1614 gene. Moreover, the transcription levels of RIA_1614 gene in the parent and the complemented strains exposed to the substrates were detected by quantitative real-time RT-PCR. Furthermore, the efflux abilities of parent, deletion and complemented strains to substrates were determined by antibiotic accumulation test. In addition, in vitro competition ability and virulence of the strains were also detected. The results showed that the deletion strain was more sensitive to aminoglycosides and organic solvents than parental strain RA-GD. When RA-GD and complemented strain were exposed to sub-repression levels of aminoglycosides and organic solvents, the transcription levels of RIA_1614 gene were significantly up-regulated. Sodium o-vanadate inhibitor assay confirmed that RIA_1614 protein contributed to amikacin and streptomycin resistance and organic solvent tolerance. Streptomycin accumulation test showed that the RIA_1614 protein was able to export streptomycin, and the addition of ATPase inhibitor sodium o-vanadate increased the accumulation of streptomycin, indicating that RIA_1614 protein was an ATP-dependent efflux transporter. Growth and competition experiments revealed that RIA_1614 protein had no significant effect on growth of RA-GD, but decreased in vitro competition ability of the strain. Furthermore, pathogenicity tests showed that RIA_1614 protein involved in the virulence of the strain. Based on the results and amino acid sequence analysis, it was determined that RIA_1614 protein was a member of ABC efflux pumps, and the protein was named RanB.

Respiration rate, growth rate and the accumulation of streptomycin in Escherichia coli.

Using chemostat cultures of Escherichia coli it was possible to vary respiration rates while maintaining a constant growth rate. This allowed the effect of variations in respiration rates on the accumulation of streptomycin to be studied in cultures at constant growth rates. At a particular dilution rate cultures exhibited higher respiration rates when phosphate limited growth than when carbon limited growth. A ubiquinone-deficient strain had a lower rate of respiration at a particular dilution rate than a related ubiquinone-sufficient strain. In spite of these differences in respiratory activity, the accumulation of streptomycin was identical in carbon- and in phosphate-limited chemostat cultures of ubiquinone-deficient and ubiquinone-sufficient strains. Moreover, accumulation of streptomycin in an anaerobic chemostat culture occurred at the same rate as that in an aerobic chemostat. There was however a lag of 1.5 h before accumulation commenced in the anaerobic culture, a feature that was not apparent in the aerobic culture. These results indicate that the lower rates of respiration in slow-growing bacteria are not responsible for the decreased accumulation of streptomycin in slow-growing compared to fast-growing cultures. Moreover, it seems unlikely that quinones are involved directly (e.g. as carriers) in streptomycin accumulation, since removal of 90% of cellular ubiquinone, or replacement of ubiquinone with a structural analogue, did not affect accumulation as long as mutant and parent cultures grew at the same rate.

Correlation between cytochrome aa3 concentrations and streptomycin accumulation in Bacillus subtilis.

Accumulation of aminoglycosides by Bacillus subtilis appears to require specific components of the electron transport chain. These components include cytochromes and the lipophilic quinone vitamin K2. The present study concerns the importance of cytochrome aa3, a terminal oxidase, in the uptake of streptomycin. Growth conditions have been established such that the concentration of cytochrome aa3 can be modified over a wide range; on defined minimal salts agar, the wild-type strain (RB1) and an strC mutant (RB95) synthesized cytochrome aa3 only when adequate amounts of Casamino Acids (Difco Laboratories, Detroit, Mich.) were present. A positive correlation between cytochrome aa3 levels and streptomycin accumulation was observed. The same correlation was seen when cytochrome aa3 was measured in relation to growth susceptibility. These correlations suggest that cytochrome aa3 is necessary for accumulation of streptomycin by B. subtilis.

Effect of growth rate on streptomycin accumulation by Escherichia coli and Bacillus megaterium.

The rate of accumulation of streptomycin by streptomycin-sensitive strains of Escherichia coli and Bacillus megaterium, grown in chemostats, was related to the growth rate prior to addition of the antibiotic. For E. coli the length of the lag period that preceded accumulation was also growth rate-dependent. Thus faster growing cultures accumulated streptomycin more rapidly and with a shorter lag than slower growing cultures. The rate of efflux of streptomycin from bacteria that had accumulated streptomycin was not greatly influenced by growth rates of the cultures. At a particular growth rate, accumulation of streptomycin was found to be faster at higher concentrations of the antibiotic. Rapid accumulation of streptomycin was not observed with continuous cultures of a streptomycin-resistant strain of E. coli. Accumulation of streptomycin was abolished when growth was inhibited by either terminating the flow of fresh medium to a chemostat or by adding inhibitors that block protein synthesis. These results suggest that the rate of accumulation of streptomycin is related to the concentration of streptomycin-sensitive ribosomes that are actively engaged in protein synthesis within the bacterial cells.

Roles of ribosomal binding, membrane potential, and electron transport in bacterial uptake of streptomycin and gentamicin.

The effects of a set of conditions on aminoglycoside uptake were determined. Membrane vesicles either with a membrane potential (delta psi) of -125 mV (adequate to drive lysine uptake) or with succinate, lactate, or phenazine methosulfate did not accumulate gentamicin unless components of protein synthesis were included. Ribosomally resistant (rpsL) Escherichia coli cells demonstrated energy-dependent phase II uptake similar to that of a streptomycin-susceptible strain of E. coli when treated with 100 micrograms of puromycin per ml. Puromycin (100 micrograms/ml) also increased the uptake of the cationic compounds polyamine and arginine. These studies support a role of protein synthesis in aminoglycoside uptake and in the development of energy-dependent phase II. delta psi of cells did not increase either at the initiation of or during energy-dependent phase II, showing that energy-dependent phase II is not due to an elevation of delta psi. In a Bacillus subtilis system, significant streptomycin uptake requires a threshold value of delta psi which varies depending upon the concentration of streptomycin used. At 25 micrograms/ml, the uptake of streptomycin reached maximal levels after exceeding the threshold value, whereas at 100 micrograms/ml there was a gradual increase of the uptake to the maximal after the threshold value was exceeded. Several studies supported the view that electron transport has a specific role other than its requirement to produce the cellular delta psi. The uptake of gentamicin was stimulated to a greater extent by phenazine methosulfate-ascorbate than by the ionophore nigericin in strains of E. coli, although nigericin stimulated delta psi to a greater degree. Cells with 25% of the normal quinone concentration had delta psi values identical to cells with the normal quinone concentration, but the quinone-deficient cells had a significantly lower rate of gentamicin uptake. KCN prevented gentamicin uptake but did not prevent the development of delta psi. The effects of ubiquinone depletion in an E. coli strain were more evident on gentamicin uptake than on ATP-driven glutamine transport or proton motive force-driven proline transport, consistent with a specific requirement for quinones in aminoglycoside uptake. A detailed explanation of the mechanism of accumulation of streptomycin and gentamicin and a proposed mechanism for killing bacterial cells by these agents have been provided.

Induction of Streptomycin Uptake in Resistant Strains of Escherichia coli

Different streptomycin-resistant strains of Escherichia coli, including an R100 plasmid-carrying strain of E. coli W3110, the ribosomally resistant mutant SM10, and the spontaneous revertant from dependence to independence d1023, exhibited poor accumulation capacity for aminoglycoside antibiotics. This was due to a failure of these mutants to induce the general polyamine transport system that is utilized by streptomycin to enter the cell. It is shown that the aminoglycoside kanamycin, which is effective on these streptomycin-resistant strains, was capable of inducing the uptake of streptomycin, thus giving rise to streptomycin accumulation up to wild-type levels. Plasmid-determined resistance, which has been speculated to be the result of a blockage of the uptake system by modified antibiotic molecules, cannot be overcome by the induction of streptomycin transport. Increase in permeability of the antibiotic does not affect the susceptibility of the bacteria. It is shown that all of the antibiotic taken up was enzymatically modified. R-plasmid-conferred resistance to aminoglycosides is therefore explained by the inactivation of the antibiotic entering the bacterial cell.

Effects of membrane-energy mutations and cations on streptomycin and gentamicin accumulation by bacteria: a model for entry of streptomycin and gentamicin in susceptible and resistant bacteria.

Several mutants of Escherichia coli affecting aerobic energy generation and energization of the bacterial membrane have been examined for their effect on streptomycin and gentamicin accumulation and susceptibility. A heme-deficient mutant (K207) and two mutants (CJ-8 [colicin K insensitive] and NR-70) associated with defective aerobic active transport were associated with decreased transport of streptomycin and gentamicin and increased resistance to those antibiotics. These mutants also exhibited increased resistance to several other aminoglycoside antibiotics, but not the aminocyclitol spectinomycin. The same observations were made with a ubiquinone-deficient mutant, but a strA derivative of this mutant was shown additionally to be saturable for streptomycin accumulation at a concentration four or more times lower than that required for saturation of the parent. A mutant uncoupled for adenosine 5'-triphosphate synthesis from electron transport and membrane Mg-adenosine 5'-triphosphatase deficient was hypersensitive to those aminoglycosides tested and spectinomycin, and showed enhanced transport of streptomycin and gentamicin. A variety of compounds structurally related to streptomycin were examined at high concentrations for inhibition of streptomycin uptake in a strA mutant of E. coli K-12 SA 1306, but no evidence for competition was detected, suggesting the absence of a common transport carrier. Four different divalent cations were shown to inhibit streptomycin and gentamicin accumulation in E. coli K-12 SA 1306. Divalent cations were shown to inhibit uptake of these two drugs in two bacterial species with distinct cell wall structures, Pseudomonas aeruginosa and Staphylococcus aureus, and to inhibit streptomycin uptake in spheroplasts of streptomycin-susceptible and -resistant E. coli. However, calcium had almost no inhibitory effect on streptomycin uptake by the ubiquinone-deficient mutant E. coli AN66. These and previous findings have been used to formulate a model for aminoglycoside entry into bacteria using a low-affinity membranous complex involved in membrane energization that includes respiratory quinones, which probably act to bind and transport aminoglycosides across the cell membrane. This phase of transport is associated with the lowest accumulation rate (termed energy-dependent phase I) that is rate limiting for susceptibility. It is further proposed that subsequent association of the membrane-bound aminoglycoside with higher-affinity binding sites on membrane-associated ribosomes carrying out a normal ribosomal cycle and protein synthesis results in a more rapid transport rate (termed energy-dependent phase II). The increased rate could result from a state of membrane energization analogous to that causing enhanced aminoglycoside transport rates seen in the uncoupled mutant, AN120. How this model explains the mechanism by which enzymatically modified aminoglycosides render cells resistant to unmodified aminoglycosides is also discussed.

Streptomycin accumulation in susceptible and resistant strains of Escherichia coli and Pseudomonas aeruginosa.

Streptomycin accumulation by susceptible strains of Escherichia coli and Pseudomonas aeruginosa has been shown to be prevented or inhibited by inhibitors of electron transport, sulfhydryl groups and protein synthesis, and agents that uncouple oxidative phosphorylation. Streptomycin is recovered from cells in an unchanged form and is intracellularly concentrated above extracellular concentrations. Accumulation kinetics are multiphasic; an initial phase which cannot be prevented by the above inhibitors is unable to cause inhibition of cell growth or loss of cell viability. Prevention of further phases of uptake does prevent these events. Inhibitor-susceptible accumulation is time dependent and begins almost immediately upon exposure of cells to streptomycin. Streptomycin accumulation remains energy dependent even when cells are losing acid-soluble [(3)H]adenine, presumably through loss of permeability control. These results demonstrate that streptomycin accumulation necessary for inhibition of cell growth or cell death requires energy and is not a process of diffusion or secondary to membrane leakage. Streptomycin accumulation in ribosomally resistant mutants of E. coli and P. aeruginosa is similar in that both energy-independent and energy-dependent accumulation can be demonstrated. The total energy-dependent accumulation is, however, significantly lower than that in streptomycin-susceptible cells due to the absence of an additional energy-dependent phase of accumulation, which seems dependent on ribosomal binding of streptomycin. Ribosomally resistant strains can be shown to concentrate streptomycin accumulated by the energy-dependent process above the external concentration in nutrient broth but not in Trypticase soy broth. The energy-dependent accumulation can be saturated in the Str(r) strain of E. coli in nutrient broth, implying limited accumulation sites.

Dihydrostreptomycin accumulation in E. coli.

DIHYDROSTREPTOMYCIN is an antibiotic composed of streptidine, dihydrostreptose and N-methyl-L-glucosamine joined by two glycosidic bonds. It differs from streptomycin only in that the aldehyde group on the middle residue (streptose) is reduced. Both compounds have similar biological actions1,2 but their accumulation by bacterial cells has been little studied. Passive diffusion is often assumed to be responsible, although Mitchell thought it improbable that a molecule such as streptomycin passes through a lipid layer3. Anand et al. proposed a mechanism in two phases4. First, a small amount of antibiotic would enter by passive diffusion regardless of an intact lipid layer and affect protein synthesis so as to cause deterioration of membrane integrity. Then more rapid accumulation would follow by passive diffusion through the disrupted lipid barrier. Alternatively, Hurwitz et al. showed streptomycin accumulation to be sensitive to chloramphenicol during initial exposure and insensitive after several minutes of exposure. They suggested facilitated diffusion, with entry of the antibiotic depending on a streptomycin-induced protein5.

Decrease of ototoxicity of streptomycin sulfate. Preliminary communication of animal experiments.

THOUGH many new antibiotics have been found, the streptomycin series have not lost their importance. They are still one of the most effective remedies for all forms of tuberculosis. However, the use of streptomycin is limited by its additional neurotoxical and ototoxical affects. Such accompaniments were first described by Brown and Hinshaw.¹Since then, a great many clinical and experimental papers concerning the ototoxicity of basic streptomyces-antibiotics have been published.^2-9 Electrophysiological experiments of Stange et al⁹concerning the efficiency of streptomycin-sulfate on excitation and adaptation of the hair-cells in the organ of Corti, especially, proved that streptomycin injures the metabolism of the sensory cells in the ear. It affects the cellular membrane and restricts its reabsorption.⁵The result is an accumulation of streptomycin in the sensory cells and, consequently, loss of function. Experiments to reduce the ototoxic effect of streptomycin have been made for several years.

Autoradiographic evidence for the impermeability of mouse peritoneal macrophages to tritiated streptomycin.

Cultured mouse peritoneal macrophages were found to be relatively impermeable to streptomycin. Based on radioactivity measurements and radioautographic evidence, macrophages were impermeable to tritiated dihydrostreptomycin for periods up to 20 hr of incubation. Little or no intracellular streptomycin could be detected even when incubation was carried out in the presence of therapeutic blood levels of carrier dihydrostreptomycin. When the cultured mouse macrophages were allowed to phagocytize staphylococci, yeast cells, or polystyrene latex particles in the presence of tritiated streptomycin, the impermeability of the cells to the antibiotic was not affected. These observations suggested that the process of phagocytosis does not facilitate the intracellular accumulation of streptomycin, as seems to be the case for the fixed phagocytic cells of the liver.

Accumulation of label from C14-streptomycin by Escherichia coli.

Hurwitz, Charles (Veterans Administration Hospital, Albany, N.Y.) and Carmen L. Rosano. Accumulation of label from C(14)-streptomycin by Escherichia coli. J. Bacteriol. 83:1193-1201. 1962.-Accumulation of label from C(14)-streptomycin by sensitive Escherichia coli occurs in the presence of chloramphenicol, provided the cells receive a prior exposure to streptomycin. The rate of accumulation increases with the concentration and length of exposure to streptomycin during the initiation phase. Accumulation of label from streptomycin in the presence of chloramphenicol is also a function of the streptomycin concentration during the killing phase. Evidence is presented for the presence of a barrier to the entry and exit of streptomycin. It is further shown that total accumulation of streptomycin can be divided into three portions: surface-adsorbed streptomycin, streptomycin present at the time of onset of loss of viability, and streptomycin accumulated by killed cells. Only about 10% of the total accumulated streptomycin is present at the onset of loss of viability and can therefore be presumed to play a role in the lethal action of the antibiotic.

FACTORS AFFECTING STREPTOMYCIN YIELDS

ALTHOUGH HIGH YIELDS of a desired fermentation product can often be obtained by empirical manipulations of the environment in which a given organism is expected to be productive, it is more satisfying scientifically to base such control, if possible, on a closer acquaintance with the nature of the fermentation. For instance, high yields of penicillin are accompanied by characteristic metabolic changes in the medium; both can be attained by changing the physical or chemical milieu of the organism (cf. Jarvis and Johnson, 1947). Early experiments with Streptomyces griseus seemed to support the hypothesis that streptomycin production would follow a similar pattern (Garner et al., 1950); however, subsequent results showed that the relation between high streptomycin yields and gross metabolism, at least as embraced by our studies, was obscure more often than not. Waksman et al. (1946) first reported some of the changes occurring, during growth of a streptomycinproducing organism. They found a gradual rise in pH of the culture on a glucose, peptone, meat extract medium, and an increase in ammonia and amino nitrogen; accumulation of streptomycin paralleled the growth of the organism. Gottlieb and Anderson (1947) used a vegetative inoculum, which gives more rapid growth, and found that the peak of streptomycin production lagged behind the growth peak. Synthesis of streptomycin proceeded only in the presence of oxygen, and there was no correlation between pH changes and streptomycin production. Dulaney and Perlman (1947) compared the chemical changes that occurred during the submerged growth of organisms in Waksman's medium and media that contained high levels of either phosphate or carbohydrate. The growth phase was accompanied by reduction of soluble medium constituents, a high oxygen demand, and little streptomycin production. This was followed by an autolytic phase in which inorganic phosphorus and soluble nitrogen were released, the oxygen demand dropped, and streptomycin was produced. Added phosphate reduced streptomvcin yields, while high levels of carbohydrate had little effect aside from prolonging the growth phase. We have isolated a culture capable of giving relatively high yields and have attempted to analyze

STREPTOMYCIN INTRAMUSCULAR DOSAGE PER UNIT BODY WEIGHT CORRELATED WITH SERUM LEVELS IN INFANTS AND CHILDREN

Predictable serum levels of streptomycin can be obtained by calculating dosage on a basis of mg./unit body weight. Dosage can be determined in this fashion in all age groups. The serum streptomycin levels following single intramuscular injections of 6.6, 11.0, and 15.4 mg./kg. body weight are graphically illustrated. The serum level following a single intramuscular injection falls more slowly during the newborn period. This is probably the result of dehydration and consequent low urine output. Healthy children with apparently normal kidney function show little accumulation of streptomycin in the serum during intermittent intramuscular injection at the three and six hour intervals. Eleven mg./kg. body weight every six hours is recommended as a satisfactory dosage schedule when it is desirable to keep the blood streptomycin level constantly above 5 µ. per milliliter.