INTRODUCTION
For over half a century, antibiotics have served as the main weapon to combat bacterial infections, but their often-indiscriminate use has led to a rapidly increasing appearance of difficult-to-treat infections caused by antibiotic-resistant pathogens. The simultaneous slowdown of the research on and development of new antibiotics makes alternative solutions a must. The ribosomally synthesized bacterial toxic peptides called bacteriocins as potential novel effective antimicrobial agents have therefore been intensively studied in recent years (
1). Numerous bacteriocins produced by Gram-positive bacteria show potential for medical application due to their low toxicity, high potency, and antimicrobial activity against methicillin-resistant
Staphylococcus aureus (MRSA) and vancomycin-resistant
Enterococcus faecalis (VRE) strains (
1). Nevertheless, so far, only thiostrepton, a bacteriocin from the thiopeptide family, is commercially used in clinical practice (
1), and some bacteriocins are in preclinical and clinical trials (
2,
3).
Bacteriocins are classified into class I posttranslationally modified bacteriocins (e.g., the lantibiotic nisin) and class II unmodified bacteriocins (
4). Among members of class II, the families of aureocin A53 (AurA53)- and enterocin L50 (EntL50)-like leaderless bacteriocins currently draw more attention due to their abundance and broad antimicrobial activity (
5,
6). It is believed that the AurA53- and EntL50-like bacteriocins cause high membrane permeability in the absence of a specific receptor; however, the exact mechanisms of cell killing may differ between individual bacteriocins (
7–10). On the other hand, some other bacteriocins such as lantibiotics or most nonribosomally synthesized peptide antibiotics kill sensitive bacteria by targeting critical steps in cell wall biosynthesis. Nisin and nisin-like lantibiotics interact with lipid II, causing inhibition of peptidoglycan synthesis and pore formation (
11). Lactococcin 972 (Lnc972) is the only bacteriocin known, apart from lantibiotics, that recognizes lipid II but does not form pores (
12). Among peptide antibiotics, lipid II serves as a target for ramoplanin, vancomycin, and teicoplanin (
13,
14). A distinct step of cell wall synthesis is inhibited by bacitracin, which binds to the lipid II carrier undecaprenyl-pyrophosphate (UPP) and prevents its dephosphorylation to undecaprenyl phosphate (UP) (
15). The mechanism of action of some peptide antibiotics, such as daptomycin and gramicidin, is similar to that of saposin-like bacteriocins. Daptomycin binds to the lipid bilayer and induces membrane permeability in the presence of calcium ions and phosphatidylglycerol (
16), while gramicidin forms dimeric channels in the membrane and transports monovalent cations, thereby disrupting ion homeostasis (
17).
Resistance to antimicrobials targeting the cell envelope is often mediated by so-called peptide-sensing and detoxification (PSD) modules that usually consist of a two-component system (TCS) and an ATP-binding cassette (ABC) transporter associated with the former by genetic context and function. Because of such compositions, these modules are sometimes referred to as four-component systems (
18). The best-known prototype of a PSD module is BceRS-BceAB, first discovered in
Bacillus subtilis (
19). Its activity relies on sensing proteins such as the membrane-bound histidine kinase (HK) BceS and the cognate ABC transporter BceAB, the latter of which not only recognizes the presence of the antimicrobials but also carries out detoxification (
20,
21). The ABC transporter comprises the BceB permease and the BceA ATPase, and its expression is regulated via a TCS consisting of the BceS HK and the cytoplasmic response regulator (RR) BceR (
19,
22). Other examples of similar four-component systems found in
B. subtilis include PsdRS-PsdAB and YxdJK-YxdLM, each ensuring robust protection against distinct peptide antimicrobials (
23). BceRS-BceAB-type resistance modules are also conserved in many other pathogenic and nonpathogenic low-G+C-content species of the phylum
Firmicutes (
24). Besides ABC transporters, some BceRS homologs orchestrate several other genes whose activity maintains cell integrity in the presence of a stressor, such as
mprF and those of the
dlt operon (
25). Products of these genes confer some resistance to cationic peptide antimicrobials by lowering the cell surface negative charge through modifications of the membrane and the cell wall, i.e., lysination of phospholipids and
d-alanylation of teichoic acids, respectively (
25). The role of the BceRS-BceAB-like modules in resistance to cell envelope-acting peptide antibiotics such as bacitracin, vancomycin, or teicoplanin has been extensively studied (
25). In contrast, the understanding of BceRS-BceAB-mediated resistance to the bacteriocins targeting the cell envelope is still fragmentary and mainly relies on studies of nisin-resistant mutants (
26). Lcn972 is the only nonlantibiotic bacteriocin known to induce a lactococcal BceRS-BceAB homolog, the YsaCB-KinG-LlrG system (
27,
28). Moreover, a recent study proposed that this system could also be engaged in
Lactococcus lactis resistance to AurA53- and EntL50-like bacteriocins since a point mutation in the
ysaB gene encoding the ABC transporter permease YsaB decreased the sensitivity to these antimicrobials. However, since the mutation in
ysaB was accompanied by an additional mutation in the
dxsA gene connected with lipid metabolism, the involvement of the YsaCB-KinG-LlrG system in resistance to AurA53- and EntL50-like bacteriocins cannot be considered proven (
29).
In this study, we examined in detail the genetic basis of L. lactis resistance to diverse AurA53- and EntL50-like leaderless bacteriocins, including four functional bacteriocins (BHT-B, Ent7, EntL50, and WelM) and two putative ones identified by homology searches (K411 and salivaricin C [SalC]). First, we show that all AurA53- and EntL50-like bacteriocins exhibit high similarity at the amino acid sequence level within families and very low similarity between families and that K411 belongs to the former family and SalC belongs to the latter. The differences in amino acid sequences notwithstanding, members of both families adopt a similar globular saposin-like fold and have broad-spectrum antimicrobial activity. We then obtained spontaneous resistant mutants by exposing sensitive L. lactis strains to selected AurA53- or EntL50-like bacteriocins and identified the mutations responsible for the resistance phenotype. Resistance to bacteriocins from both families turned out to be due to mutations in genes encoding components of the PSD module YsaCB-KinG-LlrG. These mutations also conferred resistance to membrane-targeting peptide antibiotics such as daptomycin and gramicidin and triggered the increased expression of the dltABCD and ysaDCB operons. We propose that the main determinant of this multiresistance is the activity of the FtsX domain freed from the C-terminal part of the YsaB protein by truncating mutations. Finally, we show that the acquired resistance increased the sensitivity to bacitracin, suggesting that this antibiotic is beyond the control of FtsX.
DISCUSSION
In recent years, antibiotic-resistant bacterial strains have been emerging faster than new antimicrobials are being developed and approved for medical use. AurA53- and EntL50-like bacteriocins are saposin-like, broad-spectrum, lipid-interacting antimicrobials that, owing to their unique characteristics, offer a promising alternative to combat infections caused by antibiotic-resistant pathogens (
6). In contrast to the numerous studies on their physicochemical properties, structure, activity, and mode of action, mechanisms leading to the development of resistance to these agents have never been investigated. Since such resistance may limit their future application, detailed studies are needed to minimize this potential problem. Here, we studied the
L. lactis resistome involved in the appearance of resistance to four known (BHT-B, Ent7, EntL50, and WelM) and two newly identified (K411 and SalC) AurA53- and EntL50-like bacteriocins and its relationship with susceptibility to antibiotics targeting the cell envelope. We showed that these bacteriocins have broad-spectrum activity, including strains of
E. faecalis,
E. faecium,
S. aureus, and
Streptococcus spp., whose antibiotic-resistant mutants are currently the most prevalent causes of severe, hospital-acquired infections (
47), as well as strains of
L. monocytogenes and
C. jejuni responsible for foodborne infections (
48), suggesting their likely effectiveness in clinical use. Moreover, the inhibitory activity of AurA53- and EntL50-like bacteriocins against
Lactococcus garvieae, the etiological agent of lactococcosis in fish and cow mastitis (
49,
50), may be a rationale for their use in veterinary medicine also. Most of the other lactic acid bacteria examined were sensitive to the tested bacteriocins, which may be a limitation for their use as natural preservatives during fermentation processes in the dairy industry. However, since oral lactobacilli are one of the etiological factors in the development of dental caries (
51), it is conceivable that AurA53- and EntL50-like bacteriocins may find application in dental care products.
Our results indicate that resistance to AurA53- and EntL50-like bacteriocins can develop as an indirect result of point mutations in the
ysaCB or
llrG gene encoding the YsaCB-KinG-LlrG peptide-sensing and detoxification (PSD) module (
Fig. 5). This is one of the most important systems regulating the stress response in the cell envelope and was speculated to protect
L. lactis from AurA53- and EntL50-like bacteriocins, but no studies have been performed to confirm those speculations (
29). It is believed to be a homolog of the prototypical BceAB-BceRS PSD module from
B. subtilis (
27,
28), which mediates resistance to peptide antimicrobials such as bacitracin, mersacidin, actagardine, and plectasin (
23). Nonetheless, since YsaCB-KinG-LlrG also shares comparable amino acid sequence similarity with two other
B. subtilis Bce-like modules, PsdAB-PsdRS and YxdLM-YxdJK, which respectively protect against nisin, subtilin, and gallidermin and the cationic antimicrobial peptide LL-37 (
23), it therefore cannot be considered a direct functional equivalent of any of the three. So far, the lactococcal YsaCB-KinG-LlrG module has been shown to protect against only nisin and Lcn972 (
28,
46). Here, in spontaneous
L. lactis mutants resistant to AurA53- and EntL50-like bacteriocins, we identified single point mutations in three genes encoding the lactococcal YsaBC-KinG-LlrG system. Mutations in
ysaB were the most common, but those in
ysaC and
llrG, although less frequent, were also sufficient to confer the same level of resistance to the bacteriocins tested, indicating that the components of the YsaBC-KinG-LlrG system more or less equally participate in the mechanism of resistance development through the accumulation of mutations. Notably, the mutation in
llrG conferred resistance to bacteriocins in the absence of
ysaCB, pointing to its independence from this ABC transporter. In previously obtained
L. lactis mutants resistant to Lcn972, the causative mutations caused amino acid substitutions in the middle and C-terminal parts of the YsaB protein, specifically in the intracellular loops between TMH4 and -5 or TMH8 and -9 or within TMH7 and TMH9 (
27,
28). Here, we observed a similar localization of mutations, but they were wholly different, nonsense or frameshift rather than missense, and they all led to the truncation of YsaB, sparing its N-terminal FtsX domain. Since none of the single, double, or triple deletion mutants of
ysaB,
ysaC, and/or
llrG that we constructed were resistant to any of the bacteriocins tested, we concluded that the resistance of the spontaneous mutants was not due to an inactivation of the encoded proteins but instead relied on specific changes in their functionality. Also, previously reported point mutations in
ysaCB,
kinG, or
llrG have been proposed to decrease
L. lactis sensitivity to Lcn972 and nisin, and those localized in
ysaB were shown to cause the constitutive expression of
ysaDCB (
27,
28). Similar gain-of-function mutations in the
nsaS and
nsaR genes encoding the two-component system (TCS) in
S. aureus have also been identified as being responsible for nisin resistance. It was shown that nisin by itself could not sufficiently induce NsaSR to trigger resistance, whereas the mutations in
nsaS,
nsaR, or their promoter led to the constitutive activation of NsaSR and the upregulation of its regulon, resulting in nisin resistance (
52,
53). Such mutation-driven activation of the TCS can lead to a modulation of the expression of various genes that protect cells from cell envelope stress via diverse mechanisms. For example, in
B. subtilis, BceRS and PsdRS regulate the expression of the cognate ABC transporters only, while YxdJK mediates resistance to LL-37 through likely indirect control of
dltABCD operon expression as well (
54,
55). Similarly, the GraRS TCS in
S. aureus mediates resistance to nisin (
56), vancomycin, and polymyxin B (
57) by regulating the expression of the cognate ABC transporter as well as of the
mprF gene and the
dltABCD operon (
58). Here, it was tempting to speculate that the KinG-LlrG TCS of
L. lactis could regulate the expression of the
lysS (
ylcG) and/or
dlt genes to introduce positive charges into the cell envelope, thereby preventing its interaction with the positively charged bacteriocins. This hypothesis is supported by the fact that a putative BceR-like binding box was detected in the promoter of the
dltABCD and
ysaDCB genes in
L. lactis (
24,
28). Indeed, in this study, both operons responded with upregulation to a point mutation in
llrG, suggesting the functionality of both operators and the role of LlrG modification in conferring resistance to the bacteriocins tested, most probably by activating Dlt-dependent cell wall modification. On the contrary, modified LlrG does not appear to be involved in the regulation of the gene expression of
lysS (
ylcG), the closest lactococcal homolog of
mprF from
B. subtilis involved in protection against antimicrobials through cell membrane modification. One could also assume that KinG-LlrG upregulates the
dgkB and
dxsA genes for lipid metabolism, previously proposed to be involved in membrane remodeling for protection against AurA53- and EntL50-like bacteriocins (
29); however, this study showed that both genes are beyond LlrG control. The role of the point mutation in
ysaB in the mechanism of resistance to the bacteriocins and peptide antibiotics tested remains unclear. This mutation, like that in
llrG, also leads to the upregulation of
dltABCD but without an increase in
llrG transcription, suggesting that the activation of LlrG action occurs at the protein rather than the gene level.
Bacteriocins are often thought to have different mechanisms of action, and thereby also to require distinct resistance mechanisms, than commonly used antibiotics and consequently should be active against antibiotic-resistant pathogens (
59). However, we show here that bacteriocins targeting the cell envelope, such as the AurA53- and EntL50-like ones, nisin, and Lcn972, evoke a cell response similar to those of some antibiotics, i.e., engaging the same PSD module, and therefore can be subject to the same resistance mechanisms, which are activated after specific point mutations in genes encoding module components. So far, only a few studies have shown a correlation between resistance to nisin on the one hand and resistance to bacitracin, gramicidin, and some β-lactams on the other (
60–62) or between Lcn972 and bacitracin, vancomycin, and penicillin G (
28,
63). Here, of the wide range of antibiotics tested against the AurA53- and EntL50-like bacteriocin-resistant mutants, significant correlations were observed only for membrane-acting peptide antibiotics such as daptomycin and bacitracin targeting the lipid II cycle UPP intermediate. The changes in resistance levels of spontaneous mutants observed for another membrane-acting antibiotic, gramicidin, were of a lesser degree than those for daptomycin, which suggests that the resistance mechanisms for these two antibiotics may not be identical. Notably, we found no changes in resistance to antibiotics acting on intracellular or nonmembrane targets of the cell envelope, such as various lipid II moieties. Daptomycin is currently the frontline treatment for infections caused by antibiotic-resistant
S. aureus or
Enterococcus spp., and daptomycin resistance is most commonly associated with mutations in genes involved in the cell wall and membrane modifications (
mprF,
dltABCD, and
pgsA) and the stress response (
liaFSR and
vraSR) (
16,
64). Gramicidin, because of its toxicity, is used less extensively, and the mechanism of resistance is still poorly understood. It has previously been linked to an increased content of etherized
d-alanine in teichoic acid (
65), while increased sensitivity to gramicidin was observed in a
Streptococcus pneumoniae mutant lacking the YsaCB homolog (
61). Here, we propose the activation of the YsaCB-KinG-LlrG module in
L. lactis through diverse gain-of-function mutations in the
ysaCB or
llrG gene as an indirect mechanism of resistance to these two membrane-targeting peptide antibiotics. In turn, the upregulation of the
dltABCD genes induced by the modified LlrG leading to a reduction in the negative charge of the cell envelope seems the most likely direct resistance mechanism responsible for the repulsion of cationic calcium-daptomycin complexes.
Bacitracin resistance has previously been linked with YsaCB in
L. lactis (
28). While the mechanism of lactococcal YsaCB-dependent resistance is unknown, it has been elucidated for its homolog in
B. subtilis, the BceAB transporter, which forms a sensory complex in the cytoplasmic membrane through a direct interaction between the permease BceB and the histidine kinase BceS (
22). BceS monitors the ability of BceAB to detoxify through a flux-sensing mechanism and activates BceAB expression by phosphorylating the response regulator BceR (
20). Subsequently, BceAB binds to the bacitracin-UPP complex through the action of a large extracellular loop of BceB and releases this cell wall precursor from the grip of the antibiotic, thereby allowing uninterrupted murein synthesis (
21,
66). Here, we show that the mechanism of bacitracin resistance, although based on the same YsaCB-KinG-LlrG module, differs from that acting on the bacteriocins studied here or membrane-acting antibiotics. Since most of the mutations affecting this module, be it the spontaneous point mutations or deletions of individual genes, increased the sensitivity to bacitracin, it can be assumed that this system works against it most efficiently in its native form, whereas resistance to the other antimicrobials tested here requires specific mutations. An exception to this rule was a point mutation in
llrG, which resulted in decreased sensitivity to bacitracin compared to the sensitive parental strain MUT_402. Hence, extrapolating the available data from
B. subtilis, we propose that mutations in
L. lactis that shortened or deprived the cell of YsaB thereby prevented its UPP-releasing activity or inhibited flux sensing between YsaCB and KinG, leading to the hypersensitivity of the mutants to bacitracin. On the other hand, the protective effect against bacitracin of the point mutation in
llrG may be due to the enhancement of the activity of the encoded response regulator and the resulting activation of
dltABCD and
ysaD mediated by the modified LlrG, as we demonstrated by quantitative analysis of the expression of these genes.
In addition to the large extracellular loop of the YsaB permease, we identified an FtsX domain at its N terminus and propose it to be an indirect, critical driver of resistance against the envelope-targeting bacteriocins, daptomycin, and gramicidin but not bacitracin. No information is available on the determinants of the contribution of FtsX to resistance, but over 260 transporters containing this domain have been identified in genomes of
Firmicutes and classified as BceAB-type transporters (
67). Here, using Pfamseq data, we identified several proteins with a YsaB-like architecture containing the FtsX domain at their N termini and a large extracellular loop, such as ABC transporters from three Bce-like modules in
B. subtilis or the VraDE transporter form
S. aureus. The FtsX domain is present at the C termini of the FtsX, MacB, and LolC proteins of
Escherichia coli, members of the MacB transporter superfamily that are involved in cell division, resistance to macrolide antibiotics, and the transport of lipoproteins, respectively (
68). Nevertheless, it has not been confirmed that the functions of the proteins containing the FtsX domain are due to its presence and not to their other domains. However, our present observation that all
ysaB point mutations increasing the resistance to bacteriocins were downstream of this domain strongly indicated its critical role. This conclusion was confirmed by expressing the FtsX domain alone in
trans, which also caused resistance. The mechanism by which the FtsX domain confers resistance remains unknown, but its action is clearly dependent on both LlrG and YsaC since in the absence of either of them, FtsX failed to cause resistance. On the other hand, the overexpression in
trans of
llrG or a specific amino acid substitution affecting its ability to activate the transcription of
dltABCD was sufficient to confer resistance even in the absence of FtsX. This suggests that the modified or overproduced LlrG confers resistance to diverse antimicrobials by activating Dlt-mediated cell wall remodeling independently of the FtsX domain or, for that matter, even the whole YsaCB transporter.
Altogether, our results show that L. lactis readily acquires resistance to AurA53- and EntL50-like bacteriocins and cross-resistance to membrane-active peptide antibiotics through gain-of-function point mutations in genes encoding components of the YsaCB-KinG-LlrG PSD module. In the case of the YsaB permease, the critical driver of resistance is the trimming off of the N-terminal FtsX domain from the central and C-terminal parts. The function of the FtsX domain requires the presence of the ATPase YsaC and the transcriptional regulator LlrG, suggesting a cascade of events from activating mutations in the ABC transporter YsaCB, through the LlrG-dependent activation of the dltABCD genes involved in protective cell wall remodeling. In contrast, genes involved in cell membrane modifications in response to cellular stress appear to be independent of LlrG-mediated control. A shortcut to resistance bypassing the YsaCB system is also possible through the direct activation of LlrG by mutation. Owing to the distinct resistance mechanisms resulting from the two-domain structure of YsaB, the acquisition of resistance to AurA53- and EntL50-like bacteriocins and membrane-active peptide antibiotics concomitantly increases the susceptibility to bacitracin, which provides a rationale for designing multicomponent formulations with an appropriately selected composition allowing the risk of the development of resistance to be minimized.