A clinical isolate, Serrafia marcescens 75, was found to be susceptible to netilmicin and yet had a high level of aminoglycoside 2"-O-nucleotidyltransferase activity for netilmicin. Kinetic studies of the partially purified enzyme revealed substrate inhibition for gentamicin and tobramycin at concentrations greater than 10-2 mM, but this was not observed for netilmicin. The MICs of the aminoglycosides tested exhibited a good inverse correlation with the K,. values for the enzyme and a direct correlation with the V,..1/K, ratios of the enzyme.Enzymatic modification of aminoglycosides does not necessarily confer resistance to the drugs (1, 3, 4, 10). We describe a clinical isolate, Serratia marcescens 75, which was highly susceptible to netilmicin and yet had a high level of aminoglycoside 2"-O-nucleotidyltransferase [ANT(2")] activity for netilmicin when assayed with excess aminoglycoside substrate. We examined the relationship between the MICs of netilmicin, tobramycin, and gentamicin and the kinetic parameters of the ANT(2') enzyme which modified each of these aminoglycosides.S. marcescens 75 was tested for susceptibility to aminoglycosides by an agar dilution method (7). Inocula of 104 CFU of cells grown overnight in brain heart infusion broth (BBL Microbiology Systems, Cockeysville, Md.) were applied with a pronged replicator (7) onto Mueller-Hinton agar (BBL) containing the test antibiotics in twofold dilutions. The strain was highly resistant to gentamicin and tobramycin, but susceptible to netilmicin (Table 1).Sonic extracts of S. marcescens 75 were prepared for the assay of aminoglycoside-modifying activity as previously described (9). Aminoglycoside-modifying activity was assayed by adsorption of the radioactive product onto phosphocellulose filter disks (Whatman P-81) by the method of Haas and Dowding (5). For the adenylylating assay, the final concentrations of reagents were as follows: 0.033 M Tris-hydrochloride, pH 7.8; 7.5 mM MgCl2; 2.5 mM dithiothreitol; tobramycin and yet did not confer resistance to netilmicin, even in another genetic background, we transferred resistance to tobramycin into Escherichia coli JSRO-N, a plasmidfree, nalidixic acid-resistant recipient. Transconjugants were selected with a frequency of 5 x 10-6 per donor cell on Mueller-Hinton agar containing tobramycin at 12.5 ,ug/ml and nalidixic acid as the counterselecting agent at 25 ,ug/ml. The MICs of gentamicin, tobramycin, and netilmicin were 50, 50, and 1.56 ,ug/ml, respectively. Sonic extracts from two transconjugants chosen for study had adenylylating activity for gentamicin, tobramycin, netilmicin, and kanamycin at ca. 50% the level of the activity from the donor strain. Again, there was negligible acetylating or phosphorylating activity.An 18-liter culture of S. marcescens 75 grown in brain heart infusion broth containing 15 ,ug of gentamicin per ml was incubated with agitation at 37°C until the optical density at 600 nm was 1.5. The cells were harvested, washed twice with 0.15 M NaCl, and centrifuged again. The final pe...