Clinical isolates of Haemophilus ducreyi were shown to be resistant to tetracycline. Resistance was associated in some strains with a 30-megadalton plasmid capable of transferring resistance in conjugative matings with other strains of H. ducreyi and other species of Haemophilus. Restriction endonuclease digestion patterns suggest a relationship between H. ducreyi plasmids and other tetracycline resistance plasmids in Haemophilus. The presence of plasmid-mediated resistance to the tetracyclines limits the use of these agents for the treatment of chancroid.Tetracyclines have been reported as effective therapy for chancroid (4,24). Recent studies, however, have reported clinical resistance and in vitro resistance of the causative organism, Haemophilus ducreyi, to the tetracyclines (10,15,16). In our laboratory, in vitro studies with a large collection of strains have shown over 90% of the isolates from selected geographic areas to be resistant to tetracyclines.Since tetracycline resistance has been shown previously to be plasmid mediated in other species of Haemophilus (14), and since plasmid-mediated resistance to ampicillin (5-7) and sulfonamides (3) has been previously demonstrated in H. ducreyi, we looked for plasmid-mediated resistance to tetracyclines in this species.We report here the demonstration and preliminary characterization of a conjugative plasmid encoding tetracycline resistance in clinical isolates of H. ducreyi.
MATERIALS AND METHODSBacterial strains and plasmids. Bacterial strains and plasmids named in this study are listed in Table 1. The remainder of the strains were clinical isolates of H. ducreyi.Media. Strains of H. ducreyi were routinely grown on GC agar base (GIBCO Diagnostics, Madison, Wis.) supplemented with 1% hemoglobin and 1% CVA enrichment (GIBCO).MICs were determined by agar dilution as described previously (11).Plasmid DNA. Strains were screened for the presence of plasmids as described by Meyers et al. (19) and previously reported (3, 6). Plasmid DNA for restriction digestion was prepared by a modification (8) nisms from 4 ml of these suspensions were filtered onto 0.45-,um polycarbonate filters. After overnight incubation on the surface of a chocolate agar plate, the organisms were resuspended and spread over the surface of chocolate agar containing tetracycline (4 ,ug/ml) and streptomycin (1,000 ,ug/ml). The clones isolated were screened for plasmid DNA, and their antibiotic resistance was confirmed by disk diffusion testing.
RESULTSThe distribution of MICs for 35 strains of H. ducreyi is shown in Fig. 1. Resistant strains were defined as those having an MIC 2 4 ,ug/ml. Tetracycline-resistant strains were found in every geographical area surveyed, with the percentage of resistant strains varying from 16 to 100 (Table 2).Forty-one tetracycline-resistant strains were screened for the presence of plasmids. All but one strain contained plasmids similar in size to one of three previously described nonconjugative plasmids of molecular mass 4.9, 5.7, and 7.0 megadaltons (Mdal) (3, ...