The synthesis and 0 acetylation in vitro of peptidoglycan by Proteus mirabilis was studied in microorganisms made permeable to specifically radiolabelled nucleotide precursors by treatment with either diethyl ether or toluene. Optimum synthesis occurred with cells permeabilized by 1% (vol/vol) toluene in 30 mM MgCl2 in in vitro experiments with 50 mM Tris-HCl buffer (pH 6.80). Acetate recovered by mild base hydrolysis from sodium dodecyl sulfate-insoluble peptidoglycan synthesized in the presence of UDP-[acetyl-j-_4CjN-acetyl-Dglucosamine was found to be radioactive. The peptidoglycan (PG) of Proteus mirabilis is similar in composition and structure to those of other members of the family Enterobacteriaceae, except for one important distinction, the presence of 0-linked acetyl groups. This modification to PG occurs at the C-6 hydroxyl group of N-acetylmuramyl residues, producing the corresponding 2,6-diacetylmuramyl derivative. O-Acetylated PG is resistant to the hydrolytic activity of many lysozymes, including human ones (11 and references therein). Thus, following infection, large fragments of 0-acetylated PG persist and circulate in a host organism, enhancing the induction of the many pathobiological effects of PG (for a review, see reference 30), including rheumatoid arthritis (14). That a number of bacteria, including many pathogenic species (both gram-positive ones, e.g., Staphylococcus aureus [16,31,35], and gram-negative ones e.g., Neisseria gonorrhoeae [34] and P. mirabilis [11,13]) possess 0-acetylated PG makes this an important phenomenon that ironically has received little attention. The PG of some species of bacteria has been reported to be 0 acetylated to the extent of up to 70%, so that it can confer both intrinsic resistance and complete resistance to lysozyme hydrolysis (4,11,20,25,27).Although 0-acetylated PG was first observed more than 30 years ago (1, 7) and the biological significance of this modification was discerned soon after (6), very little is known about the biosynthetic process involved in PG 0 acetylation. It is known to be stimulated either when cells are in the stationary phase of growth or under conditions which mimic the stationary phase (e.g., under the influence of chloramphenicol [28] acetylation occurs within the PG sacculus and outside the cytoplasm (9,17,18,(21)(22)(23)33). Indeed, PG 0 acetylation has also been demonstrated to continue in an in vitro P. mirabilis PG biosynthetic system (25), albeit to a lesser extent than that observed in vivo. Furthermore, searches for lipid(bactoprenyl)-linkedN-acetylglucosaminyl-N,O-diacetylmuramyl-pentapeptide precursors in either the cytoplasm or the cytoplasmic membrane have proved futile (22,33). These observations thus suggest that both an acetyltransferase and a source of transferable acetate must be present outside the cytoplasm. Such conditions would preclude the utilization of the typical activated acetate precursors, such as acetyl coenzyme A or acetyl phosphate, since they are not transported out of the cytoplasm.Through in...