Bacterial infections are major life-threatening events in hospitals, care homes, and communities (7). Antimicrobial chemotherapy is the primary treatment option for bacterial infections and is successful in most cases. However, bacterial cells repeatedly exposed to antimicrobial agents gain resistance, mainly due to (i) alterations of the drug target, (ii) enzymatic modifications of antibiotics, or (iii) reduced drug accumulation as a consequence of efflux pump-mediated drug exclusion or a tight membrane barrier (12,15,16). Expression of the resistance-nodulation-cell division (RND)-type efflux pump is a major mechanism for multidrug resistance in 14).Serratia marcescens is a Gram-negative bacterium ubiquitous in nature and an inhabitant of hospital environments, where it potentially causes nosocomial and opportunistic infections. This organism can cause septicemia, meningitis, endocarditis, and surgical site infections in immunocompromised patients (7). The high and broad intrinsic resistance of S. marcescens to various antibiotics makes infections with this bacterium difficult to treat.S. marcescens encodes at least three RND-type efflux pumps, SdeAB, SdeCDE, and SdeXY, which play an important role in resistance to antibiotics (2-4, 8-10). The wild-type cells of S. marcescens produce undetectable levels of the SdeAB protein (10). When wild-type S. marcescens cells were exposed to increasing concentrations of a biocide, cetylpyridinium chloride, they gained resistance to the biocide as well as to various antimicrobial agents. Such cells produced elevated levels of the SdeAB protein (10). Yet, the genetic alteration(s) that caused the SdeAB expression was not identified. There may be a natural inducer of the SdeAB efflux pump.The sdeR gene was reported to be an activator of the sdeAB operon because its overexpression rendered the wild-type strain resistant to various antibiotics. However, data supporting the direct involvement of the sdeR product in the expression of the SdeAB proteins is lacking (3). The sdeR gene was found to be located upstream of the sdeAB operon. However, the nucleotide sequence of sdeR and the region upstream of sdeAB in the biocide-resistant cells were comparable within the parental cells. Therefore, it is not clear how the sdeR and sdeAB genes were overexpressed.We studied the gene responsible for the sdeAB operon's expression and discovered that sdeS located downstream of the operon regulates the expression of sdeAB.
MATERIALS AND METHODSBacterial strains, plasmids, and growth conditions. The bacterial strains and plasmids used are listed in Table 1. Escherichia coli strains DH5␣ and S17-1 were used for genetic manipulations and as a mobilizer, respectively. LB broth contains 1% tryptone, 0.5% yeast extract, and 0.5% NaCl per liter, adjusted to pH 7.0. NB broth contains a 0.8% strength of nutrient broth (Difco).Recombinant DNA techniques. Chromosomal DNA from S. marcescens cells was isolated by the procedure described by Ausubel et al. and manipulated according to standard methods (1).T...