Antibiotic resistance is ancient
Antibiotic resistance is ancient
Vanessa M. D'Costa1,2*, Christine E. King3,4*, Lindsay Kalan1,2, Mariya Morar1,2, Wilson W. L. Sung4, Carsten Schwarz3,Duane Froese5, Grant Zazula6, Fabrice Calmels5, Regis Debruyne7, G. Brian Golding4, Hendrik N. Poinar1,3,4 & Gerard D. Wright1,2
The discovery of antibiotics more than 70 years ago initiated a
with high concentrations of Escherichia coli harbouring the gfp (green
period of drug innovation and implementation in human and
fluorescent protein) gene from Aequorea victoria (Supplementary
animal health and agriculture. These discoveries were tempered
in all cases by the emergence of resistant microbes1,2. This history
After fracturing of the samples (Supplementary Fig. 3), total DNA
has been interpreted to mean that antibiotic resistance in patho-
was extracted from a series of five subsamples taken along the radius of
genic bacteria is a modern phenomenon; this view is reinforced by
each core (Supplementary Information). Quantitative polymerase
the fact that collections of microbes that predate the antibiotic eraare highly susceptible to antibiotics3. Here we report targeted
metagenomic analyses of rigorously authenticated ancient DNAfrom 30,000-year-old Beringian permafrost sediments and the
Dawson tephra: 25,300 14C yr BP
identification of a highly diverse collection of genes encoding res-
(30,430–30,030 calendar yr BP)
istance to b-lactam, tetracycline and glycopeptide antibiotics.
Structure and function studies on the complete vancomycin resist-
Microtus &
ance element VanA confirmed its similarity to modern variants.
These results show conclusively that antibiotic resistance is anatural phenomenon that predates the modern selective pressure
of clinical antibiotic use.
Recent studies of modern environmental and human commensal
microbial genomes have a much larger concentration of antibioticresistance genes than has been previously recognized4–6. In addition,
metagenomic studies have revealed diverse homologues of knownresistance genes broadly distributed across environmental locales.
Elevation above datum (m)
This widespread dissemination of antibiotic resistance elements isinconsistent with a hypothesis of contemporary emergence and
Loess (primary and
instead suggests a richer natural history of resistance2. Indeed,
estimates of the origin of natural product antibiotics range from2 Gyr to 40 Myr ago7,8, suggesting that resistance should be similarly
old. Previous publications claim to have cultured resistant bacteria
from Siberian permafrost (for example ref. 9), but these results remaincontentious (see Supplementary Information).
To determine whether contemporary resistance elements are modern
or whether they originated before our use of antibiotics, we analysed
DNA sequences recovered from Late Pleistocene permafrost sediments.
The samples were collected east of Dawson City, Yukon, at the BearCreek (BC) site (Fig. 1); prominent forms of ground ice (ice wedges and
surface icings) are preserved in the exposure, immediately overlain by a
distinctive volcanic ash layer, the Dawson tephra10,11 (SupplementaryTable 1 and Supplementary Figs 1 and 2). The tephra has been dated at
several sites in the area to about 25,300 radiocarbon (14C) years BP, or
about 30,000 calendar years10,12. The cryostratigraphic context is similarto other sites in the area preserving relict permafrost and indicates thatthe permafrost has not thawed since the time of deposition (Sup-
plementary Information). In the absence of fluid leaching, the site repre-sents an ideal source of uncontaminated and securely dated ancient
Figure 1 Stratigraphic profile and location of Bear Creek site. Elevation isgiven in metres above base of exposure. Permafrost samples from below
Dawson tephra were dated to about 30 kyr BP. Preservation of the ice below and
Two frozen sediment cores (BC1 and BC4), 10 cm apart, were
above the sample indicates that the sediments have not thawed since
obtained 50 cm below the tephra. In accordance with appropriate
deposition. Silhouettes represent mammals and birds identified from ancient
protocols13, we monitored contamination introduced during coring
DNA sequences that are typical of the regional Late Pleistocene environment.
by spraying the drilling equipment and the outer surface of the cores
aDNA, ancient DNA.
1Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada, L8N 3Z5. 2Department of Biochemistry and Biomedical Sciences, McMaster University,Hamilton, Ontario, Canada, L8N 3Z5. 3McMaster Ancient DNA Centre, Department of Anthropology, McMaster University, Hamilton, Ontario, Canada, L8S 4L9. 4Department of Biology, McMaster University,Hamilton, Ontario, Canada, L8S 4K1. 5Department of Earth and Atmospheric Sciences, University of Alberta, Edmonton, Alberta, Canada, T6G 2E3. 6Yukon Palaeontology Program, Department of Tourismand Culture, Yukon Government, PO Box 2703, Whitehorse, Yukon, Canada, Y1A 2C6. 7Muse´um National d'Histoire Naturelle, UMR 7206 Eco-anthropologie, 57 rue Cuvier, CP139, 75231 Paris cedex 05,France.
*These authors contributed equally to this work.
2011
Macmillan Publishers Limited. All rights reserved
chain reaction (qPCR) analysis confirmed extremely high yields of gfp
Supplementary Table 8). Querying the permafrost sequences against
on both core exteriors, with 0.1% or less of this amount at the centre
the contaminant data set with the use of BLAST further confirmed
(Supplementary Information and Supplementary Fig. 4). This sup-
their disparity: only 1% of the reads had 95–100% identity to a con-
ports negligible leaching or cross-contamination during subsampling.
taminant sequence, with a single sequence showing 100% identity.
A crucial step lending support for the authenticity of the ancient
We next developed a series of assays to detect genes encoding resist-
DNA was to confirm the presence of DNA derived from flora and fauna
ance to several major classes of antibiotic and representing diverse
characteristic of a late Pleistocene age, and the absence of common
strategies of drug evasion (for example target modification, target pro-
modern or Holocene floral and faunal sources. To explore the vertebrate
tection and enzymatic drug inactivation) (Supplementary Information).
and plant diversity, we amplified fragments of the mitochondrial 12S
Determinants included the ribosomal protection protein TetM, which
rRNA and chloroplast trnL and rbcL genes (Supplementary Table 3).
confers resistance to tetracycline antibiotics by weakening the inter-
Amplicons were sequenced with the 454 GS-FLX platform and iden-
action between the drug and the ribosome; the D-Ala-D-Ala dipeptide
tified by BLAST analysis of GenBank sequences (Supplementary
hydrolase VanX, which is a component of the vancomycin resistance
operon; the aminoglycoside-antibiotic-modifying acetyltransferase
The vertebrate sequences included abundant Late Pleistocene
AAC(3); a penicillin-inactivating b-lactamase Bla (a member of the
megafauna such as Bison, Equus and Ovis, as well as rodents (Microtus
TEM group of b-lactamases); and the ribosome methyltransferase
and Ellobius) and the rock ptarmigan, Lagopus mutus (Supplementary
Erm, which blocks the binding of macrolide, lincosamide and type B
Fig. 6 and Supplementary Table 5). Mammuthus was detectable at low
streptogramin antibiotics. Amplification of vanX, tetM and bla frag-
copy numbers with the use of a mammoth-specific qPCR assay, which is
ments was successful, and triplicate PCR products from multiple
consistent with the low ratio of these fossils relative to bison and horse in
extracts were cloned and multiple clones were sequenced.
the region11,14. The rbcL and trnL sequences revealed many plant groups
The b-lactamase sequences demonstrated amino-acid identities
that are also well documented in Beringia, including the grasses Poa and
between 53% and 84% with known determinants and clustered with
Festuca, sage (Artemisia) and willow (Salix)15 (Supplementary Figs 7 and
one of two groups of enzymes: characterized b-lactamases from strepto-
8, and Supplementary Tables 6 and 7). No sequences of common
mycetes and uncharacterized b-lactamase-like hydrolytic proteins
Holocene vertebrates (for example elk or moose) or plants (for example
(Fig. 2a and Supplementary Fig. 14). We identified several tetM-related
spruce) were identified despite sequence conservation across the primer-
genes in the permafrost, most of which were most closely related to the
binding sites; these results are consistent with other reports16 that have
actinomycete subset of ribosomal protection proteins, including the
argued against DNA leaching in permafrost sediments.
biochemically characterized self-resistance element OtrA from the
We focused our investigation of bacterial 16S rRNA sequences on
oxytetracycline producer Streptomyces rimosus18 (Fig. 2b). Most intri-
the Actinobacteria, known for their ability to synthesize diverse
guing was the identification of vanX gene fragments, which spanned
secondary metabolites and for harbouring antibiotic resistance genes4.
the entire phylogenetic space of characterized vancomycin resistance
Deep sequencing of 16S amplicons (Supplementary Information)
determinants found in the clinic and in the environment. These branch
revealed genera commonly found in soil and permafrost microbial
away from the cellular dipeptidases that are the likely progenitors the
communities17, including Aeromicrobium, Arthrobacter and Frankia
vanX family (Supplementary Fig. 10).
(Supplementary Fig. 9 and Supplementary Table 8). Analysis of con-
Vancomycin resistance took the clinical community by surprise
taminant 16S sequences derived from extraction and PCR control re-
when it emerged in pathogenic enterococci in the late 1980s19. In both
actions (Supplementary Table 4) suggested that these do not
clinical pathogens19 and contemporary soil environments4, resistance
contribute to the ancient DNA data set; in fact not only were the copy
results from the acquisition of a three-gene operon vanH–vanA–vanX
numbers 1,000–30,000-fold lower than from the permafrost extracts,
(vanHAX). These enzymes collectively reconstruct bacterial peptido-
but with the exception of unclassified bacteria there was also very
glycan to terminate in D-alanine-D-lactate in place of the canonical
little overlap in the genera identified (Supplementary Fig. 9 and
D-alanine-D-alanine, which is required for vancomycin binding and
Kinetococcus radiotolerans
St. griseus
cellulosae
St. rimosus*
St. scabies
St. aver BC4
St. sp. AA#4
St. coelicolor
St. scabies
St. griseusGTP-binding protein
Figure 2 Genetic diversity of ancient antibiotic resistance elements.
activity has been biochemically verified are noted with a single asterisk
a, b, Unrooted Bayesian phylogenies of translated b-lactamase (bla) (a) and
(Supplementary Information). The scale bar represents 0.1 substitutions per
tetracycline resistance (tetM) (b). Blue denotes predicted resistance enzymes,
site. Posterior probabilities are shown for a, and those of 0.7 or more are
and green those associated with other functions; permafrost-derived sequences
indicated for b. All unlabelled tips derive from ancient sequences. BC1, Bear
are labelled with the originating core name. Sequences in which resistance
Creek sample 1; BC4, Bear Creek sample 4.
2011
Macmillan Publishers Limited. All rights reserved
subsequent antibiotic action. Although most forms of resistance are
With few exceptions, the vanHAX operon is invariant in genetic
attributed to a single gene, this complex mechanism is exclusively
organization; it therefore offers a matchless template for confirming its
associated with resistance and thus its presence provides unambiguous
presence with PCR assays that span the vanHA and vanAX boundaries.
confirmation of its role as a resistance determinant.
Two short qPCR assays were designed to confirm this contiguity
a vanHAX operon orientation
Amplicons and primer sites
Figure 3 Ancient vancomycin resistance elements. a, vanHAX amplicons
overlaid with modern VanA (green), where the V-loop is coloured red; right:
used in this study, with primer names noted above each arrow. b, Unrooted
ball-and-stick representation of ATP binding. The electron density shown is an
Bayesian phylogeny of translated vanA sequences; blue denotes strains with
Fo 2 Fc map contoured at 3s. d, Comparison of modern and ancient VanA
vanHAX clusters confirmed to confer resistance; sequences containing stop
monomer structures. The V-loop is coloured red and detailed in the ball-and-
codons but homology throughout are noted with a single asterisk
stick figures. Ligands are shown in grey. Dashed lines represent hydrogen
(Supplementary Information). BC1, Bear Creek sample 1; BC4, Bear Creek
sample 4. c, VanAA2 structure. Left: ribbon diagram of the VanAA2 dimer (blue)
2011
Macmillan Publishers Limited. All rights reserved
Table 1 vanHAX permutation tests
Length (base pairs)
Probability of similarity by chance alone to Streptomyces coelicolor genes
* Clones from independent replication in France. {Includes both H1AX and H2AX.
(Fig. 3a and Supplementary Information). Positive results, including
resistance is an ancient, naturally occurring phenomenon widespread
particularly high yields of the smallest amplicon, A6X (Supplemen-
in the environment. This is consistent with the rapid emergence of
tary Table 9), encouraged us to attempt amplification across both
resistance in the clinic and predicts that new antibiotics will select for
boundaries (that is, the complete vanA gene) in a single 1.2-kilobase
pre-existing resistance determinants that have been circulating within
amplicon. We also targeted fragments anchored on either boundary
the microbial pangenome for millennia. This reality must be a guiding
and extending as far as possible into vanA. None of the sequences from
principle in our stewardship of existing and new antibiotics.
these products, or those generated by an independent laboratory (Sup-plementary Information), were present in GenBank. No contaminants
were detected in more than 300 control reactions.
Permafrost cores were collected at Bear Creek, Yukon, then shipped frozen to the
Phylogenetic analyses showed that many of the ancient vanHAX
McMaster Ancient DNA Centre and stored at 240 uC. All subsequent procedures
sequences cluster with characterized glycopeptide-resistant strains of
before PCR/qPCR amplification were performed in dedicated clean rooms, physicallyseparated from laboratories containing modern DNA, bacterial cultures and amp-
Actinobacteria containing vanHAX cassettes (for example streptomy-
lification products. Contaminant leaching into the centre of cores after sampling was
cetes, glycopeptide-producing Amycolatopsis species and the nitrogen-
monitored by qPCR assays designed to detect E. coli DNA encoding the jellyfish green
fixing Frankia sp. EAN1pec) (Fig. 3b and Supplementary Figs 11 and
fluorescent protein sprayed onto coring equipment and the external surfaces of all
12). Another group falls between the actinobacterial sequences and the
collected cores. DNA was extracted from the centre of subsampled permafrost cores.
Firmicutes-derived cluster, which includes environmental Paenibacillus
PCR assays were designed to target vertebrates, plants, bacteria and specific antibiotic
isolates and the pathogenic Enterococci, and may reflect an intermediate
resistance elements. All products were sequenced with either the 454 GS-FLX
platform or by standard cloning and sequencing procedures (GenBank accession
Permutation tests were performed with the PRSS algorithm20 (1,000
numbers JN316287–JN366376). The ancient vanA gene identified from thepermafrost was synthesized and expressed in E. coli, and the His
permutations each) to confirm that the sequences were statistically
was purified by immobilized metal-affinity chromatography. This protein was
similar to those of vancomycin resistance genes (vanHAX) present
used in enzymatic studies to determine steady-state kinetics and was also studied
in modern Streptomyces. As shown in Table 1, all vanHA-spanning
by crystallography using the vapour-diffusion hanging-drop method. Data were
clones have significant similarity to vanH and vanA, and all vanAX-
collected at the National Synchrotron Light Source, Brookhaven National
spanning clones have significant similarity to vanA and vanX.
Laboratory, beamline X25 (PDB 1E4E).
To ascertain whether the complete vanA sequences are indeed func-
tional and do not represent PCR artefacts or pseudogenes, we synthe-
Received 28 March; accepted 22 July 2011.
sized four open reading frames from the 40 H1AX/H2AX sequences
Published online 31 August 2011.
(Supplementary Information). Two of these generated soluble proteins
Livermore, D. M. Has the era of untreatable infections arrived? J. Antimicrob.
suitable for purification to homogeneity. Enzymatic characterization
Chemother. 64, i29–i36 (2009).
indicated that these ligases were indeed
Wright, G. D. The antibiotic resistome: the nexus of chemical and genetic diversity.
Nature Rev. Microbiol. 5, 175–186 (2007).
(Supplementary Fig. 13), and analysis revealed steady-state kinetic
Hughes, V. M. & Datta, N. Conjugative plasmids in bacteria of the ‘pre-antibiotic'
parameters consistent with contemporary enzymes derived from both
era. Nature 302, 725–726 (1983).
the clinic and the environment (Supplementary Table 10). These
D'Costa, V. M., McGrann, K. M., Hughes, D. W. & Wright, G. D. Sampling theantibiotic resistome. Science 311, 374–377 (2006).
results clearly show that the vanHAX genes identified in the ancient
Dantas, G., Sommer, M. O. A., Oluwasegun, R. D. & Church, G. M. Bacteria subsisting
samples encode enzymes capable of genuine antibiotic resistance.
on antibiotics. Science 320, 100–103 (2008).
We further confirmed the link between 30,000-year-old VanA and
Sommer, M. O. A., Dantas, G. & Church, G. M. Functional characterization of theantibiotic resistance reservoir in the human microflora. Science 325, 1128–1131
contemporary enzymes by determining the three-dimensional struc-
ture of VanAA2 by X-ray crystallography (Supplementary Table 11 and
Baltz, R. H. Antibiotic discovery from actinomycetes: will a renaissance follow the
Supplementary Information). The quaternary and tertiary structures
decline and fall? SIM News 55, 186–196 (2005).
Hall, B. G. & Barlow, M. Evolution of the serine b-lactamases: past, present and
of VanAA2, crystallized in the ATP-bound form, show the overall
future. Drug Resist. Updat. 7, 111–123 (2004).
D-Ala-D-X ligase fold of modern enzymes including VanA from
Mindlin, S. Z., Soina, V. S., Petrova, M. A. & Gorlenko, Z. M. Isolation of antibiotic
vancomycin-resistant Enterococcus faecium (Fig. 3c, d). Superposition
resistance bacterial strains from Eastern Siberia permafrost sediments. Russ. J.
Genet. 44, 27–34 (2008).
of ancient and modern VanA (Fig. 3c, d) reveals conservation of
10. Froese, D. G., Zazula, G. D. & Reyes, A. V. Seasonality of the late Pleistocene Dawson
quaternary and tertiary structure with minor differences in Mg21
tephra and exceptional preservation of a buried riparian surface in central Yukon
and ATP c-phosphate coordination. The V-loop comprises the biggest
Territory, Canada. Quat. Sci. Rev. 25, 1542–1551 (2006).
11. Froese, D. G. et al. The Klondike goldfields and Pleistocene environments of
structural change; 13 amino-terminal residues (233–246) are absent
Beringia. GSA Today 19, 4–10 (2009).
from the electron density map of VanAA2, including His 241 (His 244
12. Brock, F., Froese, D. G. & Roberts, R. G. Low temperature (LT) combustion of
in modern VanA), responsible for the lactate selectivity. The last seven
sediments does not necessarily provide accurate radiocarbon ages for sitechronology. Quat. Geochronol. 5, 625–630 (2010).
V-loop residues (247–253) have clear electron density, undergoing a
13. Willerslev, E., Hansen, A. J. & Poinar, H. N. Isolation of nucleic acids and cultures
˚ shift. These structural differences, however, are not
from fossil ice and permafrost. Trends Ecol. Evol. 19, 141–147 (2004).
reflected in enzyme function.
14. Harington, C. R. & Clulow, F. V. Pleistocene mammals from Gold Run Creek, Yukon
Territory. Can. J. Earth Sci. 10, 697–759 (1973).
This work firmly establishes that antibiotic resistance genes predate
15. Zazula, G. D. et al. Ice-age steppe vegetation in east Beringia. Nature 423, 603
our use of antibiotics and offers the first direct evidence that antibiotic
2011
Macmillan Publishers Limited. All rights reserved
16. Haile, J. et al. Ancient DNA reveals late survival of mammoth and horse in interior
Author Contributions D.F., G.Z. and F.C. collected permafrost cores and performed
Alaska. Proc. Natl Acad. Sci. USA 106, 22352–22357 (2009).
geochemical analyses followed by subsampling by C.S., V.M.D. and C.E.K. C.E.K
17. Gilichinsky, D. et al. in Psychrophiles: From Biodiversity to Biotechnology
performed ancient DNA laboratory work and 454 sequencing. V.M.D. designed primers
(eds Margesin, R., Schinner, F., Marx, J.-C. & Gerday, C.) 83–102 (Springer, 2008).
for resistance genes, 16S and gfp. V.M.D. and C.E.K. designed and optimized the qPCR
18. Doyle, D., McDowall, K. J., Butler, M. J. & Hunter, I. S. Characterization of an
assays, and cloned and sequenced the resistance gene products. R.D. independently
oxytetracycline-resistance gene, otrA, of Streptomyces rimosus. Mol. Microbiol. 5,
confirmed the results in France. L.K. purified and characterized VanA, and M.M.
2923–2933 (1991).
crystallized VanA and determined the three-dimensional structure. W.S., G.B.G., C.E.K.
19. Courvalin, P. Vancomycin resistance in gram-positive cocci. Clin. Infect. Dis. 42,
and H.N.P. processed and analysed the floral/faunal data; V.M.D. and G.B.G. performed
S25–S34 (2006).
phylogenetic and bioinformatic analyses of the resistance gene sequences. H.N.P. and
20. Pearson, W. R. & Lipman, D. J. Improved tools for biological sequence comparison.
G.D.W. conceived the project, and V.M.D., C.E.K., D.F., H.N.P. and G.D.W. wrote the
Proc. Natl Acad. Sci. USA 85, 2444–2448 (1988).
manuscript. All authors edited the final draft.
Supplementary Information is linked to the online version of the paper at
Author Information The metagenomic sequences determined from permafrost are
deposited in GenBank under accession numbers JN316287–JN366376. Reprints and
Acknowledgements We thank A. Guarne´ for assistance in X-ray data collection. This
permissions information is available at The authors declare
work was supported by Canada Research Chairs to D.F., H.N.P. and G.D.W., a Canadian
no competing financial interests. Readers are welcome to comment on the online
Institutes of Health Research operating grant to G.D.W. (MOP-79488) and a scholarship
version of this article at Correspondence and requests for
to V.M.D., and by grants from the Natural Sciences and Engineering Research Council of
materials should be addressed to G.D.W. or H.N.P.
Canada to D.F. and H.N.P. and scholarship to C.E.K.
2011
Macmillan Publishers Limited. All rights reserved
Source: http://www4.cchn.ufes.br/dbio/disciplinas/evolucao/seminarios/1_Antibiotic_resistance_Nature2011.pdf
Volume 6 Number 3 pp. 297–304 297 RASSF1A Promoter Methylation Viera Kajabova*, Bozena Smolkova*, Levels Positively Correlate with Iveta Zmetakova*, Katarina Sebova*,Tomas Krivulcik*, Vladimir Bella†, Karol Kajo‡, Estrogen Receptor Expression Katarina Machalekova‡ and Ivana Fridrichova* in Breast Cancer Patients1,2 *Laboratory of Cancer Genetics, Cancer ResearchInstitute of Slovak Academy of Sciences, Bratislava,Slovakia; †Department of Senology, St Elizabeth CancerInstitute, Bratislava, Slovakia; ‡Department of Pathology,Slovak Medical University and St Elizabeth CancerInstitute, Bratislava, Slovakia
Page 1 of 11 Jeff Gudin, Abel Gonzalez, Joon Lee Pain Management and Palliative Care, Englewood Hospital and Medical Center, Englewood, New Jersey, USACorrespondence to: Jeff Gudin, MD. Clinical Instructor, Anesthesiology, Icahn School of Medicine at Mount Sinai, Board Certified Pain Management, Anesthesiology, Palliative Care and Addiction Medicine; Director. Pain Management and Palliative Care, Englewood Hospital and Medical Center, 350 Engle St. Englewood, New Jersey 07631, USA. Email: [email protected]; Abel Gonzalez, MD. Department of Internal Medicine, Englewood Hospital and Medical Center, 350 Engle St, Englewood NJ 07631, USA. Email: [email protected]; Joon Lee, MD. Pain Management and Palliative Care, Englewood Hospital and Medical Center, 350 Engle St, Englewood NJ 07631, USA. Email: [email protected].