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Journal of Bacteriology, December 2004, p. 8172-8180, Vol. 186, No. 24
0021-9193/04/$08.00+0     DOI: 10.1128/JB.186.24.8172-8180.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Specialized Persister Cells and the Mechanism of Multidrug Tolerance in Escherichia coli

Iris Keren,{dagger} Devang Shah,{dagger} Amy Spoering, Niilo Kaldalu,{ddagger} and Kim Lewis*

Department of Biology, Northeastern University, Boston, Massachusetts

Received 19 July 2004/ Accepted 15 September 2004

Bacterial populations produce persisters, cells that neither grow nor die in the presence of bactericidal agents, and thus exhibit multidrug tolerance (MDT). The mechanisms of MDT and the nature of persisters have remained elusive. Our previous research has shown that persisters are largely responsible for the recalcitrance of biofilm infections. A general method for isolating persisters was developed, based on lysis of regular cells by ampicillin. A gene expression profile of persisters contained toxin-antitoxin (TA) modules and other genes that can block important cellular functions such as translation. Bactericidal antibiotics kill cells by corrupting the target function (for example, aminoglycosides interrupt translation, producing toxic peptides). We reasoned that inhibition of translation will lead to a shutdown of cellular functions, preventing antibiotics from corrupting their targets, giving rise to MDT persister cells. Overproduction of the RelE toxin, an inhibitor of translation, caused a sharp increase in persisters. Functional expression of a putative HipA toxin also increased persisters, while deletion of the hipBA module caused a sharp decrease in persisters in both stationary and biofilm populations. HipA is thus the first validated persister-MDT gene. We suggest that random fluctuation in the levels of MDT proteins leads to the formation of rare persister cells. The function of these specialized dormant cells is to ensure the survival of the population in the presence of lethal factors.

* Corresponding author. Mailing address: Department of Biology, Northeastern University, 134 Mugar Hall, 360 Huntington Ave., Boston, MA 02115. Phone: (617) 373-8238. Fax: (617) 373-3724. E-mail: k.lewis{at}neu.edu.

{dagger} These authors contributed equally to this work.

{ddagger} Present address: Institute of Technology, Tartu University, Tartu 51010, Estonia.

Journal of Bacteriology, December 2004, p. 8172-8180, Vol. 186, No. 24
0021-9193/04/$08.00+0     DOI: 10.1128/JB.186.24.8172-8180.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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