DrtA, a novel major facilitator superfamily transporter, contributes to intrinsic tolerance to the chemotherapeutic agent mitomycin C in Acinetobacter baumannii

Abstract

Human-targeted non-antibiotic drugs are increasingly recognized for their intrinsic antibacterial activity, yet Gram-negative pathogens such as Acinetobacter baumannii exhibit substantial tolerance to these compounds. This tolerance is largely attributed to restricted outer membrane permeability and the activity of multidrug efflux systems. While Resistance Nodulation Division (RND) transporters have been extensively studied, the contribution of individual Major Facilitator Superfamily (MFS) transporters to non-antibiotic drug tolerance remains poorly understood. Here, we investigated H0N29_04330, designated Drug Resistance Transporter A (DrtA), a Bcr/CflA subfamily MFS transporter, to define its substrate specificity and contribution to antibiotic and non-antibiotic drug tolerance. DrtA was highly conserved across the A. calcoaceticus-baumannii complex and exhibited broad substrate specificity when heterologously expressed in an efflux-deficient Escherichia coli background, conferring resistance to benzalkonium, ethidium bromide, phenicols, and the antineoplastic agent mitomycin C. Intriguingly, drtA expression increased E. coli susceptibility to the antifolate compounds methotrexate and aminopterin, suggesting that DrtA may recognize folate-related metabolites rather than function as a dedicated antifolate transporter. In contrast, loss of drtA in its native A. baumannii host primarily impaired tolerance to mitomycin C, highlighting a context-dependent physiological role influenced by the extensive functional redundancy among A. baumannii efflux systems. Site-directed mutagenesis further identified M18 and the membrane-embedded protonatable residue D26 as critical determinants of DrtA transport activity and substrate recognition. Together with previous characterization of CraA, our findings demonstrate that Bcr/CflA subfamily MFS transporters contribute to protection against structurally diverse human-targeted compounds and expand the functional landscape of efflux-mediated intrinsic tolerance beyond conventional antibiotic resistance.