Effects of subinhibitory concentrations of nitroxoline on the surface properties of Escherichia coli

Novel nitroxoline derivative combating resistant bacterial infections through outer membrane disruption and competitive NDM-1 inhibition

ABSTRACTNew Delhi metallo-β-lactamase-1 (NDM-1) has rapidly disseminated worldwide, leading to multidrug resistance and worse clinical prognosis. Designing and developing effective NDM-1 inhibitors is a critical and urgent challenge. In this study, we constructed a library of long-lasting nitroxoline derivatives and identified ASN-1733 as a promising dual-functional antibiotic. ASN-1733 can effectively compete for Ca2+ on the bacterial surface, causing the detachment of lipopolysaccharides (LPS), thereby compromising the outer membrane integrity and permeability and exhibiting broad-spectrum bactericidal activity. Moreover, ASN-1733 demonstrated wider therapeutic applications than nitroxoline in mouse sepsis, thigh and mild abdominal infections. Furthermore, ASN-1733 can effectively inhibit the hydrolytic capability of NDM-1 and exhibits synergistic killing effects in combination with meropenem against NDM-1 positive bacteria. Mechanistic studies using enzymatic experiments and computer simulations revealed that ASN-1733 can bind to key residues on Loop10 of NDM-1, hindering substrate entry into the enzyme's active site and achieving potent inhibitory activity (Ki = 0.22 µM), even in the presence of excessive Zn2+. These findings elucidate the antibacterial mechanism of nitroxoline and its derivatives, expand their potential application in the field of antibacterial agents and provide new insights into the development of novel NDM-1 inhibitors.

Nitroxoline resistance is associated with significant fitness loss and diminishes in vivo virulence of Escherichia coli

IMPORTANCE

Antimicrobial resistance (AMR) poses a global threat and requires the exploration of underestimated treatment options. Nitroxoline, an effective broad-spectrum antibiotic, does not suffer from high resistance rates in the clinics but surprisingly, it is not heavily used yet. Our findings provide compelling evidence that Nitroxoline resistance renders bacteria unable to cause an infection in vivo, thereby reinvigorating the potential of Nitroxoline in combating AMR.

Chelation in Antibacterial Drugs: From Nitroxoline to Cefiderocol and Beyond

In the era of escalating antimicrobial resistance, the need for antibacterial drugs with novel or improved modes of action (MOAs) is a health concern of utmost importance. Adding or improving the chelating abilities of existing drugs or finding new, nature-inspired chelating agents seems to be one of the major ways to ensure progress. This review article provides insight into the modes of action of antibacterial agents, class by class, through the perspective of chelation. We covered a wide scope of antibacterials, from a century-old quintessential chelating agent nitroxoline, currently unearthed due to its newly discovered anticancer and antibiofilm activities, over the commonly used antibacterial classes, to new cephalosporin cefiderocol and a potential future class of tetramates. We show the impressive spectrum of roles that chelation plays in antibacterial MOAs. This, by itself, demonstrates the importance of understanding the fundamental chemistry behind such complex processes.

Influence of Consistency and Composition of Growth Medium on Surface Physicochemical Properties of Streptomyces

Streptomyces are known for their ability to produce various secondary metabolites used in biotechnology, human medicine and agriculture. Understanding of surface properties is very interesting in the control of interfacial phenomena. The objective of this study was to investigate the effect of consistency and composition of growth medium on the physicochemical properties of the surface of Streptomyces strains. To achieve this objective, Six Streptomyces strains belonging to bioprocess and bio-interfaces laboratory are cultivated in two media Bennett (rich) and GBA (minimum). Both media are tested in solid (agar) and liquid (broth) mode. The wettability θw, electron donor character ˠ (-), electron acceptor character ˠ (+) and Surface free energy ΔGiwi are determined using contact angle measurements. On the two solid media Bennett and GBA, Streptomyces strains develop a hydrophobic surface (96.9° <θw<167.9°) with a weak electron donor character (0.3 mJm-2 < (ˠ (-)) <12.14 mJm-2) and a strong electron acceptor character (0.26 mJm-2 < ˠ (+) < 17.8 mJm-2) and a negative surface free energy ((- 11.8 mJm-2) < ΔGiwi < (-110 mJm-2)). Whereas on both Bennett and GBA liquid media, the surfaces of Streptomyces strains are generally hydrophilic (1.3° < θw < 9.33°) with a strong electron donor character (13.76 mJm-2 < ( ˠ (-)) < 70.06 mJm-2) and a positive surface free energy. By changing the composition of the culture medium, only a slight change in the degree of hydrophobicity and surface free energy of Streptomyces is observed. Regarding the effect of medium composition on the surface properties of Streptomyces, the degree of wettability and the values of surface free energy are no longer the same when the composition of the medium changes. These results could be applied in further studies interested in interfacial phenomena and microbial adhesion in biotechnological fields.

Review of the literature and individual patients' data meta-analysis on efficacy and tolerance of nitroxoline in the treatment of uncomplicated urinary tract infections

BACKGROUND

Nitroxoline, a hydroxychinoline derivate, has been used for many years to treat urinary tract infections (UTI). Many uncontrolled, but only few controlled clinical studies have been published. Four so far unpublished, controlled clinical studies were meta-analysed.

METHODS

A narrative literature review was performed. In addition the individual patient data (IPD) of 466 females with uncomplicated UTI of four prospective, single blind, randomized, clinical studies with similar protocols using nitroxoline (250 mg tid) versus cotrimoxazole (960 mg bid) or norfloxacin (400 mg bid) as controls for 5 days (sporadic UTI) or 10 days (recurrent UTI) were meta-analysed. The primary aim was eradication of bacteriuria 7-13 days after end of therapy (test of cure). Clinical efficacy was determined by elimination of symptoms and safety by adverse events and laboratory tests.

RESULTS

Reviewing a total of 26 uncontrolled, 2 controlled and one postmarketing studies including more than 11,000 patients, good efficacy and safety of nitroxoline could be confirmed. In the four unpublished controlled studies a total of 234 patients were treated orally with nitroxoline and 232 with controls. The safety of nitroxoline was very good and comparable to the controls (adverse events 9.4% vs 7.8%; p = 0.360). In the mMITT set (at least one outcome result), in the PP set (test of cure outcome) and in the modified PP set (missing test of cure rated failure) more than 90% of the patients showed eradication of bacteriuria with nitroxoline, which also met statistical non-inferiority compared to the controls (10% non-inferiority margin) in all three evaluation sets. The clinical efficacy was similar between the two treatment groups.

CONCLUSION

The IPD meta-analysis using objective parameters (elimination of bacteriuria) demonstrated equivalent efficacy (non-inferiority) of nitroxoline with the controls tested (cotrimoxazole, norfloxacin) in the treatment of uncomplicated UTI. Considering the good safety and efficacy of nitroxoline as also shown in many uncontrolled and observational studies and the world wide increase of resistance of uropathogens against cotrimoxazole and fluoroquinolones, but not against nitroxoline within the last 20 years, nitroxoline should be reconsidered as one of the first line antibiotics for the treatment of uncomplicated UTI.

Effects of subinhibitory concentrations of amikacin and ciprofloxacin on the hydrophobicity and adherence to epithelial cells of uropathogenic Escherichia coli strains

The effect of subinhibitory concentrations of amikacin and ciprofloxacin on the hydrophobicity and adherence to uroepithelial cells of Escherichia coli strains was investigated. The hydrophobicity of the tested strains was evaluated by the bacterial adherence to hydrocarbon-xylene test and by the salt aggregation test of ammonium sulphate. The hydrophobic character of strains exposed to 1/2 to 1/8 minimal inhibitory concentration (MIC) of amikacin and 1/2 to 1/16 MIC of ciprofloxacin was altered to a hydrophilic state. Results of the SAT also correlated with these data. Moreover, comparisons were made between the number of bacteria attached to the epithelial cells before and after exposure to 1/2, 1/4 and 1/8 MIC of antibiotics. The greatest loss of adherence capability occurred at 1/2 MIC of ciprofloxacin. In conclusion, antibiotics are often present at sub-MICs and may still be effective in reducing bacterial virulence by interfering with bacterial cell functions.

Some properties of Plesiomonas shigelloides treated with aminoglycosides

The effect of aminoglycoside antibiotics (amikacin, gentamicin, netilmicin and tobramycin) at sublethal concentrations (sub-MICs) on some properties of Plesiomonas shigelloides strains was evaluated. All agents decreased the bacterial surface hydrophobicity. Amikacin (1/4 of the MIC) and netilmicin (1/4 and 1/8 of the MIC) changed the hydrophobic character of P. shigelloides surface to a hydrophilic one. Treatment of the strains with aminoglycosides decreased also motility, netilmicin being the most effective. No significant changes were found in lipolytic activity of antibiotic-treated strains. In the majority of cases aminoglycosides increased sensitivity of bacteria to hydrogen peroxide. The tested antibiotics did not induce production of short-chained N-acylhomoserine lactones signal molecules. Aminoglycosides at sub-MICs affected important activities of P. shigelloides potentially associated with their virulence in dependence on strain, antibiotic and concentration.

The effects of magnesium, calcium and EDTA on slime production by Staphylococcus epidermidis strains

Effect of magnesium, calcium and EDTA on slime production by 15 slime-positive and 13 slime-negative Staphylococcus epidermidis strains isolated from various clinical specimens was determined. The slime production on tryptic soy broth was significantly enhanced after addition of 128 mumol/L Mg2+. Similarly, the addition of Ca2+ caused a significant increase in slime production of all tested strains when concentration of Ca2+ exceeded 64 mumol/L. In contrast, in the presence of EDTA the slime production by all strains was significantly reduced. Hence Ca2+ and Mg2+ increase slime production of S. epidermidis. This finding is important in the context of the pathogenesis of biomedical implant infections caused by S. epidermidis.

Influence on Enterobacter cloacae metabolism, cell-surface hydrophobicity and motility of suprainhibitory concentrations of carbapenems

The impact of postantibiotic effect (PAE) of carbapenems (imipenem, meropenem) on the metabolism (biosynthesis of macromolecules, respiration), cell-surface hydrophobicity and motility of a clinical isolate of Enterobacter cloacae was examined. The metabolism was evaluated after 16 h and after 1 d of cultivation using 2x and 4x minimum inhibitory concentrations (MIC) of both antibiotics for the induction of PAE. Imipenem at 4 x MIC did not induce PAE. After a 16-h cultivation (in the postantibiotic phase of both carbapenems), inhibition of nucleosynthesis and protein synthesis was found; after a 1-d cultivation, during regrowth stimulation of mainly 14C-leucine incorporation was found. The presence of the exogenous intermediates of citrate cycle, viz. 2-oxoglutarate, increased the respiratory activity of the cells. The cell-surface hydrophobicity (evaluated by three methods--bacterial adhesion to hydrocarbon, nitrocellulose-filter test and salt-aggregation test) decreased after PAE of both carbapenems; meropenem was more effective. Motility (an important virulence factor) was inhibited in the postantibiotic phase of both carbapenems; the 4 x MIC caused a higher inhibition.

In vitro activity of the chelating agents nitroxoline and oxine against Mycobacterium bovis BCG

The chelating antibiotic nitroxoline (5-nitro-8-hydroxyquinoline) showed a bacteriostatic effect at a concentration of 10 microM for Mycobacterium bovis BCG. At higher concentrations the compound showed moderate cidal activity against growing bacilli. In contrast, its non-nitrated derivative oxine (8-hydroxyquinoline, MIC=2 microM) reduced the viability of a growing culture rapidly, 5000-fold at a concentration where the nitroxoline was merely bacteriostatic. Both compounds showed appreciable cidal activity against bacilli in their hypoxic dormant state.