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da Silva CR, Cabral VPDF, Rodrigues DS, Ferreira TL, Barbosa AD, de Andrade Neto JB, Barbosa SA, Moreira LEA, da Costa ÉRM, de Queiroz MVF, de Lima EA, Pinheiro DRS, Nobre Júnior HV, Valente Sá LGDA. Antibiofilm activity of promethazine against ESBL-producing strains of Escherichia coli in urinary catheters. Microb Pathog 2024; 193:106769. [PMID: 38955237 DOI: 10.1016/j.micpath.2024.106769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/17/2024] [Accepted: 06/29/2024] [Indexed: 07/04/2024]
Abstract
The bacterium Escherichia coli is one of the main causes of urinary tract infections. The formation of bacterial biofilms, especially associated with the use of urinary catheters, contributes to the establishment of recurrent infections and the development of resistance to treatment. Strains of E. coli that produce extended-spectrum beta-lactamases (ESBL) have a greater ability to form biofilms. In addition, there is a lack of drugs available in the market with antibiofilm activity. Promethazine (PMZ) is an antihistamine known to have antimicrobial activity against different pathogens, including in the form of biofilms, but there are still few studies of its activity against ESBL E. coli biofilms. The aim of this study was to evaluate the antimicrobial activity of PMZ against ESBL E. coli biofilms, as well as to assess the application of this drug as a biofilm prevention agent in urinary catheters. To this end, the minimum inhibitory concentration and minimum bactericidal concentration of PMZ in ESBL E. coli strains were determined using the broth microdilution assay and tolerance level measurement. The activity of PMZ against the cell viability of the in vitro biofilm formation of ESBL E. coli was analyzed by the MTT colorimetric assay and its ability to prevent biofilm formation when impregnated in a urinary catheter was investigated by counting colony-forming units (CFU) and confirmed by scanning electron microscopy (SEM). PMZ showed bactericidal activity and significantly reduced (p < 0.05) the viability of the biofilm being formed by ESBL E. coli at concentrations of 256 and 512 μg/ml, as well as preventing the formation of biofilm on urinary catheters at concentrations starting at 512 μg/ml by reducing the number of CFUs, as also observed by SEM. Thus, PMZ is a promising candidate to prevent the formation of ESBL E. coli biofilms on abiotic surfaces.
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Affiliation(s)
- Cecília Rocha da Silva
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Vitória Pessoa de Farias Cabral
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Daniel Sampaio Rodrigues
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Thais Lima Ferreira
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Amanda Dias Barbosa
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - João Batista de Andrade Neto
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil; Christus University Center, Fortaleza, Ceará, Brazil
| | - Sarah Alves Barbosa
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Lara Elloyse Almeida Moreira
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Érica Rayanne Mota da Costa
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Elaine Aires de Lima
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Hélio Vitoriano Nobre Júnior
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Livia Gurgel do Amaral Valente Sá
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil; Christus University Center, Fortaleza, Ceará, Brazil.
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de Melo Guedes GM, Pereira VC, Freitas AS, Honório de Souza PR, Chacon Parra AL, Brasil JA, de Medeiros Guedes RF, Pereira de Sousa PC, de Aguiar Cordeiro R, Gadelha Rocha MF, Costa Sidrim JJ, de Souza Collares Maia Castelo Branco D. Repurposing approved drugs as potential efflux pump inhibitors in multidrug-resistant Pseudomonas aeruginosa. Future Microbiol 2024; 19:495-508. [PMID: 38629920 PMCID: PMC11216505 DOI: 10.2217/fmb-2023-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/22/2023] [Indexed: 06/27/2024] Open
Abstract
Aim: To evaluate the action of promethazine, fluoxetine and carbonyl cyanide 3-chlorophenylhydrazone as efflux pump inhibitors (EPIs) against multidrug-resistant Pseudomonas aeruginosa. Methods: The effect of the compounds was evaluated in planktonic cells and bacterial biofilms. Accumulation tests were performed with ethidium bromide to prove their action as EPIs. Then, they were associated with antimicrobials. Results: Effect on planktonic cells and biofilms was found. Assays with ethidium bromide indicate their action as EPIs. Significant reductions in the metabolic activity of biofilms were observed after the association with the antimicrobials, especially for meropenem. Conclusion: It is possible to prove the action of these compounds as EPIs for P. aeruginosa and demonstrate the relevance of efflux pumps in antimicrobial resistance.
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Affiliation(s)
- Gláucia Morgana de Melo Guedes
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Laboratory of Emerging and Reemerging Pathogens, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Vinicius Carvalho Pereira
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Alyne Soares Freitas
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Paulo Roberto Honório de Souza
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Aura Lucia Chacon Parra
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Jaiane Alves Brasil
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Rodrigo Fonseca de Medeiros Guedes
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | | | - Rossana de Aguiar Cordeiro
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Laboratory of Emerging and Reemerging Pathogens, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Marcos Fábio Gadelha Rocha
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Laboratory of Emerging and Reemerging Pathogens, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
- Postgraduate Program in Veterinary Sciences, School of Veterinary, State University of Ceará, Fortaleza, Ceará, 60714-903, Brazil
| | - José Júlio Costa Sidrim
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Laboratory of Emerging and Reemerging Pathogens, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
| | - Débora de Souza Collares Maia Castelo Branco
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
- Department of Pathology and Legal Medicine, Postgraduate Program in Medical Microbiology, Laboratory of Emerging and Reemerging Pathogens, Federal University of Ceará, Fortaleza, Ceará, 60430-275, Brazil
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Guedes GMDM, Freitas AS, Pinheiro RM, Pereira VC, Melgarejo CMA, de Araujo ES, Ribeiro KVC, Bandeira SP, Cordeiro RDA, Rocha MFG, Sidrim JJC, Castelo-Branco DDSCM. Antibiofilm activity of promethazine, deferiprone, and Manuka honey in an ex vivo wound model. Lett Appl Microbiol 2023; 76:ovad119. [PMID: 37791895 DOI: 10.1093/lambio/ovad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/08/2023] [Accepted: 10/02/2023] [Indexed: 10/05/2023]
Abstract
This study evaluated the antibiofilm activity of promethazine, deferiprone, and Manuka honey against Staphylococcus aureus and Pseudomonas aeruginosa in vitro and ex vivo in a wound model on porcine skin. The minimum inhibitory concentrations (MICs) and the effects of the compounds on biofilms were evaluated. Then, counting colony-forming units (CFUs) and confocal microscopy were performed on biofilms cultivated on porcine skin for evaluation of the compounds. For promethazine, MICs ranging from 97.66 to 781.25 µg/ml and minimum biofilm eradication concentration (MBEC) values ranging from 195.31 to 1562.5 µg/ml were found. In addition to reducing the biomass of both species' biofilms. As for deferiprone, the MICs were 512 and >1024 µg/ml, the MBECs were ≥1024 µg/ml, and it reduced the biomass of biofilms. Manuka honey had MICs of 10%-40%, MBECs of 20 to >40% and reduced the biomass of S. aureus biofilms only. Concerning the analyses in the ex vivo model, the compounds reduced (P < .05) CFU counts for both bacterial species, altering the biofilm architecture. The action of the compounds on biofilms in in vitro and ex vivo tests raises the possibility of using them against biofilm-associated wounds. However, further studies are needed to characterize the mechanisms of action and their effectiveness on biofilms in vivo.
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Affiliation(s)
- Gláucia Morgana de Melo Guedes
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Alyne Soares Freitas
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Rodrigo Machado Pinheiro
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Vinicius Carvalho Pereira
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Carliane Melo Alves Melgarejo
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Emanuela Silva de Araujo
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Késia Veras Costa Ribeiro
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Silviane Praciano Bandeira
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Rossana de Aguiar Cordeiro
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Marcos Fábio Gadelha Rocha
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
- Postgraduate Program in Veterinary Sciences, School of Veterinary, State University of Ceará, Avenida Dr. Silas Munguba, 1700 - Itaperi - CEP 60714-903, Fortaleza, Ceará, Brazil
| | - José Júlio Costa Sidrim
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Débora de Souza Collares Maia Castelo-Branco
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
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Zulkipli M, Mahbub N, Fatima A, Wan-Lin SL, Khoo TJ, Mahboob T, Rajagopal M, Samudi C, Kathirvalu G, Abdullah NH, Pinho AR, Oliveira SMR, Pereira MDL, Rahmatullah M, Hasan A, Paul AK, Butler MS, Nawaz M, Wilairatana P, Nissapatorn V, Wiart C. Isolation and Characterization of Werneria Chromene and Dihydroxyacidissimol from Burkillanthus malaccensis (Ridl.) Swingle. PLANTS (BASEL, SWITZERLAND) 2022; 11:1388. [PMID: 35684161 PMCID: PMC9182682 DOI: 10.3390/plants11111388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
The secondary metabolites of endemic plants from the Rutaceae family, such as Burkillanthusmalaccensis (Ridl.) Swingle from the rainforest of Malaysia, has not been studied. Burkillanthusmalaccensis (Ridl.) Swingle may produce antibacterial and antibiotic-potentiating secondary metabolites. Hexane, chloroform, and methanol extracts of leaves, bark, wood, pericarps, and endocarps were tested against bacteria by broth microdilution assay and their antibiotic-potentiating activities. Chromatographic separations of hexane extracts of seeds were conducted to investigate effective phytochemicals and their antibacterial activities. Molecular docking studies of werneria chromene and dihydroxyacidissiminol against SARS-CoV-2 virus infection were conducted using AutoDock Vina. The methanol extract of bark inhibited the growth of Staphylococcusaureus, Escherichiacoli, and Pseudomonasaeruginosa with the minimum inhibitory concentration of 250, 500, and 250 µg/mL, respectively. The chloroform extract of endocarps potentiated the activity of imipenem against imipenem-resistant Acinetobacterbaumannii. The hexane extract of seeds increased the sensitivity of P. aeruginosa against ciprofloxacin and levofloxacin. The hexane extract of seeds and chloroform extract of endocarps were chromatographed, yielding werneria chromene and dihydroxyacidissiminol. Werneria chromene was bacteriostatic for P.aeruginosa and P.putida, with MIC/MBC values of 1000 > 1000 µg/mL. Dihydroxyacidissiminol showed the predicted binding energies of −8.1, −7.6, −7.0, and −7.5 kcal/mol with cathepsin L, nsp13 helicase, SARS-CoV-2 main protease, and SARS-CoV-2 spike protein receptor-binding domain S-RBD. Burkillanthusmalaccensis (Ridl.) Swingle can be a potential source of natural products with antibiotic-potentiating activity and that are anti-SARS-CoV-2.
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Affiliation(s)
- Masyitah Zulkipli
- School of Pharmacy, University of Nottingham Malaysia Campus, Semenyih 43500, Malaysia; (M.Z.); (N.M.); (S.L.W.-L.); (T.-J.K.)
| | - Nuzum Mahbub
- School of Pharmacy, University of Nottingham Malaysia Campus, Semenyih 43500, Malaysia; (M.Z.); (N.M.); (S.L.W.-L.); (T.-J.K.)
| | - Ayesha Fatima
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakif University, Istanbul 34093, Turkey;
| | - Stefanie Lim Wan-Lin
- School of Pharmacy, University of Nottingham Malaysia Campus, Semenyih 43500, Malaysia; (M.Z.); (N.M.); (S.L.W.-L.); (T.-J.K.)
| | - Teng-Jin Khoo
- School of Pharmacy, University of Nottingham Malaysia Campus, Semenyih 43500, Malaysia; (M.Z.); (N.M.); (S.L.W.-L.); (T.-J.K.)
| | - Tooba Mahboob
- Department of Medical Microbiology, University of Malaya, Kuala Lumpur 50603, Malaysia; (T.M.); (C.S.); (G.K.)
| | - Mogana Rajagopal
- Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur 56000, Malaysia;
| | - Chandramathi Samudi
- Department of Medical Microbiology, University of Malaya, Kuala Lumpur 50603, Malaysia; (T.M.); (C.S.); (G.K.)
| | - Gheetanjali Kathirvalu
- Department of Medical Microbiology, University of Malaya, Kuala Lumpur 50603, Malaysia; (T.M.); (C.S.); (G.K.)
| | - Nor Hayati Abdullah
- Natural Product Division, Forest Research Institute Malaysia (FRIM), Kepong 52109, Malaysia;
| | - Ana Rita Pinho
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (A.R.P.); (M.d.L.P.)
- Neuroscience and Signaling Laboratory, Institute of Biomedicine-IBIMED, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Sonia M. R. Oliveira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal;
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
| | - Maria de Lourdes Pereira
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal; (A.R.P.); (M.d.L.P.)
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Mohammed Rahmatullah
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka 1207, Bangladesh; (M.R.); (A.H.)
| | - Anamul Hasan
- Department of Biotechnology & Genetic Engineering, University of Development Alternative, Lalmatia, Dhaka 1207, Bangladesh; (M.R.); (A.H.)
| | - Alok K. Paul
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7001, Australia;
| | - Mark S. Butler
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD 4072, Australia;
| | - Muhammad Nawaz
- Department of Nano-Medicine, Institute for Research and Medical Consultations (IRM), Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Veeranoot Nissapatorn
- School of Allied Health Sciences, World Union for Herbal Drug Discovery (WUHeDD), Research Excellence Center for Innovation and Health Products (RECIHP), Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Christophe Wiart
- Institute for Tropical Biology and Conservation, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Malaysia
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Targeting bioenergetics is key to counteracting the drug-tolerant state of biofilm-grown bacteria. PLoS Pathog 2020; 16:e1009126. [PMID: 33351859 PMCID: PMC7787680 DOI: 10.1371/journal.ppat.1009126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/06/2021] [Accepted: 11/05/2020] [Indexed: 12/30/2022] Open
Abstract
Embedded in an extracellular matrix, biofilm-residing bacteria are protected from diverse physicochemical insults. In accordance, in the human host the general recalcitrance of biofilm-grown bacteria hinders successful eradication of chronic, biofilm-associated infections. In this study, we demonstrate that upon addition of promethazine, an FDA approved drug, antibiotic tolerance of in vitro biofilm-grown bacteria can be abolished. We show that following the addition of promethazine, diverse antibiotics are capable of efficiently killing biofilm-residing cells at minimal inhibitory concentrations. Synergistic effects could also be observed in a murine in vivo model system. PMZ was shown to increase membrane potential and interfere with bacterial respiration. Of note, antibiotic killing activity was elevated when PMZ was added to cells grown under environmental conditions that induce low intracellular proton levels. Our results imply that biofilm-grown bacteria avoid antibiotic killing and become tolerant by counteracting intracellular alkalization through the adaptation of metabolic and transport functions. Abrogation of antibiotic tolerance by interfering with the cell’s bioenergetics promises to pave the way for successful eradication of biofilm-associated infections. Repurposing promethazine as a biofilm-sensitizing drug has the potential to accelerate the introduction of new treatments for recalcitrant, biofilm-associated infections into the clinic. At sub-minimal inhibitory concentrations, phenothiazines have been shown to inhibit virulence as well as the formation of biofilms in a wide range of different bacterial pathogens. In this study, we analyzed the anti-bacterial effect of the FDA-approved drug, promethazine, on biofilm-grown Pseudomonas aeruginosa. We demonstrate that PMZ interferes with bacterial bioenergetics and sensitizes biofilm-grown P. aeruginosa cells to bactericidal activity of several different classes of antibiotics by several orders of magnitude. This effect was most pronounced when cells were grown under environmental conditions that induce low intracellular proton levels. Thus, it seems that a reduced proton efflux in cells that exhibit decreased respiratory activity due to their biofilm mode of growth might explain their general antimicrobial tolerance. The use of PMZ as an antibiotic sensitizer holds promise that targeting tolerance mechanisms of biofilm-grown bacteria could become a practicable way to change the way physicians treat biofilm-associated infections.
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Mechanistic Understanding Enables the Rational Design of Salicylanilide Combination Therapies for Gram-Negative Infections. mBio 2020; 11:mBio.02068-20. [PMID: 32934086 PMCID: PMC7492738 DOI: 10.1128/mbio.02068-20] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
There is a critical need for more-effective treatments to combat multidrug-resistant Gram-negative infections. Combination therapies are a promising strategy, especially when these enable existing clinical drugs to be repurposed as antibiotics. We examined the mechanisms of action and basis of innate Gram-negative resistance for the anthelmintic drug niclosamide and subsequently exploited this information to demonstrate that niclosamide and analogs kill Gram-negative bacteria when combined with antibiotics that inhibit drug efflux or permeabilize membranes. We confirm the synergistic potential of niclosamide in vitro against a diverse range of recalcitrant Gram-negative clinical isolates and in vivo in a mouse abscess model. We also demonstrate that nitroreductases can confer resistance to niclosamide but show that evolution of these enzymes for enhanced niclosamide resistance confers a collateral sensitivity to other clinical antibiotics. Our results highlight how detailed mechanistic understanding can accelerate the evaluation and implementation of new combination therapies. One avenue to combat multidrug-resistant Gram-negative bacteria is the coadministration of multiple drugs (combination therapy), which can be particularly promising if drugs synergize. The identification of synergistic drug combinations, however, is challenging. Detailed understanding of antibiotic mechanisms can address this issue by facilitating the rational design of improved combination therapies. Here, using diverse biochemical and genetic assays, we examine the molecular mechanisms of niclosamide, a clinically approved salicylanilide compound, and demonstrate its potential for Gram-negative combination therapies. We discovered that Gram-negative bacteria possess two innate resistance mechanisms that reduce their niclosamide susceptibility: a primary mechanism mediated by multidrug efflux pumps and a secondary mechanism of nitroreduction. When efflux was compromised, niclosamide became a potent antibiotic, dissipating the proton motive force (PMF), increasing oxidative stress, and reducing ATP production to cause cell death. These insights guided the identification of diverse compounds that synergized with salicylanilides when coadministered (efflux inhibitors, membrane permeabilizers, and antibiotics that are expelled by PMF-dependent efflux), thus suggesting that salicylanilide compounds may have broad utility in combination therapies. We validate these findings in vivo using a murine abscess model, where we show that niclosamide synergizes with the membrane permeabilizing antibiotic colistin against high-density infections of multidrug-resistant Gram-negative clinical isolates. We further demonstrate that enhanced nitroreductase activity is a potential route to adaptive niclosamide resistance but show that this causes collateral susceptibility to clinical nitro-prodrug antibiotics. Thus, we highlight how mechanistic understanding of mode of action, innate/adaptive resistance, and synergy can rationally guide the discovery, development, and stewardship of novel combination therapies.
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Coussens NP, Molinaro AL, Culbertson KJ, Peryea T, Zahoránszky-Köhalmi G, Hall MD, Daines DA. Better living through chemistry: Addressing emerging antibiotic resistance. Exp Biol Med (Maywood) 2018; 243:538-553. [PMID: 29409348 PMCID: PMC5882019 DOI: 10.1177/1535370218755659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The increasing emergence of multidrug-resistant bacteria is recognized as a major threat to human health worldwide. While the use of small molecule antibiotics has enabled many modern medical advances, it has also facilitated the development of resistant organisms. This minireview provides an overview of current small molecule drugs approved by the US Food and Drug Administration (FDA) for use in humans, the unintended consequences of antibiotic use, and the mechanisms that underlie the development of drug resistance. Promising new approaches and strategies to counter antibiotic-resistant bacteria with small molecules are highlighted. However, continued public investment in this area is critical to maintain an edge in our evolutionary "arms race" against antibiotic-resistant microorganisms. Impact statement The alarming increase in antibiotic-resistant microorganisms is a rapidly emerging threat to human health throughout the world. Historically, small molecule drugs have played a major role in controlling bacterial infections and they continue to offer tremendous potential in countering resistant organisms. This minireview provides a broad overview of the relevant issues, including the diversity of FDA-approved small molecule drugs and mechanisms of drug resistance, unintended consequences of antibiotic use, the current state of development for small molecule antibacterials and financial challenges that impact progress towards novel therapies. The content will be informative to diverse stakeholders, including clinicians, basic scientists, translational scientists and policy makers, and may be used as a bridge between these key players to advance the development of much-needed therapeutics.
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Affiliation(s)
- Nathan P Coussens
- National Center for Advancing Translational Sciences, Division of Pre-Clinical Innovation, Rockville, MD 20850, USA
| | - Ashley L Molinaro
- Department of Biological Sciences, Old Dominion University, Norfolk, VA 23529, USA
| | - Kayla J Culbertson
- Department of Biological Sciences, Old Dominion University, Norfolk, VA 23529, USA
| | - Tyler Peryea
- National Center for Advancing Translational Sciences, Division of Pre-Clinical Innovation, Rockville, MD 20850, USA
| | - Gergely Zahoránszky-Köhalmi
- National Center for Advancing Translational Sciences, Division of Pre-Clinical Innovation, Rockville, MD 20850, USA
| | - Matthew D Hall
- National Center for Advancing Translational Sciences, Division of Pre-Clinical Innovation, Rockville, MD 20850, USA
| | - Dayle A Daines
- Department of Biological Sciences, Old Dominion University, Norfolk, VA 23529, USA
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Zacchino SA, Butassi E, Liberto MD, Raimondi M, Postigo A, Sortino M. Plant phenolics and terpenoids as adjuvants of antibacterial and antifungal drugs. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2017; 37:27-48. [PMID: 29174958 DOI: 10.1016/j.phymed.2017.10.018] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 10/30/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND The intensive use of antibacterial and antifungal drugs has dramatically increased the microbial resistance and has led to a higher number of difficult-to-eradicate infections. Combination therapy with two or more antimicrobial drugs has emerged some years ago to overcome the issue, but it has proven to be not completely effective. Natural secondary metabolites of MW ≤ 500 represent promising adjuvants for antimicrobials and have been the object of several researches that have increased in the last two decades. PURPOSE The purpose of this Review is to do a literature search of the natural compounds that showed high enhancing capacity of antibacterials' and antifungals' effects against planktonic bacteria and fungi and to analyze which are the natural products most used in combination with a focus on polyphenols and terpenoids. RESULTS One hundred of papers were collected for reviewing. Fifty six (56) of them deal with combinations of low MW natural products with antibacterial drugs against planktonic bacteria and forty four (44) on natural products with antifungal drugs against planktonic fungi. Of the antibacterial adjuvants, 41 (73%) were either polyphenols (27; 48%) or terpenes (14; 25%). The remaining 15 papers (27%), deal with different class of natural products. Since most natural potentiators belong to the terpene or phenolic structural types, a more detailed description of the works dealing with these type of compounds is provided here. Bacterial and fungal resistance mechanisms, the modes of action of the main classes of antibacterial and antifungal drugs and the methodologies most used to assess the type of interactions in the combinations were included in the Review too. CONCLUSIONS AND PERSPECTIVES Several promising results on the potentiation effects of antifungals' and antibacterials' activities by low MW natural products mainly on polyphenols and terpenes were reported in the literature and, in spite of that most works included only in vitro assays, this knowledge opens a wide range of possibilities for the combination antimicrobial therapy. Further research including in vivo assays and clinical trials are required to determine the relevance of these antimicrobial enhancers in the clinical area and should be the focus of future studies in order to develop new antimicrobial combination agents that overpass the drawbacks of the existing antibiotics and antifungals in clinical use.
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Affiliation(s)
- Susana A Zacchino
- Área Farmacognosia, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, Rosario 2000, Argentina.
| | - Estefania Butassi
- Área Farmacognosia, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, Rosario 2000, Argentina
| | - Melina Di Liberto
- Área Farmacognosia, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, Rosario 2000, Argentina
| | - Marcela Raimondi
- Area Microbiología, Facultad de Cs. Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Rosario 2000, Argentina
| | - Agustina Postigo
- Área Farmacognosia, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, Rosario 2000, Argentina
| | - Maximiliano Sortino
- Área Farmacognosia, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, Rosario 2000, Argentina; Área Micología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, Rosario 2000, Argentina
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Thai KM, Do TN, Nguyen TVP, Nguyen DKT, Tran TD. QSAR Studies on Bacterial Efflux Pump Inhibitors. PHARMACEUTICAL SCIENCES 2017. [DOI: 10.4018/978-1-5225-1762-7.ch035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Antimicrobial drug resistance occurs when bacteria undergo certain modifications to eliminate the effectiveness of drugs, chemicals, or other agents designed to cure infections. To date, the burden of resistance has remained one of the major clinical concerns as it renders prolonged and complicated treatments, thereby increasing the medical costs with lengthier hospital stays. Of complex causes for bacterial resistance, there has been increasing evidence that proved the significant role of efflux pumps in antibiotic resistance. Coadministration of Efflux Pump Inhibitors (EPIs) with antibiotics has been considered one of the promising ways not only to improve the efficacy but also to extend the clinical utility of existing antibiotics. This chapter begins with outlining current knowledge about bacterial efflux pumps and drug designs applied in identification of their modulating compounds. Following, the chapter addresses and provides a discussion on Quantitative Structure-Activity Relationship (QSAR) analyses in search of novel and potent efflux pump inhibitors.
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Affiliation(s)
| | - Trong-Nhat Do
- University of Medicine and Pharmacy at HCMC, Vietnam
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Thai KM, Do TN, Nguyen TVP, Nguyen DKT, Tran TD. QSAR Studies on Bacterial Efflux Pump Inhibitors. ACTA ACUST UNITED AC 2015. [DOI: 10.4018/978-1-4666-8136-1.ch007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Antimicrobial drug resistance occurs when bacteria undergo certain modifications to eliminate the effectiveness of drugs, chemicals, or other agents designed to cure infections. To date, the burden of resistance has remained one of the major clinical concerns as it renders prolonged and complicated treatments, thereby increasing the medical costs with lengthier hospital stays. Of complex causes for bacterial resistance, there has been increasing evidence that proved the significant role of efflux pumps in antibiotic resistance. Coadministration of Efflux Pump Inhibitors (EPIs) with antibiotics has been considered one of the promising ways not only to improve the efficacy but also to extend the clinical utility of existing antibiotics. This chapter begins with outlining current knowledge about bacterial efflux pumps and drug designs applied in identification of their modulating compounds. Following, the chapter addresses and provides a discussion on Quantitative Structure-Activity Relationship (QSAR) analyses in search of novel and potent efflux pump inhibitors.
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Affiliation(s)
| | - Trong-Nhat Do
- University of Medicine and Pharmacy at HCMC, Vietnam
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Deng Y, Lim A, Lee J, Chen S, An S, Dong YH, Zhang LH. Diffusible signal factor (DSF) quorum sensing signal and structurally related molecules enhance the antimicrobial efficacy of antibiotics against some bacterial pathogens. BMC Microbiol 2014; 14:51. [PMID: 24575808 PMCID: PMC3941561 DOI: 10.1186/1471-2180-14-51] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 02/21/2014] [Indexed: 12/04/2022] Open
Abstract
Background Extensive use of antibiotics has fostered the emergence of superbugs that are resistant to multidrugs, which becomes a great healthcare and public concern. Previous studies showed that quorum sensing signal DSF (diffusible signal factor) not only modulates bacterial antibiotic resistance through intraspecies signaling, but also affects bacterial antibiotic tolerance through interspecies communication. These findings motivate us to exploit the possibility of using DSF and its structurally related molecules as adjuvants to influence antibiotic susceptibility of bacterial pathogens. Results In this study, we have demonstrated that DSF signal and its structurally related molecules could be used to induce bacterial antibiotic susceptibility. Exogenous addition of DSF signal (cis-11-methyl-2-dodecenoic acid) and its structural analogues could significantly increase the antibiotic susceptibility of Bacillus cereus, possibly through reducing drug-resistant activity, biofilm formation and bacterial fitness. The synergistic effect of DSF and its structurally related molecules with antibiotics on B. cereus is dosage-dependent. Combination of DSF with gentamicin showed an obviously synergistic effect on B. cereus pathogenicity in an in vitro model. We also found that DSF could increase the antibiotic susceptibility of other bacterial species, including Bacillus thuringiensis, Staphylococcus aureus, Mycobacterium smegmatis, Neisseria subflava and Pseudomonas aeruginosa. Conclusion The results indicate a promising potential of using DSF and its structurally related molecules as novel adjuvants to conventional antibiotics for treatment of infectious diseases caused by bacterial pathogens.
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Affiliation(s)
| | | | | | | | | | | | - Lian-Hui Zhang
- Institute of Molecular and Cell Biology, Proteos, 61 Biopolis Drive, Singapore 138673, Singapore.
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Langeveld WT, Veldhuizen EJA, Burt SA. Synergy between essential oil components and antibiotics: a review. Crit Rev Microbiol 2013; 40:76-94. [DOI: 10.3109/1040841x.2013.763219] [Citation(s) in RCA: 303] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
Efflux pump mechanisms perform important physiological functions such as prevention of toxin absorption from the gastrointestinal tract, elimination of bile from the hepatocytes, effective functioning of the blood-brain barrier and placental barrier, and renal excretion of drugs. They exist in all living cells, but those in the bacterial and mammalian cells are more important to the clinician and pharmacologist, as they constitute an important cause of antimicrobial drug resistance, which contributes to treatment failure, high medical bills, and increased mortality / morbidity. This review was aimed at highlighting the role of efflux pump mechanisms in microbial resistance to chemotherapeutic agents. It was also aimed to elucidate their structure and mechanisms of action so as to integrate the efflux pump mechanisms in the design and development of novel antimicrobial agents. Findings from previous studies and research on this subject assessed through Google search, Pubmed, Hinari websites, as well as standard textbooks on chemotherapy, provided the needed information in the process of this review. Efflux pump inhibitors are promising strategies for preventing and reverting efflux-mediated resistance to chemotherapeutic agents. They are usually employed as adjuncts in antimicrobial and cancer chemotherapy. Toxicity, more common with the older-generation inhibitors such as verapamil and reserpine, constitutes the greatest impediment to their clinical applications. No efflux pump inhibitor has been approved for routine clinical use, as a result of doubtful clinical efficacy and unacceptably high incidence of adverse effects, particularly inhibition of the P-450 drug metabolizing enzyme. At present, their applications are mainly restricted to epidemiological studies. Nonetheless, the search for efficacious and tolerable efflux pump inhibitors continues because of the potential benefits. There is a need to consider efflux pump substrate selectivity in the design and development of novel chemotherapeutic agents.
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Affiliation(s)
- Po Ughachukwu
- Department of Pharmacology and Therapeutics, College of Medicine, Anambra State University, Awka Campus, Anambra, Nigeria
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Worthington RJ, Melander C. Combination approaches to combat multidrug-resistant bacteria. Trends Biotechnol 2013; 31:177-84. [PMID: 23333434 DOI: 10.1016/j.tibtech.2012.12.006] [Citation(s) in RCA: 384] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 12/17/2012] [Accepted: 12/19/2012] [Indexed: 12/19/2022]
Abstract
The increasing prevalence of infections caused by multidrug-resistant bacteria is a global health problem that has been exacerbated by the dearth of novel classes of antibiotics entering the clinic over the past 40 years. Herein, we describe recent developments toward combination therapies for the treatment of multidrug-resistant bacterial infections. These efforts include antibiotic-antibiotic combinations, and the development of adjuvants that either directly target resistance mechanisms such as the inhibition of β-lactamase enzymes, or indirectly target resistance by interfering with bacterial signaling pathways such as two-component systems (TCSs). We also discuss screening of libraries of previously approved drugs to identify nonobvious antimicrobial adjuvants.
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Atosuo J, Lehtinen J, Vojtek L, Lilius EM. Escherichia coli K-12 (pEGFPluxABCDEamp): a tool for analysis of bacterial killing by antibacterial agents and human complement activities on a real-time basis. LUMINESCENCE 2012; 28:771-9. [PMID: 23129448 DOI: 10.1002/bio.2435] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 08/14/2012] [Accepted: 08/14/2012] [Indexed: 11/08/2022]
Abstract
Photorhabdus luminescens luxCDABE genes were integrated into E. coli K-12 using a high copy number plasmid containing modified luxABCDE genes under the control of the powerful Lac promoter. This strain emitted 10 times higher bioluminescence (BL) than P. luminescens. BL production under different growth conditions was studied. In both bacterial strains, the increase in BL signal correlated with the increase in optical density (OD) in a rich growth medium. However, at the logarithmic growth phase, the BL signal was roughly constant. By contrast, in minimal growth media, there was no substantial growth and the BL/cell was approximately five times higher than in the rich medium. The dynamic measurement range of BL was 10(2) -10(7) colony-forming units (CFU) in E. coli and 10(3) -10(7) CFU in P. luminescens. Because the decrease in the BL signal correlated with the decrease in CFU and OD, i.e. the number of bacterial cells killed, it proved to be very suitable for assessing the antibacterial effects of different antimicrobial agents. Unlike with plate counting, the kinetics of killing can be monitored on a real-time basis using BL measurements. Complement activities in different samples can be estimated using only one serum dilution. The transformed E. coli strain appeared to be superior to P. luminescens in these applications because E. coli was complement sensitive, the detection limit of E. coli was one order lower and the BL-producing system of P. luminescens appeared to be quite unstable.
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Affiliation(s)
- Janne Atosuo
- Department of Biochemistry and Food Chemistry, The University of Turku, Turku, Finland
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Evidence of significant synergism between antibiotics and the antipsychotic, antimicrobial drug flupenthixol. Eur J Clin Microbiol Infect Dis 2011; 31:1243-50. [PMID: 21997771 DOI: 10.1007/s10096-011-1435-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 09/20/2011] [Indexed: 10/16/2022]
Abstract
Previously, the antipsychotic, non-antibiotic compound flupenthixol dihydrochloride (Fp) was shown to exhibit distinct in vitro antibacterial activity against Gram-positive and Gram-negative bacteria and to significantly protect Swiss albino mice challenged with a known mouse virulent salmonella. The present study was designed to ascertain whether this drug could efficiently augment the action of an antibiotic or a non-antibiotic when tested in combination. A total of 12 bacterial strains belonging to various genera were selected for this study and were sensitive to the antibiotics penicillin (Pc), ampicillin, chloramphenicol, tetracycline, streptomycin, gentamicin, erythromycin, ciprofloxacin, and to the non-antibiotics methdilazine, triflupromazine, promethazine, and Fp. Pronounced and statistically significant synergism (p < 0.01) was observed when Fp was combined with Pc following the disc diffusion assay system. With the help of the checkerboard method, the fractional inhibitory concentration (FIC) index of this pair was found to be 0.375, confirming synergism. This pair of Fp+ Pc was then subjected to in vivo experiments in mice challenged with Salmonella enterica serovar Typhimurium NCTC 74. Statistical analysis of the mouse protection test suggested that this combination was highly synergistic (p < 0.001, Chi-squared analysis). Fp also revealed augmentation of its antimicrobial property when combined with streptomycin, gentamicin, ciprofloxacin, and the non-antibiotic methdilazine. The results of this study may provide alternatives for the therapy of problematic infections such as those associated with Salmonella spp.
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Combinations of antibiotics and nonantibiotic drugs enhance antimicrobial efficacy. Nat Chem Biol 2011; 7:348-50. [PMID: 21516114 DOI: 10.1038/nchembio.559] [Citation(s) in RCA: 377] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 02/10/2011] [Indexed: 11/08/2022]
Abstract
Combinations of antibiotics are commonly used in medicine to broaden antimicrobial spectrum and generate synergistic effects. Alternatively, combination of nonantibiotic drugs with antibiotics offers an opportunity to sample a previously untapped expanse of bioactive chemical space. We screened a collection of drugs to identify compounds that augment the activity of the antibiotic minocycline. Unexpected synergistic drug combinations exhibited in vitro and in vivo activity against bacterial pathogens, including multidrug-resistant isolates.
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Potential role of non-antibiotics (helper compounds) in the treatment of multidrug-resistant Gram-negative infections: mechanisms for their direct and indirect activities. Int J Antimicrob Agents 2008; 31:198-208. [DOI: 10.1016/j.ijantimicag.2007.10.025] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2007] [Accepted: 10/25/2007] [Indexed: 11/17/2022]
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Gould IM. Antimicrobials: an endangered species? Int J Antimicrob Agents 2007; 30:383-4. [PMID: 17825532 DOI: 10.1016/j.ijantimicag.2007.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Accepted: 07/10/2007] [Indexed: 11/16/2022]
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