1
|
Ramirez DM, Dhiman S, Mukherjee A, Wimalasekara R, Schweizer F. Application of tobramycin benzyl ether as an antibiotic adjuvant capable of sensitizing multidrug-resistant Gram-negative bacteria to rifampicin. RSC Med Chem 2024; 15:1055-1065. [PMID: 38516601 PMCID: PMC10953491 DOI: 10.1039/d3md00602f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
The emergence of aminoglycoside resistance has prompted the development of amphiphilic aminoglycoside derivatives which target bacterial membranes. Tobramycin and nebramine ether derivatives initially designed for this purpose were optimized and screened for their potential application as outer membrane (OM) permeabilizing adjuvants. Structure-activity relationship (SAR) studies revealed that the tobramycin benzyl ether was the most optimal OM permeabilizer, capable of potentiating rifampicin, novobiocin, vancomycin, minocycline, and doxycycline against Gram-negative bacteria. The innovative use of this compound as an adjuvant is highlighted by its ability to sensitize multidrug-resistant (MDR) Gram-negative bacteria to rifampicin and restore the susceptibility of MDR Escherichia coli to minocycline.
Collapse
Affiliation(s)
| | - Shiv Dhiman
- Department of Chemistry, University of Manitoba Winnipeg MB R3T 2N2 Canada
| | - Ayan Mukherjee
- Department of Chemistry, University of Manitoba Winnipeg MB R3T 2N2 Canada
| | - Ruwani Wimalasekara
- Department of Microbiology, University of Manitoba Winnipeg MB R3T 2N2 Canada
| | - Frank Schweizer
- Department of Chemistry, University of Manitoba Winnipeg MB R3T 2N2 Canada
| |
Collapse
|
2
|
Lin IF, Lai CH, Lin SY, Lee CC, Lee NY, Liu PY, Yang CH, Huang YH, Lin JN. In Vitro and In Vivo Antimicrobial Activities of Vancomycin and Rifampin against Elizabethkingia anophelis. Int J Mol Sci 2023; 24:17012. [PMID: 38069334 PMCID: PMC10707518 DOI: 10.3390/ijms242317012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
Elizabethkingia anophelis has emerged as a critical human pathogen, and a number of isolated reports have described the successful treatment of Elizabethkingia infections with vancomycin, a drug that is typically used to target Gram-positive bacteria. This study employed in vitro broth microdilution checkerboard and time-kill assays, as well as in vivo zebrafish animal models to evaluate the individual and combination antimicrobial effects of vancomycin and rifampin against E. anophelis. The minimum inhibitory concentration ranges of vancomycin and rifampin against 167 isolates of E. anophelis were 16-256 mg/L and 0.06-128 mg/L, respectively. The checkerboard assay results revealed a synergistic effect between vancomycin and rifampin in 16.8% (28/167) of the isolates. Time-kill assays were implemented for 66 isolates, and the two-drug combination had a synergistic interaction in 57 (86.4%) isolates. In vivo zebrafish studies revealed that treatment with vancomycin monotherapy, rifampin monotherapy, or vancomycin-rifampin combination therapy yielded a higher survival rate than the control group treatment with 0.9% saline. The results of this study support the use of vancomycin to treat E. anophelis infections.
Collapse
Affiliation(s)
- I-Fan Lin
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (I.-F.L.)
| | - Chung-Hsu Lai
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (I.-F.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Shang-Yi Lin
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Ching-Chi Lee
- Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
| | - Nan-Yao Lee
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan;
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Po-Yu Liu
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan;
| | - Chih-Hui Yang
- Department of Biological Science and Technology, Meiho University, Pingtung 912, Taiwan
| | - Yi-Han Huang
- Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan
| | - Jiun-Nong Lin
- Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan; (I.-F.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan
- Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan
| |
Collapse
|
3
|
Chatupheeraphat C, Peamchai J, Luk-in S, Yainoy S, Eiamphungporn W. Synergistic effect of two antimicrobial peptides, BP203 and MAP-0403 J-2 with conventional antibiotics against colistin-resistant Escherichia coli and Klebsiella pneumoniae clinical isolates. PLoS One 2023; 18:e0294287. [PMID: 37972089 PMCID: PMC10653547 DOI: 10.1371/journal.pone.0294287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023] Open
Abstract
Drug-resistant Enterobacterales infections are a great health concern due to the lack of effective treatments. Consequently, finding novel antimicrobials or combining therapies becomes a crucial approach in addressing this problem. BP203 and MAP-0403 J-2, novel antimicrobial peptides, have exhibited effectiveness against Gram-negative bacteria. In this study, we assessed the in vitro antibacterial activity of BP203 and MAP-0403 J-2, along with their synergistic interaction with conventional antibiotics including colistin, rifampicin, chloramphenicol, ceftazidime, meropenem, and ciprofloxacin against colistin-resistant Escherichia coli and Klebsiella pneumoniae clinical isolates. The minimal inhibitory concentrations (MIC) of BP203 and MAP-0403 J-2 against tested E. coli isolates were 2-16 and 8-32 μg/mL, respectively. However, for the majority of K. pneumoniae isolates, the MIC of BP203 and MAP-0403 J-2 were >128 μg/mL. Notably, our results demonstrated a synergistic effect when combining BP203 with rifampicin, meropenem, or chloramphenicol, primarily observed in most K. pneumoniae isolates. In contrast, no synergism was evident between BP203 and colistin, chloramphenicol, ceftazidime, rifampicin, or ciprofloxacin when tested against all E. coli isolates. Furthermore, synergistic effects between MAP-0403 J-2 and rifampicin, ceftazidime or colistin were observed against the majority of E. coli isolates. Similarly, the combined effect of MAP-0403 J-2 with rifampicin or chloramphenicol was synergistic in the majority of K. pneumoniae isolates. Importantly, these peptides displayed the stability at high temperatures, across a wide range of pH values, in specific serum concentrations and under physiological salt conditions. Both peptides also showed no significant hemolysis and cytotoxicity against mammalian cells. Our findings suggested that BP203 and MAP-0403 J-2 are promising candidates against colistin-resistant E. coli. Meanwhile, the synergism of these peptides and certain antibiotics could be of great therapeutic value as antimicrobial drugs against infections caused by colistin-resistant E. coli and K. pneumoniae.
Collapse
Affiliation(s)
- Chawalit Chatupheeraphat
- Center for Research Innovation and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Jiratchaya Peamchai
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Sirirat Luk-in
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Sakda Yainoy
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| | - Warawan Eiamphungporn
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand
| |
Collapse
|
4
|
Gruppuso M, Turco G, Marsich E, Porrelli D. Antibacterial and bioactive multilayer electrospun wound dressings based on hyaluronic acid and lactose-modified chitosan. BIOMATERIALS ADVANCES 2023; 154:213613. [PMID: 37666062 DOI: 10.1016/j.bioadv.2023.213613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/11/2023] [Accepted: 08/26/2023] [Indexed: 09/06/2023]
Abstract
Antibacterial multilayer electrospun matrices based on hyaluronic acid (HA) and a lactose-modified chitosan (CTL) were synthetized (i) by combining electrospun polycaprolactone (PCL) and polysaccharidic matrices in a bilayer device and (ii) by sequentially coating the PCL mat with CTL and HA. In both cases, the antibacterial activity was provided by loading rifampicin within the PCL support. All matrices disclosed suitable morphology and physicochemical properties to be employed as wound dressings. Indeed, both the bilayer and coated fibers showed an optimal swelling capacity (3426 ± 492 % and 1435 ± 251 % after 7 days, respectively) and water vapor permeability (160 ± 0.78 g/m2h and 170 ± 12 g/m2h at 7 days, respectively). On the other hand, the polysaccharidic dressings were completely wettable in the presence of various types of fluids. Depending on the preparation method, a different release of both polysaccharides and rifampicin was detected, and the immediate polysaccharide dissolution from the bilayer structure impacted the antibiotic release (42 ± 4 % from the bilayer structure against 25 ± 2 % from the coated fibers in 4 h). All the multilayer matrices, regardless of their production strategy and composition, revealed optimal biocompatibility and bioactivity with human dermal fibroblasts, as the released bioactive polysaccharides induced a faster wound closure in the cell monolayer (100 % in 24 h) compared to the controls (78 ± 8 % for untreated cells and 89 ± 5 % for cells treated with PCL alone, after 24 h). The inhibitory and bactericidal effects of the rifampicin loaded matrices were assessed on S. aureus, S. epidermidis, E. coli, and P. aeruginosa. The antibacterial matrices were found to be highly effective except for E. coli, which was more resistant even at higher amounts of rifampicin, with a bacterial concentration of 6.4 ± 0.4 log CFU/mL and 6.8 ± 0.3 log CFU/mL after 4 h in the presence of the rifampicin-loaded bilayer and coated matrices, respectively.
Collapse
Affiliation(s)
- Martina Gruppuso
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34129 Trieste, Italy.
| | - Gianluca Turco
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34129 Trieste, Italy.
| | - Eleonora Marsich
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Via Licio Giorgieri 5, 34127 Trieste, Italy.
| | - Davide Porrelli
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza dell'Ospitale 1, 34129 Trieste, Italy.
| |
Collapse
|
5
|
Shi S, Xu M, Zhao Y, Feng L, Liu Q, Yao Z, Sun Y, Zhou T, Ye J. Tigecycline-Rifampicin Restrains Resistance Development in Carbapenem-Resistant Klebsiella pneumoniae. ACS Infect Dis 2023; 9:1858-1866. [PMID: 37669401 DOI: 10.1021/acsinfecdis.3c00186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
The goal of this study was to clarify the synergistic antibacterial activity of the combination of tigecycline (TGC) and rifampicin (RIF). Additionally, the study sought to investigate the impact of this combination on the development of mutational resistance and to assess its efficacy in an in vivo model using Galleria mellonella. Through a checkerboard test, we found that the combination of TGC and RIF showed synergistic antibacterial activity against carbapenem-resistant Klebsiella pneumoniae (CRKP). The fractional inhibition concentration index (FICI) was found to be ≤0.5, confirming the potency of the combination. Additionally, this synergistic effect was further validated in vivo using the G. mellonella infection model. TGC-RIF treatment had a lower mutant prevention concentration (MPC) than that of monotherapy, indicating its potential to reduce the development of mutational resistance. We observed a substantial variation in the MPCs of TGC and RIF when they were measured at different proportions in the combinations. Furthermore, during the resistant mutant selection window (MSW) test, we noticed a correlation between strains with low FICI and low MSW. The expression of efflux-pump-related genes, namely rarA and acrB, is significantly decreased in the combination therapy group. This indicates that altered expression levels of certain efflux pump regulator genes are associated with a combined decrease in bacterial mutation resistance. In conclusion, the combination of TGC and RIF effectively suppresses antibiotic resistance selection in CRKP. This study establishes a paradigm for evaluating drug-resistant mutant suppression in antimicrobial combination therapy.
Collapse
Affiliation(s)
- Shiyi Shi
- Department of Medical Laboratory Science, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou 325035, People's Republic of China
| | - Mengxin Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou 325000, People's Republic of China
| | - Yining Zhao
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou 325000, People's Republic of China
| | - Luozhu Feng
- Department of Medical Laboratory Science, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou 325035, People's Republic of China
| | - Qi Liu
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou 325000, People's Republic of China
| | - Zhuocheng Yao
- Department of Medical Laboratory Science, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou 325035, People's Republic of China
| | - Yao Sun
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou 325000, People's Republic of China
| | - Tieli Zhou
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou 325000, People's Republic of China
| | - Jianzhong Ye
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, Wenzhou 325000, People's Republic of China
| |
Collapse
|
6
|
Zheng M, Lupoli TJ. Counteracting antibiotic resistance enzymes and efflux pumps. Curr Opin Microbiol 2023; 75:102334. [PMID: 37329679 DOI: 10.1016/j.mib.2023.102334] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 06/19/2023]
Abstract
Bacterial pathogens are constantly evolving new resistance mechanisms against antibiotics; hence, strategies to potentiate existing antibiotics or combat mechanisms of resistance using adjuvants are always in demand. Recently, inhibitors have been identified that counteract enzymatic modification of the drugs isoniazid and rifampin, which have implications in the study of multi-drug-resistant mycobacteria. A wealth of structural studies on efflux pumps from diverse bacteria has also fueled the design of new small-molecule and peptide-based agents to prevent the active transport of antibiotics. We envision that these findings will inspire microbiologists to apply existing adjuvants to clinically relevant resistant strains, or to use described platforms to discover novel antibiotic adjuvant scaffolds.
Collapse
Affiliation(s)
- Meng Zheng
- Department of Chemistry, New York University, 100 Washington Square East, New York, NY 10003, USA
| | - Tania J Lupoli
- Department of Chemistry, New York University, 100 Washington Square East, New York, NY 10003, USA.
| |
Collapse
|
7
|
Morici P, Rizzato C, Ghelardi E, Rossolini GM, Lupetti A. Sensitization of KPC and NDM Klebsiella pneumoniae To Rifampicin by the Human Lactoferrin-Derived Peptide hLF1-11. Microbiol Spectr 2023; 11:e0276722. [PMID: 36537823 PMCID: PMC9927577 DOI: 10.1128/spectrum.02767-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A synergistic effect of non-bactericidal concentrations of the human lactoferrin (hLF)-derived peptide hLF1-11 and rifampicin against multidrug-resistant KPC (Klebsiella pneumoniae carbapenemase)-producing K. pneumoniae has been previously shown. The present study focuses on the mechanism(s) underlying this synergistic effect. The contribution of hLF1-11 and rifampicin to the synergistic effect was evaluated by killing assays with KPC K. pneumoniae cells incubated with hLF1-11 and, after washing, with rifampicin, or vice versa. Cell membrane permeability and polarization upon exposure to hLF1-11 and/or rifampicin were evaluated by ethidium bromide (EtBr) and DiBAC4(3) (bis-1,3-dibutylbarbituric acid trimethine oxonol) permeability, respectively. The effect of carbonyl cyanide m-chlorophenyl hydrazone (CCCP), an uncoupler of oxidative phosphorylation, was also evaluated. KPC K. pneumoniae cells were effectively killed after prior exposure to rifampicin for 30 to 60 min followed by treatment with hLF1-11, while no antibacterial activity was observed when cells were incubated with hLF1-11 first and then with rifampicin. EtBr accumulation increased upon exposure to hLF1-11 or the combination of hLF1-11 and rifampicin, but not upon exposure to rifampicin alone. Moreover, hLF1-11 induced a dose-dependent membrane depolarization. As expected, the antibacterial activity of hLF1-11 alone or combined with rifampicin was significantly reduced in the presence of CCCP. Furthermore, hLF1-11 and rifampicin were synergistic also against a colistin-resistant NDM (New Delhi metallo-β-lactamase)-producing K. pneumoniae strain. The results suggest that rifampicin was accumulated by KPC cells during the 30-to-60-min incubation and that the addition of hLF1-11 sensitized bacterial cells to rifampicin by inducing a transient loss of membrane potential and increased cell membrane permeability, thus facilitating the entrance and retention of rifampicin into the cytoplasm. IMPORTANCE The present study describes a synergistic effect between rifampicin, an impermeable hydrophobic antibiotic with an intracellular target, and an hLF1-11, an antimicrobial peptide derived from human lactoferrin, against multidrug-resistant Klebsiella pneumoniae. Carbapenem-resistant K. pneumoniae has recently caused an outbreak in Tuscany, Italy, thus pressing the need for the development of new treatment options. The mechanisms underlying such a synergistic effect have been studied. The results suggest that the synergistic effect was due to the transient loss of membrane potential induced by hLF1-11 and the subsequent increase in cell membrane permeability which allowed rifampicin to enter the bacterial cell. Therefore, it is likely that a sub-inhibitory concentration of hLF1-11 can efficiently permeabilize K. pneumoniae cells to rifampicin, allowing the antibiotic to reach its intracellular target. These results encourage further exploration of possible applications of this synergistic combination in the treatment of K. pneumoniae infections.
Collapse
Affiliation(s)
- Paola Morici
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Cosmeri Rizzato
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Emilia Ghelardi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Antonella Lupetti
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| |
Collapse
|
8
|
Sharma S, Takkella D, Kumar P, Gavvala K. Spectroscopic analysis to identify the binding site for Rifampicin on Bovine Serum Albumin. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2022; 283:121721. [PMID: 35964352 DOI: 10.1016/j.saa.2022.121721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
This article reports the interaction of rifampicin, one of the important antituberculosis drugs, with Bovine Serum Albumin (BSA). Herein, we have monitored the fluorescence properties of tryptophan (Trp) residue in BSA to understand the interactions between protein and rifampicin. Fluorescence intensity of BSA was quenched tremendously upon interacting with the drug. Using steady state and time-resolved spectroscopic tools the static and dynamic nature of quenching have been characterised. Time correlated single photon counting technique confirmed that out of two lifetime components ∼6.2 ns and ∼2.8 ns of BSA, the rifampicin has affected only the shorter lifetime component a lot that was assigned to Trp-213 residue. Hence, it was thought that the drug must have been located near to the amino acid residue. Molecular docking studies have revealed the structural information of drug-protein complex which supported the above conjecture, confirming the nearest tryptophan as Trp-213 to the complexing rifampicin molecule.
Collapse
Affiliation(s)
- Sudhanshu Sharma
- Department of Chemistry, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502284, India
| | - Dineshbabu Takkella
- Department of Chemistry, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502284, India
| | - Pintu Kumar
- Department of Chemistry, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502284, India
| | - Krishna Gavvala
- Department of Chemistry, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, Telangana 502284, India.
| |
Collapse
|
9
|
Ramirez DM, Ramirez D, Arthur G, Zhanel G, Schweizer F. Guanidinylated Polymyxins as Outer Membrane Permeabilizers Capable of Potentiating Rifampicin, Erythromycin, Ceftazidime and Aztreonam against Gram-Negative Bacteria. Antibiotics (Basel) 2022; 11:antibiotics11101277. [PMID: 36289935 PMCID: PMC9598282 DOI: 10.3390/antibiotics11101277] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Polymyxins are considered a last-line treatment against infections caused by multidrug-resistant (MDR) Gram-negative bacteria. In addition to their use as a potent antibiotic, polymyxins have also been utilized as outer membrane (OM) permeabilizers, capable of augmenting the activity of a partner antibiotic. Several polymyxin derivatives have been developed accordingly, with the objective of mitigating associated nephrotoxicity. The conversion of polymyxins to guanidinylated derivatives, whereby the L-γ-diaminobutyric acid (Dab) amines are substituted with guanidines, are described herein. The resulting guanidinylated colistin and polymyxin B (PMB) exhibited reduced antibacterial activity but preserved OM permeabilizing properties that allowed potentiation of several antibiotic classes. Rifampicin, erythromycin, ceftazidime and aztreonam were particularly potentiated against clinically relevant MDR Gram-negative bacteria. The potentiating effects of guanidinylated polymyxins with ceftazidime or aztreonam were further enhanced by adding the β-lactamase inhibitor avibactam.
Collapse
Affiliation(s)
| | - Danyel Ramirez
- Department of Chemistry, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Gilbert Arthur
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - George Zhanel
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
| | - Frank Schweizer
- Department of Chemistry, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Correspondence:
| |
Collapse
|
10
|
Miranda-Calderon L, Yus C, Landa G, Mendoza G, Arruebo M, Irusta S. Pharmacokinetic control on the release of antimicrobial drugs from pH-responsive electrospun wound dressings. Int J Pharm 2022; 624:122003. [PMID: 35811042 DOI: 10.1016/j.ijpharm.2022.122003] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/13/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022]
Abstract
The acidic pH of healthy skin changes during wound healing due to the exposure of the inner dermal and subcutaneous tissue and due to the potential colonization of pathogenic bacteria. In chronic non-healing wounds, the pH values vary in a wide pH range but the appearance of an alkaline shift is common. After a wound is incurred, neutral pH in the wound bed is characteristic of the activation of the cascade of regenerative and remodeling processes. In order to adjust drug release to the specific pH of the wound, herein, drug-loaded wound dressings having pH-responsiveness containing antiseptics and antibiotics and exerting different release kinetics in order to have a perfect match between the drug release kinetics, and the pH conditions of each wound type, were developed. We have fabricated drug-loaded electrospun nanofibers loaded with the antiseptic chlorhexidine, with the broad-spectrum antibiotic rifampicin, and with the antimicrobial of natural origin thymol, using the pH-dependent methacrylic acid copolymer Eudragit® L100-55, which dissolves at pH > 5.5; those drugs were loaded within Eudragit® S100, which dissolves at pH > 7 and, finally, within the methacrylic ester copolymer Eudragit® RS100 which is pH independent and slowly erodes and releases its contained cargo. The antibacterial action of those advanced wound dressings has been evaluated against methicillin-sensitive S. aureus Newman strain expressing the coral green fluorescent protein (cGFP), as a model of a Gram-positive bacteria, and against E. coli S17 strain as a model of a Gram-negative bacteria. It was demonstrated that those combinational products integrate in one device the required characteristics for a wound dressing with the therapeutic action of a contained active principle and can be selected depending on the wound acidic or alkaline status for its appropriated management.
Collapse
Affiliation(s)
- Laura Miranda-Calderon
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza 50009, Spain; Department of Chemical Engineering, University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain
| | - Cristina Yus
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza 50009, Spain; Department of Chemical Engineering, University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain
| | - Guillermo Landa
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza 50009, Spain; Department of Chemical Engineering, University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain
| | - Gracia Mendoza
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029-Madrid, Spain; Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Manuel Arruebo
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza 50009, Spain; Department of Chemical Engineering, University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029-Madrid, Spain.
| | - Silvia Irusta
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, Zaragoza 50009, Spain; Department of Chemical Engineering, University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029-Madrid, Spain.
| |
Collapse
|
11
|
Chung CH, Chandrasekaran S. A flux-based machine learning model to simulate the impact of pathogen metabolic heterogeneity on drug interactions. PNAS NEXUS 2022; 1:pgac132. [PMID: 36016709 PMCID: PMC9396445 DOI: 10.1093/pnasnexus/pgac132] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023]
Abstract
Drug combinations are a promising strategy to counter antibiotic resistance. However, current experimental and computational approaches do not account for the entire complexity involved in combination therapy design, such as the effect of pathogen metabolic heterogeneity, changes in the growth environment, drug treatment order, and time interval. To address these limitations, we present a comprehensive approach that uses genome-scale metabolic modeling and machine learning to guide combination therapy design. Our mechanistic approach (a) accommodates diverse data types, (b) accounts for time- and order-specific interactions, and (c) accurately predicts drug interactions in various growth conditions and their robustness to pathogen metabolic heterogeneity. Our approach achieved high accuracy (area under the receiver operating curve (AUROC) = 0.83 for synergy, AUROC = 0.98 for antagonism) in predicting drug interactions for Escherichia coli cultured in 57 metabolic conditions based on experimental validation. The entropy in bacterial metabolic response was predictive of combination therapy outcomes across time scales and growth conditions. Simulation of metabolic heterogeneity using population FBA identified two subpopulations of E. coli cells defined by the levels of three proteins (eno, fadB, and fabD) in glycolysis and lipid metabolism that influence cell tolerance to a broad range of antibiotic combinations. Analysis of the vast landscape of condition-specific drug interactions revealed a set of 24 robustly synergistic drug combinations with potential for clinical use.
Collapse
Affiliation(s)
- Carolina H Chung
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sriram Chandrasekaran
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
- Program in Chemical Biology, University of Michigan, Ann Arbor, MI 48109, USA
- Center for Bioinformatics and Computational Medicine, Ann Arbor, MI 48109, USA
- Rogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| |
Collapse
|
12
|
El-Sherbiny GM, Basha AM, Mabrouk MI. Control of extensively drug-resistant Pseudomonas aeruginosa co-harboring metallo-β-lactamase enzymes with oprD gene downregulation. Indian J Med Microbiol 2021; 40:51-56. [PMID: 34802794 DOI: 10.1016/j.ijmmb.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/17/2021] [Accepted: 11/07/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE to study control and treatment of infection with extensive drug-resistant carbapenem-resistant Pseudomonas aeruginosa (XDR-CRPA). METHODS Eleven Pseudomonas aeruginosa (XDR-CRPA) strains used in this study were isolated from a clinical sample, identified, and antibiotics susceptibility recorded in a previous study. Real-time PCR (RT-PCR) was performed to determine the expression level of the OprD gene. Besides, a checkerboard technique was performed to assess the effect of polymyxin-B (POX), colistin (COL), rifampicin (RIF), imipenem (IPM), and meropenem (MEM) during 2 and 3- dimensional antibiotic combinations. Further, the time-kill study was determined for the most potent combination against four representative strains, log10 changes of viable cell counts were expressed as their mean value (±SD) values. RESULTS Molecular analysis by Real-time PCR revealed that the diminished expression level of OprD mRNA was overwhelming to various degrees. The checkerboard method demonstrated that the relevant synergism was achieved in 90.9% of strains for both carbapenem antibiotics during the triple combinations. While an additive effect was noted for all the dual regimen assays. Regarding time-kill experiments, a remarkable bactericidal effect with [99.9% killing rate] was observed toward only one strain whilst a bacteriostatic attitude was proven with ≥95% bacterial eradication against the three remaining strains. CONCLUSIONS These findings underscore the promising implications of these combinations for treatment against XDR-Pseudomonas aeruginosa even they are resistant to carbapenems due to multiple mechanisms of action.
Collapse
Affiliation(s)
- Gamal M El-Sherbiny
- Department of Botany and Microbiology, Faculty of Science (Boys), Al-Azhar University, Cairo, Egypt.
| | - Amr Mohamad Basha
- Department of Microbiology, National Organization for Drug Control and Research, Egyptian Drug Authority, Giza, Egypt
| | - Mona I Mabrouk
- Department of Microbiology, National Organization for Drug Control and Research, Egyptian Drug Authority, Giza, Egypt
| |
Collapse
|
13
|
Prabhu P, Fernandes T, Chaubey P, Kaur P, Narayanan S, Vk R, Sawarkar SP. Mannose-conjugated chitosan nanoparticles for delivery of Rifampicin to Osteoarticular tuberculosis. Drug Deliv Transl Res 2021; 11:1509-1519. [PMID: 34021478 DOI: 10.1007/s13346-021-01003-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 12/20/2022]
Abstract
Tuberculosis (TB) is a potentially fatal contagious disease and is a second leading infectious cause of death in the world. Osteoarticular TB is treated using standard regimen of 1st and 2nd line anti-tubercular drugs (ATDs) for extensive period of 8-20 months. These drugs are commonly administered in high doses by oral route or by intravenous route, because of their compromised bioavailability. The common drawbacks associated with conventional therapy are poor patient compliance due to long treatment period, frequent and high dosing, and toxicity. This aspect marks for the need of formulations to eliminate these drawbacks. MTB is an intracellular pathogen of mononuclear phagocyte. This attribute makes nanotherapeutics an ideal approach for MTB treatment as macrophages capture nano forms. Polymeric nanoparticles are removed from the body by opsonization and phagocytosis, which forms an ideal strategy to target macrophage containing mycobacteria. To further improve targetability, the nanoparticles are conjugated with ligand, which serves as an easy substrate for the receptors present on the macrophage surface. The purpose of present work was to develop intra-articular injectable in situ gelling system containing polymeric nanoparticles, which would have promising advantages over conventional method of treatment. The rationale behind formulating nanoparticle incorporated in situ gel-based system was to ensure localization of the formulation in intra-articular cavity along with sustained release and conjugation of nanoparticles with mannose as ligand to improve uptake by macrophages. Rifampicin standard ATD was formulated into chitosan nanoparticles. Chitosan with 85% degree of deacetylation (DDA) and sodium tripolyphosphate (TPP) as the crosslinking agent was used for preparing nanoparticles. The percent entrapment was found to be about 71%. The prepared nanoparticles were conjugated with mannose. Conjugation of ligand was ascertained by performing Fourier transformed infrared spectroscopy. The particle size was found to be in the range of 130-140 nm and zeta potential of 38.5 mV. Additionally, we performed scanning electron microscopy to characterize the surface morphology of ligand-conjugated nanoparticles. The conjugated chitosan nanoparticles were incorporated into in situ gelling system comprising Poloxamer 407 and HPMC K4M. The gelling system was evaluated for viscosity, gelling characteristics, and syringeability. The drug release from conjugated nanoparticles incorporated in in situ gel was found to be about 70.3% at the end of 40 h in simulated synovial fluid following zero-order release kinetics. Based on the initial encouraging results obtained, the nanoparticles are being envisaged for ex vivo cellular uptake study using TB-infected macrophages.
Collapse
Affiliation(s)
- Pratiksha Prabhu
- Department of Pharmaceutics, SVKM's Dr Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India
| | - Trinette Fernandes
- Department of Pharmaceutics, SVKM's Dr Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India
| | - Pramila Chaubey
- Department of Pharmaceutics, College of Pharmacy, Shaqra University, Al-Dawadmi, Saudi Arabia
| | - Parvinder Kaur
- Foundation for Neglected Disease Research, Veerapura Village, Doddaballapur, Bangalore, 561203, India
| | - Shridhar Narayanan
- Foundation for Neglected Disease Research, Veerapura Village, Doddaballapur, Bangalore, 561203, India
| | - Ramya Vk
- Foundation for Neglected Disease Research, Veerapura Village, Doddaballapur, Bangalore, 561203, India
| | - Sujata P Sawarkar
- Department of Pharmaceutics, SVKM's Dr Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India.
| |
Collapse
|
14
|
Cerioli M, Batailler C, Conrad A, Roux S, Perpoint T, Becker A, Triffault-Fillit C, Lustig S, Fessy MH, Laurent F, Valour F, Chidiac C, Ferry T. Pseudomonas aeruginosa Implant-Associated Bone and Joint Infections: Experience in a Regional Reference Center in France. Front Med (Lausanne) 2020; 7:513242. [PMID: 33195289 PMCID: PMC7649271 DOI: 10.3389/fmed.2020.513242] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 09/22/2020] [Indexed: 11/18/2022] Open
Abstract
Background:P. aeruginosa implant-associated bone and joint infections (BJI) is considered to be one of the most difficult to treat BJI. The data focusing specifically on this pathogen are sparse, and it seems difficult to extrapolate the results obtained with Enterobacteriaceae. Methods: We performed a retrospective observation study of all P. aeruginosa implant-associated BJI diagnosed at our institution from 2011 to 2018. We defined failure as any type of relapse, including persistence of the same P. aeruginosa, superinfection by another organism(s) or any other cause of relapse such as the need for a subsequent surgery. Nonparametric statistical methods were used to compare the study groups and Kaplan-Meier curves and multivariate Cox analysis and were used to detect determinants associated with treatment failure. Results: A total of 90 patients (62% men, median age 60 years IQR 47–72) including 30 (33%) prosthetic-joint infections and 60 (66%) other implant-associated BJIs were studied. Most of them were acute (62%). During the prolonged follow-up, (median 20 months; IQR 9–37), 23 patients (26%) experienced treatment failure. Optimal surgical treatment (DAIR for acute forms, explantation, 1-stage or 2-stage exchange for others) was significantly associated with a higher success rate in the univariate analysis (p = 0.003). Sixty-four (71%) patients received effective initial treatment against P. aeruginosa administered and 81 of them (90%) did for at least 3 weeks: both these parameters correlated with a higher success rate. In the multivariate Cox-analysis optimal surgical treatment, IV effective treatment of at least 3 weeks and treatment with ciprofloxacin for at least 3 months proved to be independently associated to a better outcome in patients with P. aeruginosa implant-associated BJI. Conclusion:P. aeruginosa implant-associated BJI is one of the most difficult-to-treat BJI, with a strong impact on the prognosis of the surgical strategy. An effective initial IV antibiotic treatment for at least 3 weeks seems to be required, followed by oral ciprofloxacin for a total duration of 3 months.
Collapse
Affiliation(s)
| | - Cécile Batailler
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Anne Conrad
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Sandrine Roux
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Thomas Perpoint
- Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Agathe Becker
- Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Claire Triffault-Fillit
- Hospices Civils de Lyon, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Sebastien Lustig
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Michel-Henri Fessy
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France
| | - Frederic Laurent
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Florent Valour
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Christian Chidiac
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Tristan Ferry
- Hospices Civils de Lyon, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France.,Centre Interrégional de Référence des Infections Ostéo-articulaires complexes (CRIOAc Lyon), Hospices Civils de Lyon, Lyon, France.,Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| |
Collapse
|
15
|
Abstract
In July of 2018, the Second International Consensus Meeting (ICM) on Musculoskeletal Infection convened in Philadelphia, PA was held to discuss issues regarding infection in orthopedic patients and to provide consensus recommendations on these issues to practicing orthopedic surgeons. During this meeting, attending delegates divided into subspecialty groups to discuss topics specifics to their respective fields, which included the spine. At the spine subspecialty group meeting, delegates discussed and voted upon the recommendations for 63 questions regarding the prevention, diagnosis, and treatment of infection in spinal surgery. Of the 63 questions, 17 focused on the use of antibiotics in spine surgery, for which this article provides the recommendations, voting results, and rationales.
Collapse
|
16
|
Liu B, Tong S. An investigation of Stenotrophomonas maltophilia-positive culture caused by fiberoptic bronchoscope contamination. BMC Infect Dis 2019; 19:1072. [PMID: 31864284 PMCID: PMC6925470 DOI: 10.1186/s12879-019-4670-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/29/2019] [Indexed: 01/07/2023] Open
Abstract
Background Stenotrophomonas maltophilia (SMA) is present in hospital environments and has been one of the pathogens that cause nosocomial contamination and infections. To investigate the occurrence of Stenotrophomonas maltophilia (SMA) in bronchoscope lavage fluid (BALF) among 25 cases treated in the Division of Infection and to trace the contamination source and transmission route. Methods 25 cases of SMA positive BALF occurring from May 11 to August 10, 2018 were tested for drug sensitivity. Environmental hygiene conditions were investigated to identify the source of contamination and the route of transmission. Results BALF associated SMA was in all cases sensitive to minocycline, levofloxacin and chloramphenicol and resistant to ceftazidime and imipenem. 92.3% of samples were sensitivity to compound sulfamethoxazole. Investigation of environmental hygiene parameters revealed SMA growing on the inner wall of the fiberoptic bronchoscope as a likely source of contamination. Conclusion Incomplete cleaning and sterilization of the fiberoptic bronchoscope led to SMA nosocomial contamination. Strict sterilization procedures are required to prevent and control nosocomial contamination.
Collapse
Affiliation(s)
- Bende Liu
- Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shenglan Tong
- Department of Clinical Laboratory, First People's Hospital of Jiangxia District in Wuhan, Wuhan, 430200, China.
| |
Collapse
|
17
|
Baumert PMP, Camp J, Gölz H, Vavra M, Schuster S, Kern WV, Mischnik A. Detection of High-Level Rifaximin Resistance in Enteric Bacteria by Agar Screen. Microb Drug Resist 2019; 26:545-549. [PMID: 31855490 DOI: 10.1089/mdr.2019.0295] [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] [Indexed: 11/12/2022] Open
Abstract
Objectives: This study aimed at determining the prevalence of rifaximin resistance in a large collection of Enterobacterales resistant to third-generation cephalosporins. A simple agar screen was developed to detect high-level resistance. Methods: A total of 401 isolates nonsusceptible to third-generation cephalosporins (including 342 Escherichia coli and 39 Klebsiella spp. and 20 Enterobacter spp.) were tested by microdilution for their MICs of rifaximin and rifampicin. Isolates with a confirmed rifaximin minimal inhibitory concentration (MIC) of >64 mg/L and a number of high-level resistant, and susceptible control isolates were tested for growth on Mueller-Hinton agar supplemented with rifaximin or rifampicin at a concentration of 256 mg/L. Amino acid mutations in rpoB and the presence of rifaximin resistance-associated genes arabidopsis response regulator (arr) 2/3 were investigated. Results: Microdilution assays identified rifaximin resistance in nine E. coli and three Klebsiella spp. isolates with complete cross-resistance to rifampicin (MICs of both >64 mg/L). The rifaximin agar screen correctly identified 9/9 clinical E. coli isolates, 2/2 E. coli controls, and 3/3 Klebsiella spp. with high-level rifaximin resistance, and was negative in 45 control clinical isolates with rifaximin MICs ranging between 2 and 32 mg/L according to broth microdilution. All nine high-level rifaximin agar screen-positive E. coli clinical isolates (vs. none of the tested controls) had rpoB mutations or carried arr2/3. Conclusions: Our agar screen test has the potential to detect high-level rifaximin-resistant Enterobacterales. Such strains remain rare among extended spectrum beta-lactamase (ESBL)-positive enteric bacteria, but may emerge among patients receiving rifaximin for prevention of hepatic encephalopathy and spontaneous bacterial peritonitis or among patients receiving rifaximin for other indications.
Collapse
Affiliation(s)
- Philipp M P Baumert
- Division of Infectious Diseases, Department of Medicine II, University Hospital and Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johannes Camp
- Division of Infectious Diseases, Department of Medicine II, University Hospital and Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hannah Gölz
- Institute for Medical Microbiology and Hygiene, University Hospital and Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Martina Vavra
- Division of Infectious Diseases, Department of Medicine II, University Hospital and Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabine Schuster
- Division of Infectious Diseases, Department of Medicine II, University Hospital and Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Winfried V Kern
- Division of Infectious Diseases, Department of Medicine II, University Hospital and Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexander Mischnik
- Division of Infectious Diseases, Department of Medicine II, University Hospital and Medical Centre Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
18
|
Abstract
Infection can be a devastating complication of surgically inserted prosthetic implants and intramedullary rods, plates and pins. About 2 million implants were inserted in the United States in 2004, and, despite appropriate perioperative antibiotics, approximately 5% of internal fixation devices became infected. Infection rates in fractures that pierce the skin can be as high as 22.7%. Complications of infection include excessive antibiotic use, implant removal, reoperation, and potential amputation. Infections caused by colonized prosthetic implants are often difficult to predict, diagnose, and treat, because they form biofilms. This article explores the approach to infected implants.
Collapse
Affiliation(s)
- Dena El-Sayed
- Internal Medicine Clinic, Infectious Diseases Clinic, Ventura County Medical Center, Ventura, CA, USA
| | - Aksone Nouvong
- Department of Surgery, Division of Vascular Surgery, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Suite 526, Los Angeles, CA 90095, USA.
| |
Collapse
|
19
|
Papadopoulos A, Ribera A, Mavrogenis AF, Rodriguez-Pardo D, Bonnet E, Salles MJ, Dolores Del Toro M, Nguyen S, Blanco-García A, Skaliczki G, Soriano A, Benito N, Petersdorf S, Pasticci MB, Tattevin P, Tufan ZK, Chan M, O'Connell N, Pantazis N, Kyprianou A, Pigrau C, Megaloikonomos PD, Senneville E, Ariza J, Papagelopoulos PJ, Giannitsioti E. Multidrug-resistant and extensively drug-resistant Gram-negative prosthetic joint infections: Role of surgery and impact of colistin administration. Int J Antimicrob Agents 2019; 53:294-301. [PMID: 30395988 DOI: 10.1016/j.ijantimicag.2018.10.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/21/2018] [Accepted: 10/27/2018] [Indexed: 02/08/2023]
Abstract
Factors influencing treatment outcome of patients with Gram-negative bacterial (GNB) multidrug-resistant (MDR) and extensively drug-resistant (XDR) prosthetic joint infection (PJIs) were analysed. Data were collected (2000-2015) by 18 centres. Treatment success was analysed by surgery type for PJI, resistance (MDR/XDR) and antimicrobials (colistin/non-colistin) using logistic regression and survival analyses. A total of 131 patients (mean age 73.0 years, 35.9% male, 58.8% with co-morbidities) with MDR (n = 108) or XDR (n = 23) GNB PJI were assessed. The most common pathogens were Escherichia coli (33.6%), Pseudomonas aeruginosa (25.2%), Klebsiella pneumoniae (21.4%) and Enterobacter cloacae (17.6%). Pseudomonas aeruginosa predominated in XDR cases. Isolates were carbapenem-resistant (n = 12), fluoroquinolone-resistant (n = 63) and ESBL-producers (n = 94). Treatment outcome was worse in XDR versus MDR cases (P = 0.018). Success rates did not differ for colistin versus non-colistin in XDR cases (P = 0.657), but colistin was less successful in MDR cases (P = 0.018). Debridement, antibiotics and implant retention (DAIR) (n = 67) was associated with higher failure rates versus non-DAIR (n = 64) (OR = 3.57, 95% CI 1.68-7.58; P < 0.001). Superiority of non-DAIR was confirmed by Kaplan-Meir analysis (HR = 0.36, 95% CI 0.20-0.67) and remained unchangeable by time of infection (early/late), antimicrobial resistance (MDR/XDR) and antimicrobials (colistin/non-colistin) (Breslow-Day, P = 0.737). DAIR is associated with higher failure rates even in early MDR/XDR GNB PJIs versus implant removal. Colistin should be preserved for XDR cases as it is detrimental in MDR infections.
Collapse
Affiliation(s)
- Antonios Papadopoulos
- Fourth Department of Internal Medicine, University General Hospital 'ATTIKON', School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Alba Ribera
- Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, University General Hospital 'ATTIKON', School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dolors Rodriguez-Pardo
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Eric Bonnet
- Department of Infectious Diseases, Hôpital Joseph Ducuing, Toulouse, France
| | - Mauro José Salles
- Division of Infectious Diseases, Department of Internal Medicine, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - María Dolores Del Toro
- Infectious Diseases Unit, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - Sophie Nguyen
- Infectious Diseases Department, Gustave Dron Hospital, Tourcoing, France
| | - Antonio Blanco-García
- Bone and Joint Infection Unit, Department of Emergency Medicine, IIS-Fundación Jiménez Díaz Hospital, Madrid, Spain
| | - Gábor Skaliczki
- Department of Orthopaedics, Semmelweis University, Budapest, Hungary
| | - Alejandro Soriano
- Department of Infectious Diseases, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Natividad Benito
- Unit of Infectious Diseases, Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sabine Petersdorf
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Zeliha Kocak Tufan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Yildirim Beyazit University, Ankara Ataturk Education and Research Hospital, Ankara, Turkey
| | - Monica Chan
- Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore
| | - Nuala O'Connell
- Department of Clinical Microbiology, University Hospital Limerick, Limerick, Ireland
| | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Kyprianou
- Fourth Department of Internal Medicine, University General Hospital 'ATTIKON', School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Carlos Pigrau
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Panayiotis D Megaloikonomos
- First Department of Orthopaedics, University General Hospital 'ATTIKON', School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eric Senneville
- Infectious Diseases Department, Gustave Dron Hospital, Tourcoing, France
| | - Javier Ariza
- Department of Infectious Diseases, Hospital Universitari Bellvitge, Barcelona, Spain
| | - Panayiotis J Papagelopoulos
- First Department of Orthopaedics, University General Hospital 'ATTIKON', School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Efthymia Giannitsioti
- Fourth Department of Internal Medicine, University General Hospital 'ATTIKON', School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | | |
Collapse
|
20
|
Rodríguez-Pardo D, Pigrau C, Corona PS, Almirante B. An update on surgical and antimicrobial therapy for acute periprosthetic joint infection: new challenges for the present and the future. Expert Rev Anti Infect Ther 2016; 13:249-65. [PMID: 25578886 DOI: 10.1586/14787210.2015.999669] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Periprosthetic joint infection (PJI) is a devastating complication that can occur following any arthroplasty procedure. Approximately half of these infections develop within the first year after arthroplasty, mainly in the first 1 to 3 months. These infections are known as early PJI. It is widely accepted that many early PJIs can be successfully managed by debridement, irrigation, and prosthetic retention, followed by a course of biofilm-effective antibiotics (debridement, antibiotics, implant retention procedure), but candidate patients should meet the requirements set down in Zimmerli's algorithm. The best antibiotic regimen for acute PJI treated without implant removal remains uncertain. Rifampin-containing regimens, when feasible, are recommended in gram-positive infections, and fluoroquinolones in gram-negative cases. The duration, dosage, and administration route of antibiotics and the use of combined therapy are matters that requires further clarification, as the current level of evidence is low and most recommendations are based on experimental data, studies in small series, and expert experience.
Collapse
|
21
|
Taneja N, Kaur H. Insights into Newer Antimicrobial Agents Against Gram-negative Bacteria. Microbiol Insights 2016; 9:9-19. [PMID: 27013887 PMCID: PMC4803319 DOI: 10.4137/mbi.s29459] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/04/2016] [Accepted: 01/11/2016] [Indexed: 02/06/2023] Open
Abstract
Currently, drug resistance, especially against cephalosporins and carbapenems, among gram-negative bacteria is an important challenge, which is further enhanced by the limited availability of drugs against these bugs. There are certain antibiotics (colistin, fosfomycin, temocillin, and rifampicin) that have been revived from the past to tackle the menace of superbugs, including members of Enterobacteriaceae, Acinetobacter species, and Pseudomonas species. Very few newer antibiotics have been added to the pool of existing drugs. There are still many antibiotics that are passing through various phases of clinical trials. The initiative of Infectious Disease Society of America to develop 10 novel antibiotics against gram-negative bacilli by 2020 is a step to fill the gap of limited availability of drugs. This review aims to provide insights into the current and newer drugs in pipeline for the treatment of gram-negative bacteria and also discusses the major challenging issues for their management.
Collapse
Affiliation(s)
- Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harsimran Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
22
|
Antimicrobial Peptide Novicidin Synergizes with Rifampin, Ceftriaxone, and Ceftazidime against Antibiotic-Resistant Enterobacteriaceae In Vitro. Antimicrob Agents Chemother 2015; 59:6233-40. [PMID: 26248380 DOI: 10.1128/aac.01245-15] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/18/2015] [Indexed: 12/19/2022] Open
Abstract
The spread of antibiotic resistance among Gram-negative bacteria is a serious clinical threat, and infections with these organisms are a leading cause of mortality worldwide. Traditional novel drug development inevitably leads to the emergence of new resistant strains, rendering the new drugs ineffective. Therefore, reviving the therapeutic potentials of existing antibiotics represents an attractive novel strategy. Novicidin, a novel cationic antimicrobial peptide, is effective against Gram-negative bacteria. Here, we investigated novicidin as a possible antibiotic enhancer. The actions of novicidin in combination with rifampin, ceftriaxone, or ceftazidime were investigated against 94 antibiotic-resistant clinical Gram-negative isolates and 7 strains expressing New Delhi metallo-β-lactamase-1. Using the checkerboard method, novicidin combined with rifampin showed synergy with >70% of the strains, reducing the MICs significantly. The combination of novicidin with ceftriaxone or ceftazidime was synergistic against 89.7% of the ceftriaxone-resistant strains and 94.1% of the ceftazidime-resistant strains. Synergistic interactions were confirmed using time-kill studies with multiple strains. Furthermore, novicidin increased the postantibiotic effect when combined with rifampin or ceftriaxone. Membrane depolarization assays revealed that novicidin alters the cytoplasmic membrane potential of Gram-negative bacteria. In vitro toxicology tests showed novicidin to have low hemolytic activity and no detrimental effect on cell cultures. We demonstrated that novicidin strongly rejuvenates the therapeutic potencies of ceftriaxone or ceftazidime against resistant Gram-negative bacteria in vitro. In addition, novicidin boosted the activity of rifampin. This strategy can have major clinical implications in our fight against antibiotic-resistant bacterial infections.
Collapse
|
23
|
Rodríguez-Pardo D, Pigrau C, Lora-Tamayo J, Soriano A, del Toro MD, Cobo J, Palomino J, Euba G, Riera M, Sánchez-Somolinos M, Benito N, Fernández-Sampedro M, Sorli L, Guio L, Iribarren JA, Baraia-Etxaburu JM, Ramos A, Bahamonde A, Flores-Sánchez X, Corona PS, Ariza J. Gram-negative prosthetic joint infection: outcome of a debridement, antibiotics and implant retention approach. A large multicentre study. Clin Microbiol Infect 2014; 20:O911-9. [PMID: 24766536 DOI: 10.1111/1469-0691.12649] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 04/07/2014] [Accepted: 04/18/2014] [Indexed: 02/05/2023]
Abstract
We aim to evaluate the epidemiology and outcome of gram-negative prosthetic joint infection (GN-PJI) treated with debridement, antibiotics and implant retention (DAIR), identify factors predictive of failure, and determine the impact of ciprofloxacin use on prognosis. We performed a retrospective, multicentre, observational study of GN-PJI diagnosed from 2003 through to 2010 in 16 Spanish hospitals. We define failure as persistence or reappearance of the inflammatory joint signs during follow-up, leading to unplanned surgery or repeat debridement>30 days from the index surgery related death, or suppressive antimicrobial therapy. Parameters predicting failure were analysed with a Cox regression model. A total of 242 patients (33% men; median age 76 years, interquartile range (IQR) 68-81) with 242 episodes of GN-PJI were studied. The implants included 150 (62%) hip, 85 (35%) knee, five (2%) shoulder and two (1%) elbow prostheses. There were 189 (78%) acute infections. Causative microorganisms were Enterobacteriaceae in 78%, Pseudomonas spp. in 20%, and other gram-negative bacilli in 2%. Overall, 19% of isolates were ciprofloxacin resistant. DAIR was used in 174 (72%) cases, with an overall success rate of 68%, which increased to 79% after a median of 25 months' follow-up in ciprofloxacin-susceptible GN-PJIs treated with ciprofloxacin. Ciprofloxacin treatment exhibited an independent protective effect (adjusted hazard ratio (aHR) 0.23; 95% CI, 0.13-0.40; p<0.001), whereas chronic renal impairment predicted failure (aHR, 2.56; 95% CI, 1.14-5.77; p 0.0232). Our results confirm a 79% success rate in ciprofloxacin-susceptible GN-PJI treated with debridement, ciprofloxacin and implant retention. New therapeutic strategies are needed for ciprofloxacin-resistant PJI.
Collapse
Affiliation(s)
- D Rodríguez-Pardo
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Durante-Mangoni E, Utili R, Zarrilli R. Combination therapy in severe Acinetobacter baumannii infections: an update on the evidence to date. Future Microbiol 2014; 9:773-89. [DOI: 10.2217/fmb.14.34] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
ABSTRACT: Acinetobacter baumannii is a drug-resistant Gram-negative pathogen increasingly causing hospital-acquired infections in critically ill patients. In this review, we summarize the current mechanisms of antimicrobial resistance in A. baumannii and describe in detail recent in vitro and in vivo experimental data on the activity of antimicrobial combinations against this microorganism. We then introduce the rationale for the use of combination antibiotic therapy in resistant A. baumannii infections. Finally, we present and critically discuss both uncontrolled clinical studies and the few randomized clinical trials of combination antimicrobial therapy for these infections, with a special focus on ongoing multinational trials and optimal approach to future research in this field.
Collapse
Affiliation(s)
- Emanuele Durante-Mangoni
- Internal Medicine, University of Naples S.U.N. & AORN dei Colli, Monaldi Hospital, Via L. Bianchi, Naples, Italy
| | - Riccardo Utili
- Internal Medicine, University of Naples S.U.N. & AORN dei Colli, Monaldi Hospital, Via L. Bianchi, Naples, Italy
| | - Raffaele Zarrilli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| |
Collapse
|
25
|
Betts JW, Phee LM, Woodford N, Wareham DW. Activity of colistin in combination with tigecycline or rifampicin against multidrug-resistant Stenotrophomonas maltophilia. Eur J Clin Microbiol Infect Dis 2014; 33:1565-72. [PMID: 24781003 DOI: 10.1007/s10096-014-2101-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 03/25/2014] [Indexed: 11/25/2022]
Abstract
The antimicrobial treatment of Stenotrophomonas maltophilia infections is complicated by intrinsic multidrug resistance and a lack of reliable susceptibility data. We assessed the activity of colistin (COL), rifampicin (RIF) and tigecycline (TGC) alone and in combination using a range of in vitro susceptibility testing methodologies and a simple invertebrate model of S. maltophilia infection (Galleria mellonella). Synergy [fractional inhibitory concentration indices (FICIs) ≤0.5] between COL and either RIF or TGC was observed against 92 % and 88 % of 25 S. maltophilia isolates, respectively, despite resistance to one or another of the single agents alone. In time-kill assays, COL combined with either RIF or TGC was superior to single agents, but only the COL/RIF regimen was reliably bactericidal. The in vitro findings correlated with treatment outcomes in G. mellonella, with heightened survival observed for larvae treated with COL/RIF or COL/TGC compared with COL, RIF or TGC alone. COL combined with RIF was the most effective combination overall in both in vitro and in vivo (p < 0.05) assays. Given the difficulty in selecting appropriate therapy for S. maltophilia infections, regimens consisting of COL combined with RIF or TGC could be considered for clinical use.
Collapse
Affiliation(s)
- J W Betts
- Antimicrobial Research Group, Centre for Immunology and Infectious Disease, Blizard Institute, Queen Mary, University of London, Blizard Building, 4 Newark Street, Whitechapel, London, E1 2AT, UK
| | | | | | | |
Collapse
|
26
|
|
27
|
Tambyah PA, Hara GL, Daikos GL, Falagas ME, Mazzei T, Mouton JW, Novelli A, Chen B, Wang M, Ko WC, Li T, Fan X, Theuretzbacher U. Treatment of extensively drug-resistant Gram-negative infections in critically ill patients: Outcome of a consensus meeting at the 13th Asia-Pacific Congress of Clinical Microbiology and Infection, October 2012. J Glob Antimicrob Resist 2013; 1:117-122. [DOI: 10.1016/j.jgar.2013.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 10/26/2022] Open
|
28
|
Discovery of a novel class of boron-based antibacterials with activity against gram-negative bacteria. Antimicrob Agents Chemother 2013; 57:1394-403. [PMID: 23295920 DOI: 10.1128/aac.02058-12] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Gram-negative bacteria cause approximately 70% of the infections in intensive care units. A growing number of bacterial isolates responsible for these infections are resistant to currently available antibiotics and to many in development. Most agents under development are modifications of existing drug classes, which only partially overcome existing resistance mechanisms. Therefore, new classes of Gram-negative antibacterials with truly novel modes of action are needed to circumvent these existing resistance mechanisms. We have previously identified a new a way to inhibit an aminoacyl-tRNA synthetase, leucyl-tRNA synthetase (LeuRS), in fungi via the oxaborole tRNA trapping (OBORT) mechanism. Herein, we show how we have modified the OBORT mechanism using a structure-guided approach to develop a new boron-based antibiotic class, the aminomethylbenzoxaboroles, which inhibit bacterial leucyl-tRNA synthetase and have activity against Gram-negative bacteria by largely evading the main efflux mechanisms in Escherichia coli and Pseudomonas aeruginosa. The lead analogue, AN3365, is active against Gram-negative bacteria, including Enterobacteriaceae bearing NDM-1 and KPC carbapenemases, as well as P. aeruginosa. This novel boron-based antibacterial, AN3365, has good mouse pharmacokinetics and was efficacious against E. coli and P. aeruginosa in murine thigh infection models, which suggest that this novel class of antibacterials has the potential to address this unmet medical need.
Collapse
|
29
|
Sendi P, Zimmerli W. Antimicrobial treatment concepts for orthopaedic device-related infection. Clin Microbiol Infect 2012; 18:1176-84. [DOI: 10.1111/1469-0691.12003] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
Abed M, Towhid ST, Shaik N, Lang F. Stimulation of suicidal death of erythrocytes by rifampicin. Toxicology 2012; 302:123-8. [PMID: 23069259 DOI: 10.1016/j.tox.2012.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 09/25/2012] [Accepted: 10/03/2012] [Indexed: 01/21/2023]
Abstract
The antibiotic rifampicin is widely used in the treatment of tuberculosis. Side effects of rifampicin include hemolytic anemia. Loss of circulating erythrocytes resembling hemolytic anemia could result from stimulation of eryptosis, the suicidal erythrocyte death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine (PS) exposure at the cell surface. Stimulators of eryptosis include increase of cytosolic Ca(2+) activity ([Ca(2+)](i)) and formation of ceramide. The present study explored, whether and, if so, how rifampicin triggers eryptosis. To this end, [Ca(2+)](i) was estimated from Fluo3 fluorescence, cell volume from forward scatter in flow cytometry, PS exposure from annexin binding, ceramide formation from binding of fluorescent antibodies and hemolysis from hemoglobin release. As a result, a 48 h exposure to rifampicin (≥ 24 μg/ml) significantly increased Fluo3 fluorescence, ceramide abundance and annexin binding, and significantly decreased forward scatter. Rifampicin triggered slight, but significant hemolysis. Removal of extracellular Ca(2+) significantly blunted, but did not fully abolish rifampicin induced annexin binding. In conclusion, exposure of human erythrocytes to rifampicin is followed by suicidal erythrocyte death or eryptosis, an effect at least partially due to increase of cytosolic Ca(2+) concentration and stimulation of ceramide formation.
Collapse
Affiliation(s)
- Majed Abed
- Department of Physiology, University of Tuebingen, Tuebingen, Germany
| | | | | | | |
Collapse
|
31
|
Chromy BA, Elsheikh M, Christensen TL, Livingston D, Petersen K, Bearinger JP, Hoeprich PD. Repurposing screens identify rifamycins as potential broad-spectrum therapy for multidrug-resistant Acinetobacter baumannii and select agent microorganisms. Future Microbiol 2012; 7:1011-20. [DOI: 10.2217/fmb.12.75] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aims: Estimates suggest that the drug discovery and development processes take between 10 and 15 years, with costs ranging between US$500 million and $2 billion. A growing number of bacteria have become resistant to approved antimicrobials. For example, the Gram-negative bacterium Acinetobacter baumannii has become multidrug resistant (MDR) and is now an important pathogen to the US military in terms of wound infections. Industry experts have called for a ‘disruptive’ transformation of the drug discovery process to find new chemical entities for treating drug-resistant infections. One such attempt is drug ‘repurposing’ or ‘repositioning’ – that is, identification and development of new uses for existing or abandoned pharmacotherapies. Materials & methods: Using a novel combination of screening technologies based on cell growth and cellular respiration, we screened 450 US FDA-approved drugs from the NIH National Clinical Collection against a dozen clinical MDR A. baumannii (MDRAb) isolates from US soldiers and Marines. We also screened the collection against a diverse set of select agent surrogate pathogens. Results: Seventeen drugs showed promising antimicrobial activity against all MDRAb isolates and select agent surrogates; three of these compounds – all rifamycins – were found to be effective at preventing growth and preventing cellular respiration of MDRAb and select agent surrogate bacteria when evaluated in growth prevention assays, highlighting the potential for repurposing. Conclusion: We report the discovery of a class of known compounds whose repurposing may be useful in solving the current problem with MDRAb and may lead to the discovery of broad-spectrum antimicrobials.
Collapse
Affiliation(s)
- Brett A Chromy
- University of California Davis School of Medicine, Department of Pathology & Laboratory Medicine, Tupper Hall, Room 3440, Davis, CA 95616, USA
- Lawrence Livermore National Laboratory, 7000 East Avenue, PO Box 808, Livermore, CA 94550, USA
| | - Maher Elsheikh
- Lawrence Livermore National Laboratory, 7000 East Avenue, PO Box 808, Livermore, CA 94550, USA
| | - Tova L Christensen
- Lawrence Livermore National Laboratory, 7000 East Avenue, PO Box 808, Livermore, CA 94550, USA
| | - Doug Livingston
- Evotec San Francisco, Oyster Point Boulevard, South San Francisco, CA 94080, USA
| | - Kyle Petersen
- Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Jane P Bearinger
- Lawrence Livermore National Laboratory, 7000 East Avenue, PO Box 808, Livermore, CA 94550, USA
| | - Paul D Hoeprich
- Lawrence Livermore National Laboratory, 7000 East Avenue, PO Box 808, Livermore, CA 94550, USA
| |
Collapse
|
32
|
Quale J, Shah N, Kelly P, Babu E, Backer M, Rosas-Garcia G, Salamera J, George A, Bratu S, Landman D. Activity of Polymyxin B and the Novel Polymyxin Analogue CB-182,804 Against Contemporary Gram-Negative Pathogens in New York City. Microb Drug Resist 2012; 18:132-6. [DOI: 10.1089/mdr.2011.0163] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- John Quale
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Neha Shah
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Paul Kelly
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Elizabeth Babu
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Martin Backer
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | | | - Julius Salamera
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Avrille George
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - Simona Bratu
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| | - David Landman
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York
| |
Collapse
|
33
|
Zander W, Gerth K, Mohr KI, Kessler W, Jansen R, Müller R. Roimatacene: An Antibiotic against Gram‐Negative Bacteria Isolated from
Cystobacter ferrugineus
Cb G35 (Myxobacteria). Chemistry 2011; 17:7875-81. [DOI: 10.1002/chem.201003677] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Indexed: 11/07/2022]
Affiliation(s)
- Wiebke Zander
- Mikrobielle Wirkstoffe, Helmholtz Zentrum für Infektionsforschung, Inhoffenstraße 7, 38124 Braunschweig (Germany), Fax: (+49) 531‐61819499
| | - Klaus Gerth
- Mikrobielle Wirkstoffe, Helmholtz Zentrum für Infektionsforschung, Inhoffenstraße 7, 38124 Braunschweig (Germany), Fax: (+49) 531‐61819499
| | - Kathrin I. Mohr
- Mikrobielle Wirkstoffe, Helmholtz Zentrum für Infektionsforschung, Inhoffenstraße 7, 38124 Braunschweig (Germany), Fax: (+49) 531‐61819499
| | - Wolfgang Kessler
- Mikrobielle Wirkstoffe, Helmholtz Zentrum für Infektionsforschung, Inhoffenstraße 7, 38124 Braunschweig (Germany), Fax: (+49) 531‐61819499
| | - Rolf Jansen
- Mikrobielle Wirkstoffe, Helmholtz Zentrum für Infektionsforschung, Inhoffenstraße 7, 38124 Braunschweig (Germany), Fax: (+49) 531‐61819499
| | - Rolf Müller
- Mikrobielle Wirkstoffe, Helmholtz Zentrum für Infektionsforschung, Inhoffenstraße 7, 38124 Braunschweig (Germany), Fax: (+49) 531‐61819499
| |
Collapse
|
34
|
|
35
|
Shah SQ, Khan AU, Khan MR. Radiosynthesis and biodistribution of (99m)Tc-rifampicin: a novel radiotracer for in-vivo infection imaging. Appl Radiat Isot 2010; 68:2255-60. [PMID: 20538473 DOI: 10.1016/j.apradiso.2010.05.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 05/18/2010] [Accepted: 05/20/2010] [Indexed: 11/25/2022]
Abstract
(99m)Tc-rifampicin ((99m)Tc-RMP) a new radioantibiotic complex was synthesized specifically for the infection localization caused by methicillin-resistant Staphylococcus aureus (MRSA). The in-vitro radiochemical purity (RCP) yield, in-vivo biodistribution behavior in artificially infected rats (AIT) and scintigraphic accuracy in artificially infected rabbit (AIB) of the (99m)Tc-RMP complex was investigated using different concentration of the RMP, sodium pertechnetate (Na(99m)TcO(4)), stannous chloride dihydrate (SnCl(2) x 2H(2)O) at different pH ranges 5-6. The best RCP yield observed at 30, 60, 90 and 120 min after labeling was; 98.95+/-0.20, 98.15+/-0.24, 96.50+/-0.27 and 91.55+/-0.22%, respectively, using 1.5 mg RMP, 175 microL of SnCl(2) x 2H(2)O (1 microg/microL in 0.01 N HCl), 3 mCi of Na(99m)TcO(4), at pH 5.6. Initially in the infected muscle (INM) of the AIT the activity was lower but after 90 min it went up to 18.35+/-0.20% from 5.95+/-0.25%. The activity in the inflamed muscle (IMM), normal (NM) muscle, blood, liver and spleen was initially high that decreased with time. The ratios of the INM/NM and IMM/NM were 7.34+/-0.74 and 1.20+/-0.85, respectively. The whole body static (WBS) imaging of the MRSA infected rabbit confirmed the usefulness of the (99m)Tc-RMP as a precise radiotracer for MRSA infection imaging. On the basis of in-vitro RCP, in-vivo biodistribution and scintigraphic precision, we recommend the (99m)Tc-RMP complex prepared aseptically for in-vivo assessment of MRSA infection.
Collapse
Affiliation(s)
- Syed Qaiser Shah
- Nuclear Medicine Research Laboratory (NMRL), University of Peshawar, Room no 111, Academic Block I, Peshawar, NWFP, Pakistan.
| | | | | |
Collapse
|