Sequence-Specific Targeting of Bacterial Resistance Genes Increases Antibiotic Efficacy

PLoS Biol. 2016 Sep 15;14(9):e1002552. doi: 10.1371/journal.pbio.1002552. eCollection 2016 Sep.

Abstract

The lack of effective and well-tolerated therapies against antibiotic-resistant bacteria is a global public health problem leading to prolonged treatment and increased mortality. To improve the efficacy of existing antibiotic compounds, we introduce a new method for strategically inducing antibiotic hypersensitivity in pathogenic bacteria. Following the systematic verification that the AcrAB-TolC efflux system is one of the major determinants of the intrinsic antibiotic resistance levels in Escherichia coli, we have developed a short antisense oligomer designed to inhibit the expression of acrA and increase antibiotic susceptibility in E. coli. By employing this strategy, we can inhibit E. coli growth using 2- to 40-fold lower antibiotic doses, depending on the antibiotic compound utilized. The sensitizing effect of the antisense oligomer is highly specific to the targeted gene's sequence, which is conserved in several bacterial genera, and the oligomer does not have any detectable toxicity against human cells. Finally, we demonstrate that antisense oligomers improve the efficacy of antibiotic combinations, allowing the combined use of even antagonistic antibiotic pairs that are typically not favored due to their reduced activities.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Base Sequence
  • Carrier Proteins / genetics*
  • Carrier Proteins / metabolism
  • Cell Line
  • Drug Resistance, Bacterial / genetics*
  • Escherichia coli Proteins / genetics*
  • Escherichia coli Proteins / metabolism
  • Gene Knockdown Techniques / methods
  • Genes, Bacterial
  • Humans
  • Microbial Sensitivity Tests
  • Oligodeoxyribonucleotides, Antisense / genetics
  • Oligodeoxyribonucleotides, Antisense / pharmacology
  • Penicillanic Acid / analogs & derivatives
  • Penicillanic Acid / pharmacology
  • Piperacillin / pharmacology
  • Sulfamethoxazole / pharmacology
  • Tazobactam
  • Trimethoprim / pharmacology

Substances

  • AcrAB-TolC protein, E coli
  • Anti-Bacterial Agents
  • Carrier Proteins
  • Escherichia coli Proteins
  • Oligodeoxyribonucleotides, Antisense
  • Penicillanic Acid
  • Trimethoprim
  • Sulfamethoxazole
  • Tazobactam
  • Piperacillin