Synergy between conventional antibiotics and anti-biofilm peptides in a murine, sub-cutaneous abscess model caused by recalcitrant ESKAPE pathogens

PLoS Pathog. 2018 Jun 21;14(6):e1007084. doi: 10.1371/journal.ppat.1007084. eCollection 2018 Jun.

Abstract

With the antibiotic development pipeline running dry, many fear that we might soon run out of treatment options. High-density infections are particularly difficult to treat due to their adaptive multidrug-resistance and currently there are no therapies that adequately address this important issue. Here, a large-scale in vivo study was performed to enhance the activity of antibiotics to treat high-density infections caused by multidrug-resistant Gram-positive and Gram-negative bacteria. It was shown that synthetic peptides can be used in conjunction with the antibiotics ciprofloxacin, meropenem, erythromycin, gentamicin, and vancomycin to improve the treatment outcome of murine cutaneous abscesses caused by clinical hard-to-treat pathogens including all ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae) pathogens and Escherichia coli. Promisingly, combination treatment often showed synergistic effects that significantly reduced abscess sizes and/or improved clearance of bacterial isolates from the infection site, regardless of the antibiotic mode of action. In vitro data suggest that the mechanisms of peptide action in vivo include enhancement of antibiotic penetration and potential disruption of the stringent stress response.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abscess / drug therapy*
  • Abscess / microbiology
  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Biofilms / drug effects*
  • Biofilms / growth & development
  • Drug Synergism
  • Female
  • Gram-Negative Bacteria / pathogenicity*
  • Gram-Positive Bacteria / pathogenicity*
  • Injections, Subcutaneous
  • Mice
  • Microbial Viability
  • Peptide Fragments / pharmacology*
  • Skin Diseases, Bacterial / drug therapy*
  • Skin Diseases, Bacterial / microbiology

Substances

  • Anti-Bacterial Agents
  • Peptide Fragments