TarO-specific inhibitors of wall teichoic acid biosynthesis restore β-lactam efficacy against methicillin-resistant staphylococci

Sci Transl Med. 2016 Mar 9;8(329):329ra32. doi: 10.1126/scitranslmed.aad7364.

Abstract

The widespread emergence of methicillin-resistant Staphylococcus aureus (MRSA) has dramatically eroded the efficacy of current β-lactam antibiotics and created an urgent need for new treatment options. We report an S. aureus phenotypic screening strategy involving chemical suppression of the growth inhibitory consequences of depleting late-stage wall teichoic acid biosynthesis. This enabled us to identify early-stage pathway-specific inhibitors of wall teichoic acid biosynthesis predicted to be chemically synergistic with β-lactams. We demonstrated by genetic and biochemical means that each of the new chemical series discovered, herein named tarocin A and tarocin B, inhibited the first step in wall teichoic acid biosynthesis (TarO). Tarocins do not have intrinsic bioactivity but rather demonstrated potent bactericidal synergy in combination with broad-spectrum β-lactam antibiotics against diverse clinical isolates of methicillin-resistant staphylococci as well as robust efficacy in a murine infection model of MRSA. Tarocins and other inhibitors of wall teichoic acid biosynthesis may provide a rational strategy to develop Gram-positive bactericidal β-lactam combination agents active against methicillin-resistant staphylococci.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bacterial Proteins / metabolism*
  • Biosynthetic Pathways / drug effects*
  • Cell Wall / drug effects
  • Cell Wall / metabolism*
  • Dicloxacillin / pharmacology
  • Dicloxacillin / therapeutic use
  • Female
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Mice, Inbred BALB C
  • Microbial Sensitivity Tests
  • Models, Molecular
  • Phenotype
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Teichoic Acids / biosynthesis*
  • Treatment Outcome
  • beta-Lactams / pharmacology*

Substances

  • Bacterial Proteins
  • Teichoic Acids
  • beta-Lactams
  • Dicloxacillin