Combination therapy with polymyxin B and netropsin against clinical isolates of multidrug-resistant Acinetobacter baumannii

Sci Rep. 2016 Jun 16:6:28168. doi: 10.1038/srep28168.

Abstract

Polymyxins are last-resort antibiotics for treating infections of Gram-negative bacteria. The recent emergence of polymyxin-resistant bacteria, however, urgently demands clinical optimisation of polymyxin use to minimise further evolution of resistance. In this study we developed a novel combination therapy using minimal concentrations of polymyxin B. After large-scale screening of Streptomyces secondary metabolites, we identified a reliable polymixin synergist and confirmed as netropsin using high-pressure liquid chromatography, nuclear magnetic resonance, and mass spectrometry followed by in vitro assays using various Gram-negative pathogenic bacteria. To evaluate the effectiveness of combining polymixin B and netropsin in vivo, we performed survival analysis on greater wax moth Galleria mellonella infected with colistin-resistant clinical Acinetobacter baumannii isolates as well as Escherichia coli, Shigella flexineri, Salmonella typhimuruim, and Pseudomonas aeruginosa. The survival of infected G. mellonella was significantly higher when treated with polymyxin B and netropsin in combination than when treated with polymyxin B or netropsin alone. We propose a netropsin combination therapy that minimises the use of polymyxin B when treating infections with multidrug resistant Gram-negative bacteria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Acinetobacter Infections / microbiology
  • Acinetobacter baumannii / drug effects*
  • Acinetobacter baumannii / isolation & purification
  • Animals
  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Multiple, Bacterial / physiology
  • Drug Synergism
  • Drug Therapy, Combination
  • Escherichia coli / drug effects
  • Humans
  • Microbial Sensitivity Tests
  • Models, Animal
  • Moths / microbiology*
  • Netropsin / therapeutic use*
  • Polymyxin B / therapeutic use*
  • Pseudomonas aeruginosa / drug effects
  • Salmonella typhimurium / drug effects
  • Shigella flexneri / drug effects

Substances

  • Anti-Bacterial Agents
  • Netropsin
  • Polymyxin B