Cephamycins inhibit pathogen sporulation and effectively treat recurrent Clostridioides difficile infection

Nat Microbiol. 2019 Dec;4(12):2237-2245. doi: 10.1038/s41564-019-0519-1. Epub 2019 Aug 12.

Abstract

Spore-forming bacteria encompass a diverse range of genera and species, including important human and animal pathogens, and food contaminants. Clostridioides difficile is one such bacterium and is a global health threat because it is the leading cause of antibiotic-associated diarrhoea in hospitals. A crucial mediator of C. difficile disease initiation, dissemination and re-infection is the formation of spores that are resistant to current therapeutics, which do not target sporulation. Here, we show that cephamycin antibiotics inhibit C. difficile sporulation by targeting spore-specific penicillin-binding proteins. Using a mouse disease model, we show that combined treatment with the current standard-of-care antibiotic, vancomycin, and a cephamycin prevents disease recurrence. Cephamycins were found to have broad applicability as an anti-sporulation strategy, as they inhibited sporulation in other spore-forming pathogens, including the food contaminant Bacillus cereus. This study could directly and immediately affect treatment of C. difficile infection and advance drug development to control other important spore-forming bacteria that are problematic in the food industry (B. cereus), are potential bioterrorism agents (Bacillus anthracis) and cause other animal and human infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Toxins / genetics
  • Cell Survival / drug effects
  • Cephamycins / pharmacology*
  • Chlorocebus aethiops
  • Clostridioides difficile / drug effects*
  • Clostridioides difficile / genetics
  • Clostridioides difficile / growth & development
  • Clostridium Infections / microbiology
  • Clostridium Infections / prevention & control*
  • Disease Models, Animal
  • Gene Expression Regulation, Bacterial
  • Genes, Bacterial / genetics
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Penicillin-Binding Proteins / drug effects
  • Penicillin-Binding Proteins / genetics
  • Spores, Bacterial / drug effects
  • Vancomycin / pharmacology
  • Vero Cells / drug effects

Substances

  • Anti-Bacterial Agents
  • Bacterial Toxins
  • Cephamycins
  • Penicillin-Binding Proteins
  • Vancomycin