A broad-spectrum antibiotic adjuvant reverses multidrug-resistant Gram-negative pathogens

Nat Microbiol. 2020 Aug;5(8):1040-1050. doi: 10.1038/s41564-020-0723-z. Epub 2020 May 18.

Abstract

The rapid emergence and dissemination of multidrug-resistant (MDR) bacterial pathogens pose a serious threat to global healthcare. One particular concern is the carbapenem-resistant Enterobacteriaceae (CRE), a group of Gram-negative bacteria that have evolved resistance to all or nearly all available antibiotics. Coupled with the fact of barren antibiotic development pipeline nowadays, a critical approach is to revitalize existing antibiotics using antibiotic adjuvants. We found a short linear antibacterial peptide (SLAP)-S25 carrying four non-natural amino acids of 2,4-diaminobutanoic acid (Dab), which solely showed weak antibacterial activity but boosted the efficacy of antibiotics covering all major classes, including cefepime, colistin, ofloxacin, rifampicin, tetracycline and vancomycin, against MDR Gram-negative pathogens. Mechanistic studies showed that SLAP-S25 triggers membrane damage by binding to both lipopolysaccharide (LPS) in the outer membrane and phosphatidylglycerol (PG) in bacterial cytoplasmic membrane, to potentiate antibiotic efficacy through collaborative strategies. Lastly, SLAP-S25 effectively enhanced the activity of colistin against MDR Escherichia coli-associated infections in three animal models. Our findings provide a potential therapeutic option using existing antibiotics in combination with broad-spectrum antibiotic adjuvants, to address the prevalent infections caused by MDR Gram-negative pathogens worldwide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • A549 Cells
  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Carbapenem-Resistant Enterobacteriaceae / drug effects
  • Chlorocebus aethiops
  • Colistin / pharmacology
  • Disease Models, Animal
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Drug Resistance, Multiple, Bacterial / genetics
  • Escherichia coli / drug effects
  • Female
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacterial Infections / drug therapy
  • Humans
  • Lipopolysaccharides
  • Mice
  • Mice, Inbred BALB C
  • Microbial Sensitivity Tests
  • Phosphatidylglycerols
  • Vero Cells

Substances

  • Anti-Bacterial Agents
  • Lipopolysaccharides
  • Phosphatidylglycerols
  • Colistin