AB569, a non-toxic combination of acidified nitrite and EDTA, is effective at killing the notorious Iraq/Afghanistan combat wound pathogens, multi-drug resistant Acinetobacter baumannii and Acinetobacter spp

PLoS One. 2021 Mar 3;16(3):e0247513. doi: 10.1371/journal.pone.0247513. eCollection 2021.

Abstract

Multi-drug resistant (MDR) Acinetobacter baumannii (Ab) and Acinetobacter spp. present monumental global health challenges. These organisms represent model Gram-negative pathogens with known antibiotic resistance and biofilm-forming properties. Herein, a novel, nontoxic biocide, AB569, consisting of acidified nitrite (A-NO2-) and ethylenediaminetetraacetic acid (EDTA), demonstrated bactericidal activity against all Ab and Acinetobacter spp. strains, respectively. Average fractional inhibitory concentrations (FICs) of 0.25 mM EDTA plus 4 mM A-NO2- were observed across several clinical reference and multiple combat wound isolates from the Iraq/Afghanistan wars. Importantly, toxicity testing on human dermal fibroblasts (HDFa) revealed an upper toxicity limit of 3 mM EDTA plus 64 mM A-NO2-, and thus are in the therapeutic range for effective Ab and Acinetobacter spp. treatment. Following treatment of Ab strain ATCC 19606 with AB569, quantitative PCR analysis of selected genes products to be responsive to AB569 revealed up-regulation of iron regulated genes involved in siderophore production, siderophore biosynthesis non-ribosomal peptide synthetase module (SBNRPSM), and siderophore biosynthesis protein monooxygenase (SBPM) when compared to untreated organisms. Taken together, treating Ab infections with AB569 at inhibitory concentrations reveals the potential clinical application of preventing Ab from gaining an early growth advantage during infection followed by extensive bactericidal activity upon subsequent exposures.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acinetobacter Infections / epidemiology
  • Acinetobacter Infections / microbiology*
  • Acinetobacter baumannii / drug effects*
  • Acinetobacter baumannii / genetics
  • Adult
  • Afghan Campaign 2001-*
  • Afghanistan / epidemiology
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Biofilms / drug effects
  • Cells, Cultured
  • Disinfectants / chemistry
  • Disinfectants / pharmacology*
  • Drug Combinations
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Drug Resistance, Multiple, Bacterial / genetics
  • Edetic Acid / chemistry
  • Edetic Acid / pharmacology*
  • Fibroblasts / drug effects
  • Fibroblasts / metabolism
  • Gene Expression / drug effects
  • Humans
  • Iraq / epidemiology
  • Iraq War, 2003-2011*
  • Microbial Sensitivity Tests
  • Nitrites / chemistry
  • Nitrites / pharmacology*
  • Polymerase Chain Reaction
  • Skin / cytology
  • Wound Infection / epidemiology
  • Wound Infection / microbiology*

Substances

  • AB569
  • Anti-Bacterial Agents
  • Disinfectants
  • Drug Combinations
  • Nitrites
  • Edetic Acid

Grants and funding

A.L.B. (first author) and D.J.H. (corresponding author) Wright-Patterson Air Force Base.