Adaptation-based resistance to siderophore-conjugated antibacterial agents by Pseudomonas aeruginosa

Antimicrob Agents Chemother. 2013 Sep;57(9):4197-207. doi: 10.1128/AAC.00629-13. Epub 2013 Jun 17.

Abstract

Multidrug resistance in Gram-negative bacteria has become so threatening to human health that new antibacterial platforms are desperately needed to combat these deadly infections. The concept of siderophore conjugation, which facilitates compound uptake across the outer membrane by hijacking bacterial iron acquisition systems, has received significant attention in recent years. While standard in vitro MIC and resistance frequency methods demonstrate that these compounds are potent, broad-spectrum antibacterial agents whose activity should not be threatened by unacceptably high spontaneous resistance rates, recapitulation of these results in animal models can prove unreliable, partially because of the differences in iron availability in these different methods. Here, we describe the characterization of MB-1, a novel siderophore-conjugated monobactam that demonstrates excellent in vitro activity against Pseudomonas aeruginosa when tested using standard assay conditions. Unfortunately, the in vitro findings did not correlate with the in vivo results we obtained, as multiple strains were not effectively treated by MB-1 despite having low MICs. To address this, we also describe the development of new in vitro assays that were predictive of efficacy in mouse models, and we provide evidence that competition with native siderophores could contribute to the recalcitrance of some P. aeruginosa isolates in vivo.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Physiological / drug effects
  • Adaptation, Physiological / genetics
  • Animals
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology*
  • Biological Assay
  • Drug Resistance, Bacterial / drug effects*
  • Drug Resistance, Bacterial / genetics
  • Female
  • Iron / metabolism
  • Mice
  • Mice, Inbred ICR
  • Microbial Sensitivity Tests
  • Monobactams / chemistry
  • Monobactams / pharmacology*
  • Mutagenesis, Site-Directed
  • Oligopeptides / genetics
  • Oligopeptides / metabolism
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / genetics
  • Pseudomonas aeruginosa / growth & development
  • Pyridones / chemistry
  • Pyridones / pharmacology*
  • Siderophores / genetics
  • Siderophores / metabolism
  • Siderophores / pharmacology*
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • MB-1 monobactam compound
  • Monobactams
  • Oligopeptides
  • Pyridones
  • Siderophores
  • pyoverdin
  • Iron