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Rethinking dormancy: Antibiotic persisters are metabolically active, non-growing cells 同源大肠杆菌群体会产生多种宿主表型。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107386
K. M. Taufiqur Rahman , Ruqayyah Amaratunga , Xuan Yi Butzin , Abhyudai Singh , Tahmina Hossain , Nicholas C. Butzin

Objectives

Bacterial persisters are a subpopulation of multidrug-tolerant cells capable of surviving and resuming activity after exposure to bactericidal antibiotic concentrations, contributing to relapsing infections and the development of antibiotic resistance. In this study, we challenge the conventional view that persisters are metabolically dormant by providing compelling evidence that an isogenic population of Escherichia coli remains metabolically active in persistence.

Methods

Using transcriptomic analysis, we examined E. coli persisters at multiple time points following exposure to bactericidal concentrations of ampicillin (Amp). Some genes were consistently upregulated in Amp treated persisters compared to the untreated controls, a change that can only occur in metabolically active cells capable of increasing RNA levels.

Results

Some of the identified genes have been previously linked to persister cells, while others have not been associated with them before. If persister cells were metabolically dormant, gene expression changes over time would be minimal during Amp treatment. However, network analysis revealed major shifts in gene network activity at various time points of antibiotic exposure.

Conclusions

These findings reveal that persisters are metabolically active, non-dividing cells, thereby challenging the traditional view that they are dormant.
细菌持久体是一种多耐药亚群,能够在致命的抗生素治疗后存活和复苏,导致复发性感染和抗生素耐药性的出现。我们挑战了只有一个持久体种群的传统观点,并展示了强有力的证据,证明在一个等源大肠杆菌种群中存在多个持久体亚群,使它们能够在致命的抗生素压力下存活下来。我们在使用致死性氨苄青霉素(Amp)抗生素的多个时间点进行了转录组分析,不出所料,一些基因随着时间的推移出现了差异表达。通过比较经安培处理与未经处理的不同时间点的转录水平,我们确定了一组持续上调的基因。一些基因以前与持久性有机污染物有关,而另一些则是新发现的。随后,网络分析显示了网络之间的基因反应,但无法绘制假定基因图谱。过量表达七个假定基因会导致细胞生长缓慢或不生长,这表明高产量会对细胞造成伤害。随后,我们进行了单基因敲除,结果显示,在安培处理 3 小时后,持久体水平显著降低了 4-6 倍,在安培处理 6 小时后,持久体水平显著降低了 10-15 倍。然而,在 24 小时后观察到的存活率没有明显差异,这表明存在多个持久体亚群。我们的数学模型显示,突变体中的慢衰变部分减少了 20 倍,这表明衰变动力学在细菌存活中的重要性。这些结果证明存在多个持久体亚群,每个亚群都有不同的衰变速率。此外,这些结果还对完全休眠的观点提出了挑战,表明存在着复杂的、多方面的生存机制,并表明宿主群体本身是异质的。
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引用次数: 0
LL-37, the master antimicrobial peptide, its multifaceted role from combating infections to cancer immunity LL-37,主抗菌肽,其多方面的作用,从对抗感染到癌症免疫。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107398
Anand K. Keshri , Suraj S. Rawat , Anubha Chaudhary , Swati Sharma , Ananya Kapoor , Parul Mehra , Rimanpreet Kaur , Amit Mishra , Amit Prasad
Antimicrobial peptides (AMPs) represent a unique group of naturally occurring molecules having diverse biological activities, including potent antimicrobial properties. Among them, LL-37 has emerged as a significant player, demonstrating its multifaceted roles during bacterial, fungal, and viral infections, as well as exhibiting intriguing implications in cancer. This review delves into the versatile functions of LL-37, elucidating its mechanisms of action against microbial pathogens and its potential to modulate immune responses. We explored the efficacy of LL-37 in disrupting bacterial membranes, inhibiting fungal growth, and interfering with viral replication, highlighting its potential as a therapeutic agent against a wide array of infectious diseases. Furthermore, we discussed the emerging role of LL-37 in cancer immunity, where its immunomodulatory effects and direct cytotoxicity towards cancer cells offer novel avenues for cancer therapy in the near future. We provided a comprehensive overview of the activities of LL-37 across various diseases and underscored the importance of further research into harnessing the therapeutic potential of this potential antimicrobial peptide along with other suitable candidates.
抗菌肽(AMPs)是一组独特的天然分子,具有多种生物活性,包括有效的抗菌特性。其中,LL-37已成为一个重要的参与者,在细菌、真菌和病毒感染中显示出其多方面的作用,以及在癌症中显示出有趣的意义。本文综述了LL-37的多种功能,阐明了其对微生物病原体的作用机制及其调节免疫反应的潜力。我们探索了LL-37在破坏细菌膜、抑制真菌生长和干扰病毒复制方面的功效,强调了它作为治疗多种传染病的药物的潜力。此外,我们还讨论了LL-37在癌症免疫中的新作用,其免疫调节作用和对癌细胞的直接细胞毒性为不久的将来癌症治疗提供了新的途径。我们全面概述了LL-37在各种疾病中的活性,并强调了进一步研究利用这种潜在抗菌肽和其他合适候选肽的治疗潜力的重要性。
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引用次数: 0
Corrigendum to “Clostridioides difficile infections were predominantly driven by fluoroquinolone-resistant Clostridioides difficile ribotypes 176 and 001 in Slovakia in 2018-2019” [International Journal of Antimicrobial Agents, 62 (2023) 1-9/106824] “2018-2019年斯洛伐克艰难梭菌感染主要由氟喹诺酮耐药艰难梭菌核型176和001驱动”[国际抗微生物药物杂志,62(2023)1-9/106824]。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107408
Adriana Plankaova , Marie Brajerova , Vaclav Capek , Gabriela Balikova Novotna , Pete Kinross , Jana Skalova , Anna Soltesova , Pavel Drevinek , Marcela Krutova
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引用次数: 0
Anakinra efficacy in COVID-19 pneumonia guided by soluble urokinase plasminogen activator receptor: Association with the inflammatory burden of the host 阿那白在可溶性尿激酶纤溶酶原激活物受体引导下治疗COVID-19肺炎的疗效:与宿主炎症负荷的关系
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107405
Evdoxia Kyriazopoulou , Karolina Akinosoglou , Eleni Florou , Elli Kouriannidi , Artemis Bogosian , Olga Tsachouridou , Konstantinos N. Syrigos , Nikolaos Gatselis , Haralampos Milionis , Ilias C. Papanikolaou , Styliani Sympardi , Maria Dafni , Antonia Alevizou , Alexia-Vasiliki Amvrazi , Errika Alexandrou , Kyprianos Archontoulis , Katerina Argyraki , Zoi Alexiou , Yakinthi Georgiou , Dimitra Gkogka , Evangelos J. Giamarellos-Bourboulis

Background

Anakinra was approved by the European Medicines Agency and received Emergency Use Authorization by the United States Food and Drug Administration for patients with COVID-19 pneumonia at risk for severe respiratory failure (SRF) with blood levels of soluble urokinase plasminogen activator receptor (suPAR) ≥ 6 ng/mL. We report the final results of the phase II open-label single-arm SAVE trial in a large population.

Methods

Patients with COVID-19 pneumonia and suPAR levels ≥ 6 ng/mL received subcutaneous anakinra 100 mg once daily for 10 days. The primary outcome was the incidence of SRF by day 14. Secondary outcomes were 30-day mortality, incidence of SRF according to time delay for start of treatment, safety, and associations with the inflammatory burden of the host.

Results

From March 2020 to March 2022, a total of 992 patients were enrolled. The incidence of SRF was 18.8%, similar to the results of the phase III pivotal SAVE-MOREtrial. The overall 30-day mortality was 9.5%. Participants were divided into 4 subgroups according to time delay between symptoms onset and start of anakinra. The incidence of SRF was similar for all subgroups. Serious adverse events were reported in 15.4%; only 3 were possibly related to anakinra. The most common adverse event was increased liver function tests. A post hoc comparison with the pivotal phase III trial showed similar anakinra outcomes among patient subgroups by levels of inflammatory mediators and D-dimers.

Conclusions

Results support the efficacy of anakinra as being similar to that of the pivotal registrational trial for COVID-19 pneumonia. The lack of a comparator group is a limitation.

Trial Registration

ClinicalTrials.gov, NCT04357366
Anakinra已获得欧洲药品管理局(ema)批准,并获得美国食品和药物管理局(fda)的紧急使用授权,用于血液中suPAR(可溶性尿激酶纤溶酶原激活物受体)水平≥6 ng/ml、有严重呼吸衰竭(SRF)风险的COVID-19肺炎患者。我们报告在大人群中进行的II期开放标签单臂SAVE试验的最终结果。suPAR水平≥6 ng/ml的COVID-19肺炎患者皮下注射阿那金100mg,每日1次,连续10天。主要终点是第14天SRF的发生率。次要结局是30天死亡率、根据治疗开始时间延迟的SRF发生率、安全性以及与宿主炎症负担的关联。从2020年3月到2022年3月,992名患者入组。SRF的发生率为18.8%,与III期关键试验的结果相似。总体30天死亡率为9.5%。根据症状发作和阿那白开始的时间延迟将参与者分为四个亚组。所有亚组的SRF发生率相似。严重不良事件占15.4%;只有3个可能与阿那金那有关。最常见的不良事件是肝功能检查增加。与关键III期试验的事后比较显示,在炎症介质和d -二聚体水平不同的患者亚组中,anakinra的结果相似。结果支持anakinra在COVID-19肺炎关键注册试验中的类似疗效。缺乏比较国组是一个限制。试验注册:ClinicalTrials.gov, NCT04357366。
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引用次数: 0
Evaluating the antibacterial activity of engineered phage ФEcSw endolysin against multidrug-resistant Escherichia coli strain Sw1 评价工程噬菌体ФEcSw内溶素对多重耐药大肠杆菌Sw1的抑菌活性。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107395
Maheswaran Easwaran , Rajiv Gandhi Govindaraj , Misagh Naderi , Michal Brylinski , Mahanama De Zoysa , Hyun-Jin Shin

Objective

The emergence of bacteriophage-encoded endolysins hold significant promise as novel antibacterial agents, particularly against the growing threat of antibiotic-resistant bacteria. Therefore, we investigated the phage ФEcSw endolysin to enhance the lytic activity against multi-drug-resistant Escherichia coli Sw1 through site-directed mutagenesis (SDM) guided by in silico identification of critical residues.

Methods

A computational analysis was conducted to elucidate the protein folding pattern, identify the active domains, and recognize critical residues of ФEcSw endolysin. Structural similarity-based docking simulations were employed to identify residues potentially involved in both recognition and cleavage of the bacterial peptidoglycan. Phage endolysin was amplified, cloned, expressed, and purified from phage ФEcSw. Pure endolysin (EL) activity was subsequently validated through SDM.

Results

Our studies revealed both open and closed conformations of ФEcSw endolysin within specific residue ranges (51–60 and 128–141). Notably, the active site was identified and contains the crucial catalytic residues, Glu19 and Asp34. A time-kill assay demonstrated that the holin (HL) – EL effectively reduced E. coli Sw1 growth by 46% within 12 h. Furthermore, treatment with HL, EL, and HL-EL significantly increased bacterial membrane permeability (11%, 74%, and 85%, respectively) within just 1 h. Importantly, SDM identified a double mutant (K19/H34) of the endolysin exhibiting the highest lytic activity compared to the wild-type and other mutants (E19D, E19K, D34E, and D34H) due to increase net charge from +3.23 to +6.29.

Conclusions

Our findings demonstrate that phage endolysins and HLs or engineered endolysin hold significant potential as therapeutic agents to combat multidrug-resistant bacterial infections.
目的:噬菌体编码的内溶素作为新型抗菌剂的出现具有重要的前景,特别是针对日益增长的抗生素耐药细菌的威胁。因此,我们对噬菌体ФEcSw内溶素进行了研究,以提高其对多重耐药大肠杆菌Sw1的裂解活性,方法是在硅基识别关键残基的指导下进行定点诱变。方法:通过计算分析阐明蛋白质折叠模式,识别活性结构域,识别ФEcSw内溶素的关键残基。采用基于结构相似性的对接模拟来鉴定可能参与细菌肽聚糖(PG)识别和裂解的残基。从噬菌体ФEcSw中扩增、克隆、表达并纯化噬菌体内溶素。纯内溶素(EL)活性随后通过定点诱变验证。结果:我们的研究揭示了ФEcSw内溶素在特定残留范围内的开放和封闭构象(51-60和128-141)。值得注意的是,活性位点被确定并包含关键的催化残基Glu19和Asp34。一项时效试验表明,Holin (HL) - EL在12小时内有效地降低了大肠杆菌Sw1的生长46%。此外,HL、EL和HL-EL治疗在1小时内显著增加了细菌膜通透性(分别为11%、74%和85%)。重要的是,位点定向诱变鉴定出一种双突变体(K19/H34)的内溶素,与野生型和其他突变体(E19D, E19K, D34E和D34H)相比,由于净电荷从+3.23增加到+6.29,因此具有最高的裂解活性。结论:我们的研究结果表明,噬菌体内溶素和holins或工程内溶素作为对抗多重耐药细菌感染的治疗药物具有巨大的潜力。
{"title":"Evaluating the antibacterial activity of engineered phage ФEcSw endolysin against multidrug-resistant Escherichia coli strain Sw1","authors":"Maheswaran Easwaran ,&nbsp;Rajiv Gandhi Govindaraj ,&nbsp;Misagh Naderi ,&nbsp;Michal Brylinski ,&nbsp;Mahanama De Zoysa ,&nbsp;Hyun-Jin Shin","doi":"10.1016/j.ijantimicag.2024.107395","DOIUrl":"10.1016/j.ijantimicag.2024.107395","url":null,"abstract":"<div><h3>Objective</h3><div>The emergence of bacteriophage-encoded endolysins hold significant promise as novel antibacterial agents, particularly against the growing threat of antibiotic-resistant bacteria. Therefore, we investigated the phage ФEcSw endolysin to enhance the lytic activity against multi-drug-resistant <em>Escherichia coli</em> Sw1 through site-directed mutagenesis (SDM) guided by in silico identification of critical residues.</div></div><div><h3>Methods</h3><div>A computational analysis was conducted to elucidate the protein folding pattern, identify the active domains, and recognize critical residues of ФEcSw endolysin. Structural similarity-based docking simulations were employed to identify residues potentially involved in both recognition and cleavage of the bacterial peptidoglycan. Phage endolysin was amplified, cloned, expressed, and purified from phage ФEcSw. Pure endolysin (EL) activity was subsequently validated through SDM.</div></div><div><h3>Results</h3><div>Our studies revealed both open and closed conformations of ФEcSw endolysin within specific residue ranges (51–60 and 128–141). Notably, the active site was identified and contains the crucial catalytic residues, Glu19 and Asp34. A time-kill assay demonstrated that the holin (HL) – EL effectively reduced <em>E. coli</em> Sw1 growth by 46% within 12 h. Furthermore, treatment with HL, EL, and HL-EL significantly increased bacterial membrane permeability (11%, 74%, and 85%, respectively) within just 1 h. Importantly, SDM identified a double mutant (K19/H34) of the endolysin exhibiting the highest lytic activity compared to the wild-type and other mutants (E19D, E19K, D34E, and D34H) due to increase net charge from +3.23 to +6.29.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrate that phage endolysins and HLs or engineered endolysin hold significant potential as therapeutic agents to combat multidrug-resistant bacterial infections.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"65 1","pages":"Article 107395"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retraction notice to “Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial” [International Journal of Antimicrobial Agents 56 (2020), 105949] 《羟氯喹联合阿奇霉素治疗COVID-19:一项开放标签非随机临床试验的结果》撤回通知[国际抗菌药物杂志56(2020),105949]。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107416
Philippe Gautret , Jean-Christophe Lagier , Philippe Parola , Van Thuan Hoang , Line Meddeb , Morgane Mailhe , Barbara Doudier , Johan Courjon , Valérie Giordanengo , Vera Esteves Vieira , Hervé Tissot Dupont , Stéphane Honoré , Philippe Colson , Eric Chabrière , Bernard La Scola , Jean-Marc Rolain , Philippe Brouqui , Didier Raoult
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引用次数: 0
Effect of clinically relevant antibiotics on bacterial extracellular vesicle release from Escherichia coli 临床相关抗生素对大肠杆菌胞外囊泡释放的影响
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107384
Panteha Torabian , Navraj Singh , James Crawford , Gabriela Gonzalez , Nicholas Burgado , Martina Videva , Aidan Miller , Janai Perdue , Milena Dinu , Anthony Pietropaoli , Thomas Gaborski , Lea Vacca Michel
Sepsis, a leading cause of death in hospitals, can be defined as a dysregulated host inflammatory response to infection, which can lead to tissue damage, organ failure and cardiovascular complications. Although there is no cure for sepsis, the condition is typically managed with broad-spectrum antibiotics to eliminate any potential bacterial source of infection. However, a potential side effect of antibiotic treatment is the enhanced release of bacterial extracellular vesicles (BEVs), membrane-bound nanoparticles containing proteins and other biological molecules from their parent bacterium. Some of the Gram-negative extracellular vesicle (EV) cargo, including peptidoglycan associated lipoprotein and outer membrane protein A, have been shown to induce both acute and chronic inflammation in host tissue. It was hypothesized that the antibiotic concentration and mechanism of action may affect the amount of released BEVs, which could potentially exacerbate the host inflammatory response. This study evaluated nine clinically relevant antibiotics for their effect on EV release from Escherichia coli. Several beta-lactam antibiotics caused significantly more EV release, while quinolone and aminoglycoside antibiotics caused less vesiculation. Further study is warranted to corroborate the correlation between an antibiotic's mechanism of action and its effect on EV release, but these results underline the importance of antibiotic choice when treating patients with sepsis.
败血症是导致医院患者死亡的主要原因,可定义为宿主对感染的炎症反应失调,可导致组织损伤、器官衰竭和心血管并发症。虽然败血症无法治愈,但通常会使用广谱抗生素来消除潜在的细菌感染源。然而,抗生素治疗的一个潜在副作用是增强细菌胞外小泡(BEVs)的释放,BEVs 是一种膜结合纳米颗粒,其母体细菌含有蛋白质和其他生物分子。一些革兰氏阴性 EV 货物,包括肽聚糖相关脂蛋白(Pal)和外膜蛋白 A(OmpA),已被证明能诱发宿主组织的急性和慢性炎症。我们推测,抗生素的浓度及其作用机制会对释放的 BEV 数量产生影响,从而有可能加剧宿主的炎症反应。在这项研究中,我们评估了九种临床相关抗生素对大肠杆菌释放 EV 的影响。几种β-内酰胺类抗生素导致了明显更多的EV释放,而喹诺酮类和氨基糖苷类抗生素导致的水泡相对较少。要证实抗生素的作用机制与其对 EV 释放的影响之间的相关性还需要进一步的研究,但这些结果强调了在治疗败血症患者时选择抗生素的重要性。
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引用次数: 0
NpmC – a novel A1408 16S rRNA methyltransferase in the gut of humans and animals 人和动物肠道中的新型 A1408 16S rRNA 甲基转移酶 NpmC。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107382
Bosco R. Matamoros , Carlos Serna , Emilia Wedel , Natalia Montero , Finn Kirpekar , Bruno Gonzalez-Zorn
NpmA and NpmB are 16S rRNA methyltransferases that act on residue A1408 and confer high-level resistance to almost all aminoglycosides; however, these methyltransferases are rarely reported. A novel gene, npmC, was identified after analysisng all world-wide available metagenomic projects in a One Health context. This gene has a high level of similarity (91.5%) with npmA and up to 92.7% similarity at amino acidic level. The protein encoded by this gene presents the conserved motifs required for A1408 methylation. npmC was synthesized and its expression in Escherichia coli resulted in a high level of resistance to 4,5-disubstituted 2-deoxystreptamine (2-DOS) and 4-monosubstituted 2-DOS aminoglycosides, as well as moderate resistance to 4,6-disusbstituted 2-DOS aminoglycosides, including the last resort aminoglycoside, plazomicin. Methylation at residue A1408 was confirmed by mass spectrometry assays. Analysis of the npmC gene background revealed that its genetic context was associated with different insertion sequences that could mobilise the gene. Similarities in the genetic context between npmC and npmA indicate that they share a common ancestor. The immediate genetic context of this methyltransferase indicates a high relationship to the Eubacteriales order. This finding reveals the dark matter of the microbiome as a potential source of novel resistance genes, expands the list of the true pan-aminoglycoside 16S rRNA methyltransferases, which threaten the usefulness and development of next-generation aminoglycosides.
作用于残基 A1408 的 16S rRNA 甲基转移酶(NpmA 和 NpmB)对几乎所有氨基糖苷类药物都具有高水平的耐药性,但有关它们的报道却很少。通过分析 "一个健康 "背景下的元基因组项目,我们在中国和加拿大的人类和动物肠道微生物组中发现了一个新基因 npmC,它与 npmA 的同一性为 91.5%,在氨基酸水平上的同一性高达 92.7%。该基因编码的蛋白质具有 A1408 甲基化所需的保守基序。该基因的表达导致了对 4,5-二取代的 2-脱氧链霉胺(2-DOS)和 4-单取代的 2-DOS 氨基糖苷类的高度耐药性,以及对 4,6-二取代的 2-DOS 氨基糖苷类(包括最后的氨基糖苷类 plazomicin)的中度耐药性。质谱分析进一步证实了残基 A1408 的甲基化。对 npmC 基因背景的分析表明,该基因的遗传背景与不同的插入序列有关,这些插入序列可能会调动该基因。npmC 和 npmA 基因背景的相似性表明,它们有一个共同的祖先。这种甲基转移酶的直接遗传背景表明,它们与 Eubacteriales 目关系密切。这一发现扩大了真正的泛氨基糖苷类 16S rRNA 甲基转移酶的名单,威胁到下一代氨基糖苷类药物的实用性和开发。
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引用次数: 0
Eliminating the tigecycline resistance RND efflux pump gene cluster tmexCD-toprJ in bacteria using CRISPR/Cas9 利用 CRISPR/Cas9 消除细菌中抗替加环素 RND 外排泵基因簇 tmexCD-toprJ。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107390
Lei Xu , Xiaoyu Lu , Yan Li , Patrick Butaye , Shangshang Qin , Zhiqiang Wang , Ruichao Li

Objectives

Tigecycline, a last-resort antibiotic in the tetracycline class, has been effective in treating infections caused by multidrug-resistant bacteria. However, the emergence of the tigecycline resistance gene cluster tmexCD-toprJ, which encodes a resistance-nodulation-division efflux pump, has significantly limited its therapeutic effectiveness. This study aims to explore the potential of CRISPR/Cas9-based plasmids to target and cleave tmexCD-toprJ gene cluster from bacterial plasmids and chromosomal integrative conjugative elements (ICEs), respectively.

Methods

We developed two CRISPR/Cas9-based plasmids, pCas9Kill and pCas9KillTS. The pCas9Kill plasmid designed to eliminate tmexCD-toprJ from plasmids through electroporation, while the pCas9KillTS plasmid, delivered through conjugation, targeted tmexCD-toprJ within ICEs on the bacterial chromosome. The plasmid modifications were assessed using nanopore long-read sequencing.

Results

Electroporation with the pCas9Kill plasmid resulted in the removal of tmexCD-toprJ from plasmids, restoring bacterial susceptibility to tigecycline. Nanopore sequencing revealed that the plasmids were repaired by insertion sequences after tmexCD-toprJ removal. In contrast, the pCas9KillTS plasmid introduced via conjugation to target tmexCD-toprJ gene cluster on ICEs within the chromosome. This approach led to chromosomal cleavage and subsequent bacterial cell death.

Conclusion

Our results demonstrate that both plasmids effectively inactivated tmexCD-toprJ, with pCas9Kill restoring tigecycline susceptibility in plasmid-bearing strains and pCas9KillTS causing targeted cell death in chromosomal ICE-harbouring bacteria. This study highlights the potential of CRISPR/Cas9 systems in addressing antibiotic resistance, providing a promising strategy to combat tigecycline-resistant pathogens.
替加环素是四环素类抗生素中的最后一种,在治疗耐多药细菌引起的感染方面一直很有效。然而,编码耐药-结节-分裂外排泵的替加环素耐药基因簇 tmexCD-toprJ 的出现大大限制了其治疗效果。在本研究中,我们开发了两种基于 CRISPR/Cas9 的质粒 pCas9Kill 和 pCas9KillTS,分别用于靶向和裂解细菌质粒和染色体整合共轭元件(ICE)中的 tmexCD-toprJ 基因簇。pCas9Kill 质粒旨在通过电穿孔消除质粒中的 tmexCD-toprJ,从而使细菌对替加环素重新敏感。纳米孔长读序测序显示,在去除 tmexCD-toprJ 后,质粒被插入序列修复。相比之下,pCas9KillTS 质粒是通过共轭作用引入染色体内 ICEs 上的 tmexCD-toprJ 基因簇。这种方法导致了染色体裂解和随后的细菌细胞死亡。我们的研究结果表明,这两种质粒都能有效灭活 tmexCD-toprJ,pCas9Kill 能使携带质粒的菌株恢复对替加环素的敏感性,而 pCas9KillTS 则能使携带染色体 ICE 的细菌发生定向细胞死亡。这项研究凸显了 CRISPR/Cas9 系统在解决抗生素耐药性方面的潜力,为抗击耐虎环素病原体提供了一种前景广阔的策略。
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引用次数: 0
Ceftazidime-avibactam (CAZ-AVI) pharmacokinetics in critically ill patients undergoing continuous venovenous hemodiafiltration (CVVHDF) 头孢唑肟-阿维巴坦(CAZ-AVI)在接受连续静脉血液透析(CVVHDF)的重症患者中的药代动力学。
IF 4.9 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-01 DOI: 10.1016/j.ijantimicag.2024.107394
Amaury O'Jeanson , Konstantinos Ioannidis , Elisabet I. Nielsen , Lamprini Galani , Aghavni Ginosyan , Harry Paskalis , Irena Loryan , Helen Giamarellou , Lena E. Friberg , Ilias Karaiskos

Purpose

To investigate the pharmacokinetics (PK) of ceftazidime-avibactam (CAZ-AVI) in critically ill patients undergoing continuous venovenous hemodiafiltration (CVVHDF), and compare with a general phase III trial population.

Methods

A prospective PK study was conducted in critically ill patients who received CVVHDF for acute kidney injury, treated with CAZ-AVI (1000/250 mg or 2000/500 mg q8h). Plasma and CVVHDF-circuit samples were collected to determine CAZ-AVI concentrations. Individual PK parameters at steady-state were estimated using non-compartmental analysis. For visual comparison, plasma concentrations from CVVHDF patients were overlaid with simulated data from patients not receiving CVVHDF based on previously developed population PK models.

Results

A total of 35 plasma samples and 16 CVVHDF-circuit samples were obtained from four patients, with two patients sampled on two separate occasions. Median total clearance and volume of distribution were 4.54 L/h and 73.2 L for CAZ and 10.5 L/h and 102 L for AVI, respectively. Median contribution of CVVHDF to total clearance was 19.8% for CAZ and 5.3% for AVI. Observed CAZ-AVI PK profiles were generally within the 90% confidence interval of model predictions, but the observed concentrations were notably lower early (0–2 h) and higher later (4–8 h) in the dosing interval, suggesting a higher volume of distribution.

Conclusions

These results suggest that the CAZ-AVI dose regimens used in this study can be applicable in critically ill patients undergoing CVVHDF, despite the different shape of the PK profiles observed in this population. Further research with a larger patient cohort is warranted to validate and refine these findings.
目的:研究头孢他啶-阿维菌素(CAZ-AVI)在接受连续静脉血液透析(CVVHDF)的重症患者中的药代动力学(PK),并与一般 III 期试验人群进行比较:在因急性肾损伤接受CVVHDF治疗的重症患者中开展了一项前瞻性PK研究,患者接受CAZ-AVI(1000/250 mg或2000/500 mg q8h)治疗。收集血浆和 CVVHDF 电路样本以确定 CAZ-AVI 的浓度。采用非室分析法估算稳态时的单个 PK 参数。为了进行直观比较,根据先前开发的群体 PK 模型,将 CVVHDF 患者的血浆浓度与未接受 CVVHDF 患者的模拟数据进行了叠加:共从四名患者身上采集了35份血浆样本和16份CVVHDF-回路样本,其中两名患者分别在两个不同的场合采样。CAZ 的总清除率和分布容积中位数分别为 4.54 升/小时和 73.2 升,AVI 的总清除率和分布容积中位数分别为 10.5 升/小时和 102 升。CAZ和AVI的CVVHDF在总清除率中所占比例的中位数分别为19.8%和5.3%。观察到的CAZ-AVI PK曲线一般在模型预测的90%置信区间内,但观察到的浓度在给药间隔的早期(0-2小时)明显较低,后期(4-8小时)较高,表明分布容积较大:这些结果表明,尽管在接受CVVHDF治疗的重症患者中观察到的PK曲线形状不同,但本研究中使用的CAZ-AVI剂量方案仍适用于此类患者。有必要对更大的患者群体进行进一步研究,以验证和完善这些发现。
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引用次数: 0
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International Journal of Antimicrobial Agents
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