Regulation of virulence and antibiotic resistance by two-component regulatory systems in Pseudomonas aeruginosa

The Gram-negative opportunistic pathogen Pseudomonas aeruginosa ubiquitously inhabits soil and water habitats and also causes serious, often antibiotic resistant, infections in immunocompromised patients (e.g. cystic fibrosis). This versatility is mediated in part by a large repertoire of two-component regulatory systems that appear instrumental in the regulation of both virulence processes and resistance to antimicrobials. Major two-component regulatory system proteins demonstrated to regulate these diverse processes include PhoP–PhoQ, GacA–GacS, RetS, LadS, and AlgR, among others. Here, we summarize the current body of knowledge of these and other two-component systems that provides insight into the complex regulation of virulence and resistance in P. aeruginosa .     

10种中草药提取物体外抗铜绿假单胞菌作用研究

通过对粗糠柴等10种中草药采用80%乙醇室温下浸渍制备的提取物进行体外抗铜绿假单胞菌及其耐药菌活性研究,并采取药敏纸片法测定临床分离菌株的耐药性。结果表明:这10种中草药80%乙醇提取物中,粗糠柴的乙酸乙酯层对铜绿假单胞菌标准菌及其耐药菌的抑菌效果最好,其抑菌圈直径范围在10~17 mm之间,MIC范围在0.125~0.5 mg·mL~(-1)之间,MBC范围在0.5~1 mg·mL~(-1)之间;正丁醇层、水层的抑菌活性较乙酸乙酯层弱,石油醚层对铜绿假单胞菌没有效果。而小叶藤黄、滇南红厚壳、续随子的乙酸乙酯层,巴豆、罗汉松、肉桂醇提物对铜绿假单胞菌及其耐药菌株有较弱抗菌活性;滇南红厚壳的正丁醇层、续随子乙酸乙酯层以及大八角和郁金的醇提物对铜绿假单胞菌及其耐药菌株均无活性。从这些数据中可以得出,粗糠柴的乙酸乙酯层、正丁醇层和水层对铜绿假单胞菌及其耐药菌有较好的抑菌活性,尤以乙酸乙酯层活性最好,而粗糠柴的石油醚层没有活性。     

Synergistic activity of chlorhexidine and synoeca-MP peptide against Pseudomonas aeruginosa

‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬This study aims to evaluate the in vitro antimicrobial and immunomodulatory activities and cytotoxicity of chlorhexidine (CHX) and synoeca-MP peptide alone or in combination against Pseudomonas aeruginosa. The antimicrobial property was evaluated by the determination of minimal inhibitory concentration, minimum bactericidal concentration, and planktonic bacteria and biofilm inhibition. Immunomodulatory activity was determined by enzyme-linked immunosorbent assay and nitric oxide production by the Griess reaction method. According to the results, synoeca-MP combined with CHX demonstrated antimicrobial effectiveness compared with its isolated use, in addition to immunomodulatory activity (upregulating MPC-1 and tumor necrosis factor-α and downregulating nitric oxide and interleukin-10). In this context, it is expected that the substances, together, could be capable of controlling bacterial infection and dissemination, besides potentiating macrophages’ immune response against the studied microorganism. Moreover, reducing the CHX concentration by the addition of synoeca-MP peptide may, in a beneficial way, minimize the undesirable effects of both, CHX and synoeca-MP in a clinical setting.     

The hydrophobic uptake pathway across the outer membrane of the antibiotic supersusceptible Pseudomonas aeruginosa mutant Z61

Abstract The Pseudomonas aeruginosa antibiotic supersusceptible mutant Z61 was 50–400-fold more susceptible than its wild-type parent K799 to 5 hydrophobic antibiotics. The strain Z61 outer membrane also demonstrated enhanced permeability towards a hydrophobic fluorescent probe. Strain Z61 cells had an altered cell surface, as revealed by phase-partitioning experiments, a lower amount of Lipid A phosphate, and a reduction in the number of Mg²⁺ binding sites in Lipid A, as demonstrated by dansyl polymyxin competition experiments. An antibiotic permation pathway directly through the outer membrane bilayer, rather than through porin proteins, is proposed for strain Z61.     

In vitro interactions of tobramycin with various nonantibiotics against Pseudomonas aeruginosa and Burkholderia cenocepacia

Pseudomonas aeruginosa and Burkholderia cepacia are the major pathogens that colonize the airway surface and cause progressive respiratory failure and high mortality, especially in cystic fibrosis (CF) patients. Tobramycin is the treatment of choice, but persistent usage enables the infectious organisms to activate defence mechanisms, making eradication rarely successful. Combinations of antibiotic and nonantibiotic compounds have been tested in vitro against P. aeruginosa and B. cepacia , but with mixed results. Sodium ions interfere with the bacterial tobramycin uptake system, but amiloride partially reverses this antagonism. In this pilot study, we extend previous findings of the effectiveness of tobramycin in combination with amiloride and other nonantibiotics against a P. aeruginosa type strain, and against four P. aeruginosa strains and one Burkholderia cenocepacia strain isolated from CF patients. Significantly, the four clinical P. aeruginosa strains were tobramycin resistant. We also find that Na⁺ and K⁺, but not Cl⁻, are the chief antagonists of tobramycin efficacy. These results suggest that chemotherapy for CF patients might not only be compromised by antibiotic-resistant pathogens alone, but by a lack of penetration of antibiotics caused either by bacterial biofilms or the high sodium flux in the CF lung, or by antagonistic effects of some drug combinations, any of which could allow the persistence of drug-susceptible bacteria.     

Role for rpoS gene of Pseudomonas aeruginosa in antibiotic tolerance

The alternative sigma factor, RpoS has been described as a central regulator of many stationary phase-inducible genes and a master stress-response regulator under various stress conditions. We constructed an rpoS mutant in Pseudomonas aeruginosa and investigated the role of rpoS gene in antibiotic tolerance. The survival of the rpoS mutant cells in stationary phase was approximately 70 times lower when compared with that of the parental strain at 37 degrees C for 2 h after the addition of biapenem. For imipenem, the survival was approximately 40 times lower. Heat stress promoted an increase in the survival of the parental strain to biapenem, but the same was not found to be the case for the rpoS mutant. Our results indicate that rpoS gene is involved in tolerance to antibiotics in P. aeruginosa during the stationary phase and heat stress. However, under osmotic stress, tolerance to biapenem was not dependent on the rpoS gene.     

Analysis of antibiotic resistance gene expression in Pseudomonas aeruginosa by quantitative real-time-PCR

In Pseudomonas aeruginosa many of the clinically relevant resistance mechanisms result from changes in gene expression as exemplified by the Mex drug efflux pumps, the AmpC beta-lactamase and the carbapenem-specific porin OprD. We used quantitative real-time-PCR to analyze the expression of these genes in susceptible and antibiotic-resistant laboratory and clinical strains. In nalB mutants, which overexpress OprM, we observed a four- to eightfold increase in the expression of mexA, mexB, and oprM genes. MexX and mexY genes were induced eight to 12 times in the presence of 2 mg L(-1) tetracycline. The mexC/oprJ and mexE/oprN gene expression levels were increased 30- to 250-fold and 100- to 760-fold in nfxB and nfxC mutants, respectively. We further found that in defined laboratory strains expression levels of ampC and oprD genes paralleled beta-lactamase activity and OprD protein levels, respectively. Our data support the use of quantitative real-time-PCR chain reaction for the analysis of the antimicrobial resistance gene expression in P. aeruginosa.     

Reduction of antibiotic-induced biofilm accumulation of Pseudomonas aeruginosa by quaternized phytoglycogen

Biofilms are oft cited as a factor in the unwanted persistence and recalcitrance of microbial life and a strong research initiative exists to identify, understand, and target vulnerabilities. Phytoglycogen is a biodegradable nanoparticulate biomaterial that is purified from crop plants. Importantly, the highly branched glucan structure provides a scaffold on which to construct novel polymers. Functionalized phytoglycogen (FP) was synthesized using green chemistry principles. Screening of several molecules identified a form of quaternized phytoglycogen which reduced biofilm formation and accretion by Pseudomonas aeruginosa. Exposing P. aeruginosa to modified phytoglycogen and antibiotic in combination not only substantively reduced biofilms, but also prevented increased biofilm formation, a biological response to suboptimal antibiotic concentrations. Treatment of pregrown biofilms with sub-minimum inhibitory concentration antibiotic alone also led to increased proliferation, whereas FP-antibiotic combinations prevented or reduced the extent of this. Swimming, swarming and twitching motility, all critical for biofilm development, were negatively affected by FP. This work supports phytoglycogen as a promising foundational molecule for novel polymers, including those with anti-biofilm function. Critically, in addition to published reports on how suboptimal antibiotic concentrations promote biofilm formation, we demonstrated a similar effect upon pre-existing biofilms, indicating a further route for the failure of antibiotic therapies.     

Characterization of antimicrobial resistance of Pseudomonas aeruginosa isolated from canine infections

Aims: To determine the prevalence of Pseudomonas aeruginosa among dogs with suspected soft tissue infections and to characterize these isolates. Methods and Results: Swabs were taken from infected soft tissues of 402 dogs. Pseudomonas aeruginosa strains were confirmed phenotypically and tested for susceptibility to 11 antimicrobial agents and genotyped by SpeI pulsed‐field gel electrophoresis (PFGE). The genetic basis of fluoroquinolone (FQ) resistance and the presence of integrons were also characterized. A total of 27 (6·7%) dogs tested positive for Ps. aeruginosa. Fourteen different SpeI patterns were observed in 25 typeable strains. Among the β‐lactams, three isolates presented resistance to ticarcillin and carbenicillin, while only one isolate exhibited resistance to ceftazidime. Among the aminoglycosides (AGs), three strains showed resistance to amikacin, and four strains exhibited resistance to gentamicin and tobramycin. Four strains with mutations that led to the substitution of Thr at position 83 with Ile in GyrA and the exchange of Ser at position 87 with Leu in ParC displayed resistance to all tested FQs. These strains also carried class 1 integrons and showed resistance to between 6 and 10 antimicrobials. These integrons included four different gene cassettes (aacA4‐aadA1, bla_OXA‐31‐aadA2, aadA1‐arr‐3‐catB3 and cmlA5‐cmlA‐aadA1). Conclusions: A small proportion of infected dogs treated in two animal hospitals in Beijing, China carried Ps. aeruginosa isolates. Low levels of resistance to anti‐pseudomonal agents were observed in these strains. Significance and Impact of the Study: This study is the first report on the antimicrobial resistance profiles of Ps. aeruginosa isolated from infected canine origin in China. Additionally, this is the first report of the oxacillin resistance gene bla_OXA‐31 in a canine Ps. aeruginosa isolate.     

铜绿假单胞菌XQ17提取物对革兰阳性菌的拮抗作用

从临床分离的1株铜绿假单胞菌能够产生拮抗物质,对其粗提物的初步研究表明,能有效杀灭受试的多数革兰阳性菌。通过比较其基本特征,与已知的铜绿假单胞菌产生的其他抗菌物质如Pyocyanin、Phenazine-1-carboxamide、Pseudomonic acid、pyocin等有明显区别,提示可能是一种具有潜在应用价值的新抗菌物质。     

Synergistic effects of heat and antibiotics on Pseudomonas aeruginosa biofilms

Upon formation of a biofilm, bacteria undergo several changes that prevent eradication with antimicrobials alone. Due to this resistance, the standard of care for infected medical implants is explantation of the infected implant and surrounding tissue, followed by eventual reimplantation of a replacement device. Recent studies have demonstrated the efficacy of heat shock for biofilm eradication. To minimize the heat required for in situ biofilm eradication, this study investigated the hypothesis that antibiotics, while ineffective by themselves, may substantially increase heat shock efficacy. The combined effect of heat and antibiotics on Pseudomonas aeruginosa biofilms was quantified via heat shock in combination with ciprofloxacin, tobramycin, or erythromycin at multiple concentrations. Combined treatments had synergistic effects for all antibiotics for heat shock conditions of 60°C for 5 min to 70°C for 1 min, indicating an alternative to surgical explantation.     

Activity and interactions of antibiotic and phytochemical combinations against Pseudomonas aeruginosa in vitro

In this study the in vitro activities of seven antibiotics (ciprofloxacin, ceftazidime, tetracycline, trimethoprim, sulfamethoxazole, polymyxin B and piperacillin) and six phytochemicals (protocatechuic acid, gallic acid, ellagic acid, rutin, berberine and myricetin) against five P. aeruginosa isolates, alone and in combination are evaluated. All the phytochemicals under investigation demonstrate potential inhibitory activity against P. aeruginosa. The combinations of sulfamethoxazole plus protocatechuic acid, sulfamethoxazole plus ellagic acid, sulfamethoxazole plus gallic acid and tetracycline plus gallic acid show synergistic mode of interaction. However, the combinations of sulfamethoxazole plus myricetin shows synergism for three strains (PA01, DB5218 and DR3062). The synergistic combinations are further evaluated for their bactericidal activity against P. aeruginosa ATCC strain using time-kill method. Sub-inhibitory dose responses of antibiotics and phytochemicals individually and in combination are presented along with their interaction network to suggest on the mechanism of action and potential targets for the phytochemicals under investigation. The identified synergistic combinations can be of potent therapeutic value against P. aeruginosa infections. These findings have potential implications in delaying the development of resistance as the antibacterial effect is achieved with lower concentrations of both drugs (antibiotics and phytochemicals).     

DNA vaccines against chronic lung infections by Pseudomonas aeruginosa

Vaccines containing outer membrane protein F (OprF) of Pseudomonas aeruginosa are effective in reducing lesion severity in a mouse pulmonary chronic infection model. One OprF-based vaccine, called F/I, contains carboxy oprF sequences fused to oprI in an expression vector. When delivered three times biolistically by gene gun, the F/I vaccine induces protection that is antibody-mediated in outbred mice. To demonstrate the role of F/I-induced antibody-mediated immunity, B-cell-deficient [B(-)] and B-cell-intact [B(+)] mice were immunized with F/I, challenged with Pseudomonas, and examined for lesion severity. As expected, F/I-immunized B(+) mice had fewer and less severe lesions than vector-immunized B(+) mice. However, surprisingly, F/I- and vector-immunized B(-) mice were equally protected to levels similar to F/I-immunized B(+) mice. Examination of immune cell populations and cytokine levels indicated a relative increase in the quantity of CD3+ T-lymphocytes in vector- or F/I-immunized and challenged B(-) mice compared to B(+) mice. These data indicate the protective role played by cell-mediated immunity in B(-) mice, which supports our hypothesis that cell-mediated immunity can play an important role in protection against P. aeruginosa.     

耐喹诺酮类铜绿假单胞菌的耐药性分析及血清学分型

目的了解广州地区喹诺酮类耐药铜绿假单胞菌的耐药性及泵抑制剂对其耐药水平降低的作用,并调查血清型分布情况。方法用法国生物梅里埃公司的微生物鉴定和药敏分析系统VITEK-2对127株铜绿假单胞菌进行鉴定和药敏检测,并采用羰酰氰基-对-氯苯胺(CCCP)与环丙沙星共同作用,以琼脂稀释法测定耐药菌的最低抑菌浓度(M IC)的变化,同时用玻片凝集法对耐药株进行血清学分型。结果环丙沙星耐药菌对哌拉西林/他唑巴坦(65.5%)的敏感率最高,只有阿米卡星(64.4%)、哌拉西林(51.7%)和妥布霉素(50.6%)的敏感率大于50.0%,而敏感菌对美罗培南(97.5%)及左氧氟沙星(97.5%)的敏感率最高,妥布霉素(95.0%)次之,对临床常用的13种抗生素,耐药菌较敏感菌的敏感性明显降低(P值均<0.001);耐药菌受泵抑制CCCP作用,M IC降低1~4个稀释度;血清分型率为93.1%,耐药菌的血清型以B型(20.7%)和L型(19.5%)为主。结论耐喹诺酮类铜绿假单胞菌对临床常用抗生素的敏感性降低,并呈多重耐药,使用抗生素 泵抑制剂可提高药物对铜绿假单胞菌的敏感性;血清学分型可以快速简单地监测铜绿假单胞菌在医院内的流行情况。     

In vitro activity of honey,total alkaloids of Sophora alopecuroides and matrine alone and in combination with antibiotics against multidrug-resistant Pseudomonas aeruginosa isolates

Natural products, including honey, total alkaloids of Sophora alopecuroides (TASA) and matrine have been used in combination with antibiotics against various pathogenic bacteria. However, there are limited data on the antibacterial activity of these natural products in combination against multidrug-resistant Pseudomonas aeruginosa strains. The in vitro activity of honey, TASA and matrine alone and in combination with antibiotics against P. aeruginosa isolates was investigated. In this study, four biofilm-producing P. aeruginosa isolates, which were resistant to multiple antibiotics, were used. These natural products were not the most effective single agent against four isolates. The fractional inhibitory concentration index method revealed the synergistic effect of matrine and TASA-honey in combination with ciprofloxacin (Cip) against all tested isolates. When these combinations were used, the resistance of isolates to Cip was decreased significantly (six to eightfold reduction in the minimum inhibitory concentration of Cip. The disk diffusion method showed that all isolates were resistant to β-lactams. Combinations of these antibiotics with TASA and matrine changed slightly the activity of either antibiotic used as a single agent. All isolates produced metallo-β-lactamase enzymes (MBL). Pretreatment isolates with Cip-matrine and Cip-TASA-honey resulted in a statistically downregulated expression of the mexA gene. These natural products can be used against overactivating MexAB-OprM but not MBL-producing P. aeruginosa isolates.     

光动力作用对铜绿假单胞杆菌杀伤效应的研究

目的:探讨不同的光动力剂量下光动力疗法(photodynam ic therapy,PDT)对体外培养的铜绿假单胞杆菌的杀伤效应。方法:以耐药性较强的铜绿假单胞杆菌(Pseudom onas aeruginos,P.aeruginosa)为研究对象,采用亚甲基蓝(m ethylene b lue,MB)作为光敏剂,用656 nm的激光作为光源(m axoutput=300 mW),对不同系列浓度的MB进行不同剂量的光照,用菌落计数的办法来观测PDT对铜绿假单胞杆菌的杀伤作用;同时利用血培养基检测铜绿假单胞杆菌致病性的改变。结果:在光照剂量相同的情况下,浓度适中(131.7 m ol)的亚甲基蓝溶液能够有效地杀伤铜绿假单胞杆菌,使其致病性降低;而浓度较高(1 317 m ol)或较低(13.17 m ol)的亚甲基蓝溶液对铜绿假单胞杆菌的杀伤作用相对较弱。结论:光动力作用对体外培养的铜绿假单胞杆菌具有明确的杀伤作用,但是其效果和剂量关系密切,所以在治疗过程中必须寻找合适的光敏剂剂量。