ACS Infectious Diseases

Many commonly prescribed non-antibiotic medicines have off-target antimicrobial activity, yet their impact on antibiotic efficacy remains poorly understood. In this study, we investigated eight widely used UK prescription medicines and identified simvastatin, amlodipine, and fluoxetine as growth inhibitory towards methicillin-resistant Staphylococcus aureus (MRSA). These drugs disrupt bacterial membranes, with amlodipine and fluoxetine also triggering stress responses linked to cell wall and membrane damage. Further mechanistic analysis using transposon mutant screening revealed that simvastatin impairs cell wall synthesis by inhibiting the mevalonate pathway. Notably, checkerboard assays demonstrated antagonistic interactions: simvastatin reduced the efficacy of {beta}-lactams and vancomycin, amlodipine with vancomycin and daptomycin, and fluoxetine with vancomycin activity. Prolonged exposure to these drugs also accelerated resistance development to vancomycin and daptomycin. Together, these findings underscore the potential for commonly prescribed non-antibiotic medicines to undermine antibiotic therapy, warranting further study given the rising S. aureus treatment failures.

Multidrug-resistant (MDR) Klebsiella pneumoniae, classified by the World Health Organization (WHO) as a critical priority pathogen, represents a global health thereat requiring novel antimicrobials urgently. Here we evaluated the in vitro antimicrobial activity of a novel iridium-based compound (OMKP-3), against MDR K. pneumoniae. OMKP-3 exhibited robust antimicrobial activity in M9 minimal media (MIC=6.25{micro}g/mL) and rapid bactericidal effect (MBC=12.5{micro}g/mL) against the tested MDR K. pneumoniae strains. OMKP-3 showed antibiofilm ability and was active against multiple MDR Gram-negative pathogens, including Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa and Serratia marcescens (MIC range:6.25-25{micro}g/mL). Importantly, OMKP-3 showed no cytotoxicity against mammalian cells after 24 hours of exposure. When combined with polymyxin B, OMKP-3 acted as an adjuvant, enhancing polymyxin B activity (FIC[≤]0.5). OMKP-3 was less prone to induce high-level resistance in MDR K. pneumoniae compared to ciprofloxacin, and supressed the growth of resistant bacteria at a low and non-cytotoxic concentration (4xMIC). K. pneumoniae strains harboring truncated Ompk35/36 porin genes exhibited higher OMKP-3 MICs, indicating that these porins may serve as an important entry pathway. Spectrometry analysis revealed that OMKP-3 was able to accumulate intracellularly (1.57{micro}g/mL), with minimal Resistance-Nodulation-Division (RND) efflux pump extrusion involvement. Furthermore, analysis of the resistant mutant, harboring a mutation in the outer membrane protein DegS, together with fluorescence microscopy, suggests that OMKP-3 induces membrane-associated damage. No cross-resistance between OMKP-3 and commonly used antibiotics was observed. Collectively, these findings identify OMKP-3 as a promising novel antimicrobial agent against MDR K. pneumoniae, likely acting through an unexplored bacterial target. ImportanceMultidrug-resistant (MDR) Klebsiella pneumoniae is a critical global health threat and is among the leading causes of hospital0hyphenorendash;associated mortality, largely due to the scarcity of effective therapeutic options. Alarmingly, the current antimicrobial pipeline fails to address this issue, relying largely on derivatives of existing scaffolds that offer only short-term clinical benefit due to rapid resistance emergence. Developing antibiotics against Gram-negative pathogens is particularly challenging because of their highly impermeable outer membrane and efficient efflux systems, limiting intracellular drug accumulation. Metal-based antimicrobials emerge as a promising alternative. Our findings showed that OMKP-3, an iridium complex, exhibits potent bactericidal activity against MDR K. pneumoniae without selecting for high-level resistance, suggesting the potential for sustained therapeutic efficacy. Additionally, it demonstrated to accumulate intracellularly with minimal efflux involvement. Together, these features position OMKP-3 as a valuable and underexplored novel antimicrobial strategy for addressing the escalating threat of MDR K. pneumoniae infections.

Although receptor-mediated mechanisms account for the therapeutic action of numerous FDA-approved drugs, emerging evidence suggests that many of these therapeutics have off-target antimicrobial activities. One example is fingolimod, an immunomodulator used to treat multiple sclerosis, that has been reported to have antimicrobial effects associated with membrane permeabilization. Yet the molecular mechanism by which fingolimod alters bacterial membranes remains unknown. As a cationic amphiphilic drug (CAD), fingolimod is comprised of both hydrophobic and positively charged regions that can enable membrane interactions. We show that fingolimod compromises membrane integrity in E. coli and P. aeruginosa, contributing to its antimicrobial activity. To determine how fingolimod disrupts membrane integrity, we used planar lipid bilayer electrophysiology with phospholipid compositions mimicking E. coli membranes. Using gramicidin A channels as molecular biosensors, we show that fingolimod alters both mechanical properties and surface charge of lipid bilayers at concentrations that have antimicrobial effects. At higher concentrations, fingolimod directly permeabilizes lipid bilayers, as revealed by conductance measurements and Bilayer Overtone Analysis. Molecular dynamics simulations correlate fingolimods preference for pore-favoring curvature with its strong interactions with lipids and trans-leaflet translocation. These findings establish a molecular mechanism for fingolimods off-target activity and provide a starting point for understanding how some CAD structures can drive membrane-specific effects that compromise bacterial physiology. ImportanceMany commonly prescribed drugs, beyond their primary action via receptor targets, modify cell membranes. A mechanistic understanding of how these drugs interact with bacterial membranes will have a significant impact on drug design and on the evaluation of potential side effects. Furthermore, the emerging need for new antimicrobial drugs has led to increased interest in drug repurposing. Elucidating the molecular mechanisms of these compounds interactions with bacterial membranes can ultimately provide critical insights into redesigning existing drugs as antimicrobials and into identifying unintended membrane-related effects that may contribute to their therapeutic or off-target effects.

Macrolides are an antibiotic class widely used in both human and veterinary medicine, and function by interfering with protein synthesis. Regrettably, numerous strategies for evading the antibiotic properties of macrolides have been found in bacteria, including enzyme-mediated inactivation. These mechanisms are now widely disseminated among pathogenic, animal-associated and environmental bacteria making them a One Health issue. Macrolide esterases, which hydrolyze the macrolactones ester bond, confer one such resistance mechanism. Two types of macrolide esterases have thus far been identified, the well-studied erythromycin esterases and the recently discovered Est-type enzymes that belong to the /{beta}-hydrolase superfamily. We present detailed structure-function studies for four diverse Est type esterases: which only share 44-66% sequence identity (EstTSf, EstTSt, EstTBc, and EstXEc). In addition to resistance profiling and substrate specificity studies, we present structures for all four enzymes, including structures for EstTBc and EstXEc in complex with tylosin and tylvalosin macrolides, post hydrolysis. Complementing the data with mutational and kinetic studies allowed for a detailed analysis of the structural basis for macrolide-enzyme interactions. Combined the data suggest that promiscuous binding and imprecise positioning, mediated by a water-cage, dictate substrate specificity for Est-type macrolide resistance enzymes. These insights may prove beneficial for next-generation antibiotic development.

Staphylococcus aureus is the leading cause of soft tissue infections that can be treated with antibiotics. However, it can also cause significant mortality and morbidity due to systemic infections and infections of surgical implants. Implant infections typically require invasive surgery, and treatment often necessitates removal of the implant because S. aureus biofilms are extremely difficult to eradicate with antibiotic treatment alone. Therefore, there is a significant need for improved diagnostic tools for rapid, non-invasive confirmation of S. aureus infections. We recently developed an activity-based probe containing an oxadiazolone electrophile that selectively labels the S. aureus-specific serine hydrolase, FphE, by covalent binding to its active site serine residue. Here we describe a Cy5-labeled version of the probe, JJ-OX-012, and its characterization as an imaging agent for detecting biofilms both in vitro and in vivo. The probe labeled S. aureus biofilms in vitro, with virtually no background labeling of bacteria that lack FphE expression. Furthermore, we demonstrate that JJ-OX-012 can be used for non-invasive fluorescent imaging as a way to detect S. aureus biofilms in vivo. Overall, these findings support the potential for using covalent probes targeting FphE as imaging agents for rapid detection and diagnosis of staphylococcal infections in vivo.

Natural products have provided most of our modern pharmacopoeia, serving as active molecules or scaffolds for active molecules. Their use in drug development is often inspired by their traditional or historical medical use. For many decades, this discovery pipeline has focused on identifying a single molecule responsible for much of the biological activity of a "raw" natural product preparation (e.g. a whole-plant extract) and scoping this molecule for clinical potential. However, it is increasingly realised that historical/traditional remedies with significant biological activity may owe this activity to the combined action of multiple molecules. Concomitantly, microbiologists increasingly argue that effectively fighting antimicrobial-resistant infections will rely on combination therapies that combine multiple antimicrobials and/or adjuvant molecules. We previously reconstructed a complex historical remedy, Balds eyesalve. Our reconstruction of this remedy had strong antibiofilm activity, which relied on the presence of multiple ingredients. Here, we report that Balds eyesalve has multiple mechanisms of action against exemplar Gram-positive (Staphylococcus aureus) and Gram-negative (Acinetobacter baumannii) pathogens. Balds eyesalve depolarises and permeabilises the plasma membrane, and the Gram-negative outer membrane; inhibits expression of bacterial adhesins, virulence factors and efflux pumps in both S. aureus and A. baumannii; inhibits quorum sensing in S. aureus; and causes downregulation of genes involved in de novo nucleotide biosynthesis in S. aureus. Lastly, we show that this multifaceted mechanism of action makes it difficult for S. aureus, A. baumannii, and Pseudomonas aeruginosa to evolve resistance against Balds eyesalve. Balds eyesalve could be used to identify a defined cocktail of natural products suitable for preclinical testing as a multi-target antibacterial preparation to which resistance may arise more slowly than current single-molecule antibiotics. ImportanceThe increasing mortality and economic cost of antimicrobial resistance (AMR) have made it one of the biggest threats to global health. Available antibiotics are in short supply due to the slow progress in the discovery of new antibiotics. Hence, there is a need for alternative treatment options against difficult-to-treat infections. We have identified a natural product cocktail based on a historical remedy with broad-spectrum antibacterial activity and a multifaceted mechanism of action. We have shown that there is slower resistance evolution to this cocktail compared to mainline antibiotics, and it could be used as the foundation of an alternative treatment to antibiotics in clinical settings.

The increasing cases of resistance among UTI pathogens pose a significant threat to the continued clinical use of nitrofurantoin. In this study, we explored the molecular mechanisms underlying nitrofurantoin resistance and investigated the potential of synergistic activity of salicylates in enhancing the antibacterial activity of nitrofurantoin. In our initial observation, deletion of lon ({Delta}lon) conferred enhanced susceptibility to nitrofurantoin. We identified the critical role of Lon protease in regulating the sensitivity to nitrofurantoin. Investigation into the mechanisms revealed that the lon deletion strains show a higher level of marA and nfsA, which is likely to facilitate the conversion of nitrofurantoin from its pro form to its active form. The {Delta}lon strains displayed an elevated level of ROS, membrane alteration and filamentation upon treatment with nitrofurantoin. Higher ROS levels and membrane alteration were reversed upon treatment with glutathione, further confirming the role of oxidative stress in mediating the sensitivity to nitrofurantoin. Building on these mechanistic insights, we tested salicylates to synergistically enhance the efficacy of nitrofurantoin by indirectly inducing marA through the repression of the mar operon, thereby enhancing nfsA transcription. Both sodium salicylate and acetyl salicylate enhanced the efficacy of nitrofurantoin and lowered the dose of nitrofurantoin required to inhibit the growth of the WT strain. Importantly, this synergistic effect with acetyl salicylate was also observed in nitrofurantoin-resistant clinical isolates, where the combination reduced the effective nitrofurantoin concentration required for growth inhibition. This work provides novel insights into the roles of transcriptional regulators and proteolysis in antibiotic susceptibility, advancing the notion that antibiotic adjuvants are a reliable means of reviving the efficacy of antibiotics. ImportanceThis study unravels the uncharacterised role of Lon protease in nitrofurantoin susceptibility and illustrates the enhanced efficacy of nitrofurantoin-salicylate combinations as a promising therapeutic strategy to overcome emerging resistance in UTI pathogens. This study highlights the importance of investigating the repurposing of other FDA-approved molecules to combat resistance.

Tuberculosis, often considered the worlds deadliest infectious disease, is associated with over one million deaths annually. The emergence of drug-resistant strains of Mycobacterium tuberculosis (Mtb) makes anti-tuberculosis drug development a critical priority. Griselimycin (GM) is a cyclic peptide that targets the essential DNA sliding clamp of Mtb. While GM is a promising Mtb antibiotic, its poorly understood structure-activity relationship has stalled derivatization. To investigate the contribution of each amino acid towards its activity, we assessed the antibiotic activity of an alanine scan library in M. tuberculosis and M. smegmatis. Residues essential for activity and tolerable to modification were identified, and the impact of backbone N-methylation at each position was determined. Edits to cyclization chemistry, unnatural amino acid incorporation, and replacing the acetylated N-terminus with a free amine were also investigated. Lastly, incorporation of an N-terminal fluorophore enabled visualization of GM accumulation inside of mycobacteria both in and outside of macrophage cells, where Mtb natively resides. These findings present the first comprehensive structure-activity investigation into GM and can be used to rationally design future analogues.

Antimicrobial resistance poses major therapeutic challenges, particularly for multidrug-resistant mycobacterial infections caused by Mycobacterium tuberculosis (Mtb) and non-tuberculous mycobacteria (NTM). L,D-Transpeptidases (Ldts) are attractive drug targets due to their essential role in peptidoglycan cell wall crosslinking, yet existing assays suffer from low throughput and limited sensitivity. We report a versatile, bead-based platform for high-throughput analysis of Ldt activity and inhibitor discovery. We incubated peptidoglycan stem peptides, either naturally harvested or synthetically immobilized on abiotic surfaces, with Ldts and a fluorescent acyl acceptor to quantitatively monitor crosslinking. After optimizing assay parameters, we profiled six Mycobacterium smegmatis Ldt paralogs, including the first characterization of a class 6 Ldt with chemically defined substrate sequences. Utilizing a series of acyl acceptors, we demonstrated modifications within the acyl acceptor that are tolerated by mycobacterial Ldts. Screening of {beta}-lactam antibiotics revealed potent inhibition by (carba)penems, while cephalosporins, monobactams and penams showed negligible activity. The assay achieved excellent performance metrics and was successfully adapted to ELISA and 96-well formats, providing a powerful tool for discovering Ldt-targeted therapeutics against tuberculosis and related infections.

Globally, Mycobacterium tuberculosis remains a significant disease burden. Although effective treatment regimens exist, drug resistance continues to emerge. This clinical resistance, combined with side effects and protracted treatment times from the current front-line therapies, means there is a need to identify novel agents to combat this disease. Here we report on a new chemical series, identified by whole-cell phenotypic growth inhibition screening that demonstrates significant activity across multiple media. Mode of action studies indicate that this series targets the same biological pathway as Ethambutol (EMB), a drug used in the current frontline treatment of tuberculosis. Screening selected analogues against clinical isolates, resistant to EMB, demonstrated differential sensitivity both across the molecules and against the different specific resistant mutations. The data obtained suggests that this series has potential to be developed into a viable, alternative to EMB. TOC figure O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=93 SRC="FIGDIR/small/702510v1_ufig1.gif" ALT="Figure 1"> View larger version (14K): org.highwire.dtl.DTLVardef@1a80c05org.highwire.dtl.DTLVardef@1ad3ce9org.highwire.dtl.DTLVardef@79fe79org.highwire.dtl.DTLVardef@131ed78_HPS_FORMAT_FIGEXP M_FIG C_FIG

Invasive infections caused by Candida spp. are associated with high morbidity and mortality, particularly in immunocompromised patients, and are increasingly difficult to treat due to rising antifungal resistance. Here, we further investigate the antifungal properties of a previously reported nickel N-heterocyclic biscarbene derived from caffeine (compound 5) and describe the synthesis of an analogous nickel N-heterocyclic biscarbene based on benzimidazole (compound 8), designed to evaluate the impact of the biscarbene and xanthine frameworks on activity and toxicity. Compound 5 displayed selective activity against Candida glabrata, inhibited biofilm formation and showed greater cellular accumulation in this species. In a Galleria mellonella infection model, 5 significantly reduced fungal burden while exhibiting lower cytotoxicity than the benzimidazole analogue 8. Importantly, although compound 5 and fluconazole are individually fungistatic, their combination was fungicidal against C. glabrata. In the presence of compound 5, the minimal inhibitory concentration of fluconazole decreased against both a fluconazole-resistant petite mutant and a respiratory-competent C. glabrata strain evolved in vitro to fluconazole resistance. Compound 5 increased the frequency of petite mutants, suggesting an effect on mitochondrial function; however, its retained activity against these mutants and its synergism with fluconazole in the petite background indicate an additional mechanism of action. These findings identify 5 as a promising antifungal adjuvant and support its potential use in combination therapy to enhance azole efficacy against C. glabrata. ImportanceInvasive infections caused by C. glabrata are increasingly hard to treat because this pathogen is often tolerant to azoles and is developing resistance to echinocandins, leaving clinicians with few effective options. Our work explores a nickel-caffeine complex that shows selective activity against C. glabrata and low toxicity, features that make it attractive as a potential therapeutic lead. Notably, this compound enhances the activity of fluconazole, turning a commonly used fungistatic drug into a fungicidal combination against both susceptible and resistant C. glabrata. By also affecting mitochondrial function yet remaining active in respiratory-deficient mutants, the compound appears to act through mechanisms distinct from existing antifungals. These properties suggest that metal-based xanthine complexes could be developed as adjuvants to restore or boost azole efficacy against difficult-to-treat C. glabrata infections, addressing an important priority identified for fungal pathogens.

Intravital microscopy enables direct visualization of dynamic cellular processes within intact tissues, but its application to Mycobacterium tuberculosis (Mtb) has been limited by Biosafety Level 3 (BSL-3) containment requirements and the technical challenges of stabilizing the lung for high-resolution imaging. Here, we present a protocol that combines the thoracic Window for High-Resolution Imaging of the murine Lung (WHRIL) with a genetically defined, triple-auxotrophic Mtb strain (mc27902) approved for use under BSL-2 conditions. We describe the construction of a tdTomato-expressing derivative (mc28471) preparation of bacteria for intravenous infection and intravital imaging in reporter mice. This system enables visualization of rapid bacterial entry into the pulmonary vasculature, subsequent aggregation, and vascular occlusion, dissemination into the lung parenchyma, and macrophage uptake over three days post-infection. This protocol provides the first practical platform for real-time intravital imaging of mycobacteria in the lung and establishes a foundation for mechanistic studies of bacterial physiology, host recognition, and immune-mediated clearance using safe Mtb surrogates. SummaryThis protocol describes a biosafety level 2 (BSL-2)-compatible intravital imaging platform for visualizing Mycobacterium tuberculosis (Mtb) in the intact murine lung at single cell resolution. By combining the Window for High-Resolution Imaging of the murine Lung (WHRIL) with a fluorescently labeled, genetically defined triple auxotrophic Mtb strain (mc27902), this approach overcomes long-standing biosafety and technical barriers that have prevented real-time imaging of mycobacterial infection in vivo. The method enables direct visualization of early bacterial localization, aggregation, vascular interactions, and macrophage uptake during the initial hours to days following infection, providing a practical foundation for mechanistic studies of host-pathogen interactions under safe experimental conditions.

The rise of MDR Klebsiella pneumoniae and its resistance to the last-resort antibiotic colistin poses a significant threat to global healthcare. While genomic studies have identified several resistance mutations, the transient proteomic shifts that occur during the initial exposure of sensitive strains to lethal antibiotic doses remain poorly characterised. In this study, we employed a label-free quantitative proteomics approach to investigate the protein expression profile of K. pneumoniae strain ATCC 13883 treated with colistin at its MIC. Membrane proteins were extracted at critical growth stages, and differentially abundant proteins (DAPs) were analysed using Gene Ontology and KEGG pathway enrichment analysis. Our proteomic analysis identified 718 DAPs (339 upregulated and 379 downregulated). The cellular response was characterised primarily by outer membrane remodelling and a significant upregulation of the capsule-associated kinase Wzc and the ArnBCADTEF operon, which facilitates lipid A modification with L-Ara4N moiety. Paradoxically, while RND-family efflux pumps (AcrAB) were significantly induced, the global activator RamA and major porins (OmpA, OmpX, LamB) were downregulated, possibly to minimise antibiotic entry. KEGG pathway enrichment analysis further revealed a synchronised metabolic shift, characterised by an intensified TCA cycle flux to fuel high-energy resistance processes despite a general slowdown in carbohydrate metabolism. Our findings demonstrate that K. pneumoniae responds to colistin stress through a rapid, multifaceted proteomic reorganisation involving charge neutralisation, structural reinforcement of the cell envelope, and metabolic re-routing. These results provide a molecular blueprint of the early adaptive response, identifying several proteins as potential therapeutic targets.

Multidrug efflux pumps transport antibiotics across the cellular membrane resulting in resistance conferred to the host organism. Efflux pump inhibitors (EPIs) potentiate the efficacy of antibiotics by blocking drug efflux and hold promise as adjuvant therapeutics in the fight against multidrug resistant pathogenic bacteria. A hurdle in the field has been the lack of selectivity of small molecule EPIs which often display off-target toxicity due to non-specific binding. To tackle this specificity challenge, we aimed to maximize an inhibitors binding surface area to efflux pumps by designing miniprotein EPIs using computational protein design and an E. coli co-expression assay to screen inhibition in cells. We used S. aureus NorA as a model efflux transporter since it confers drug resistance to fluoroquinolones, puromycin, and other cytotoxic compounds. Starting from a focused miniprotein library of only 86 members, we identified inhibitors in the screen that blocked NorA transport under active efflux conditions in vitro. Our most promising inhibitor I-23 was validated by solving a cryo-EM structure of the miniprotein in complex with NorA, which stabilized the transporter in the outward-open conformation. I-23 has a ferredoxin-like fold with one of its {beta}-hairpins inserted into the substrate binding pocket of NorA and other parts of the globular fold occupying the shallow pocket and making extensive intermolecular contacts with NorA. An arginine residue on the tip of the hairpin loop was positioned near an anionic patch required for NorA antibiotic efflux. The identified structural motifs in this work could be employed to explore the molecular properties of peptidoglycan penetration; full realization of the therapeutic potential of the designed miniprotein inhibitors will require determining the principles for facilitating passage of [~]7 to 8 kDa miniproteins across the peptidoglycan bacterial cell wall.

Toxoplasma gondii is a protozoan parasite capable of infecting most warm-blooded animals, including humans, and can cause severe disease in immunocompromised individuals and the developing fetus. Current treatments for toxoplasmosis are effective only against the acute stage of infection and have limited or no activity against the latent bradyzoite stage found within tissue cysts. The mitochondrion of T. gondii is a validated drug target, and the clinically used drug atovaquone acts by inhibiting the mitochondrial electron transport chain (ETC) at the coenzyme Q:cytochrome c oxidoreductase (bc1 complex). In this study, we evaluate two legacy 4(1H)-quinolones: ICI 56,780 and WR 243246, previously shown to inhibit the Plasmodium falciparum bc1 complex, for their efficacy against T. gondii. Both compounds inhibit tachyzoite growth with low-nanomolar EC values and disrupt parasite mitochondrial function by blocking cytochrome c reduction and collapsing the mitochondrial membrane potential. Notably, ICI 56,780 protects mice from lethal infection with type I RH tachyzoites. Importantly, ICI 56,780 also exhibits potent activity against chronic-stage parasites, reducing cyst size and bradyzoite viability in vitro and showing low-nanomolar EC values against in vivo-derived bradyzoites. In mice chronically infected with T. gondii, treatment with ICI 56,780 significantly decreases brain cyst burden. Although these 4(1H)-quinolones display some pharmacokinetic limitations, our findings highlight their potential as promising chemotypes active against both acute and chronic stages of T. gondii and provide a framework for future medicinal chemistry efforts to improve drug-like properties while preserving or enhancing anti-bradyzoite activity.

Compounds that bind to the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) main protease (MPro) often produce biphasic concentration-response curves (CRCs) in biochemical assays; low concentrations activate the enzyme and high concentrations inhibit it. This biphasic behavior complicates data analysis. Here, we compare three approaches to data analysis: fitting the Hill equation to the activation phase, fitting it to the inhibition phase, and fitting an enzyme kinetics model that incorporates dimerization and ligand binding to the complete CRC. In the latter case, cellular efficacy is predicted by extrapolating the model to high enzyme concentrations. For compounds in our drug lead series, all three procedures yield inhibitory concentrations that are correlated with live-virus antiviral assays. The latter procedure provides the most accurate forecast of cellular efficacy rank. These data analysis procedures may be valuable for antiviral drug discovery against MERS-CoV MPro and other enzymes with similar kinetics.

Pseudomonas aeruginosa is an adaptable organism, frequently found in chronic infections, and for which antimicrobial resistance is a growing concern. Therefore, there is an urgent need for alternative therapeutic strategies. Cationic antimicrobial peptides (AMPs) offer potent bactericidal activity but suffer from limited selectivity and potential host toxicity. To enhance species-specific targeting, we designed two prodrug variants of the AMP D-Bac8CLeu2,5 - EEEE-D-Bac8CLeu2,5 and ELEG-D-Bac8CLeu2,5 -- engineered for activation by the P. aeruginosa extracellular aminopeptidase PaAP. While both prodrug motifs effectively neutralized the positive charge of D-Bac8CLeu2,5 and prevented DNA-peptide complex formation, EEEE-D-Bac8CLeu2,5 showed negligible antimicrobial activity due to slow and incomplete activation. In contrast, ELEG-D-Bac8CLeu2,5 underwent rapid PaAP-mediated activation, restoring bactericidal activity in planktonic cultures and biofilms. PaAP contributed significantly to complete prodrug activation, particularly within biofilms, where the accumulation of partially activated intermediates correlated with biphasic killing kinetics. The prodrug showed reduced activity against other ESKAPEE pathogens, demonstrating selective activation by P. aeruginosa. Experiments selecting resistant bacteria revealed distinct mutations in lipopolysaccharide biosynthesis pathways for D-Bac8CLeu2,5 and the prodrug, with limited cross-resistance. These findings establish aminopeptidase-activated AMP prodrugs as a promising approach for species-selective antimicrobial therapy and highlight the feasibility of exploiting bacterial enzymes for controlled antimicrobial peptide activation. Table of contents graphic O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=99 SRC="FIGDIR/small/715093v1_ufig1.gif" ALT="Figure 1"> View larger version (35K): org.highwire.dtl.DTLVardef@4a5505org.highwire.dtl.DTLVardef@13e578org.highwire.dtl.DTLVardef@3e3080org.highwire.dtl.DTLVardef@e24266_HPS_FORMAT_FIGEXP M_FIG C_FIG

The emergence of antimicrobial resistance (AMR) has driven the search for alternative therapeutic strategies, including antivirulence approaches targeting bacterial quorum sensing (QS). Azelaic acid (AzA), a naturally occurring dicarboxylic acid with known antimicrobial properties, has not previously been characterized as a QS inhibitor in Gram-negative pathogens. This study evaluated the dual antimicrobial and antivirulence activity of AzA against reference strains and clinical isolates of Pseudomonas aeruginosa, Enterobacteriaceae, and Staphylococcus aureus through in vitro assays and molecular docking analyses. Minimum inhibitory concentration (MIC) values ranged from 250 to 1000 {micro}g/mL, with lower MICs observed in clinical isolates of E. coli and S. aureus. Subinhibitory concentrations (250, 500 and 750 {micro}g/mL) were used to assess QS-regulated virulence factors in P. aeruginosa, including pyocyanin, elastase, alginate, and protease production. AzA exhibited a significant, dose-dependent inhibition of all evaluated virulence factors across both reference and multidrug-resistant (MDR) and pan-drug-resistant (PDR) clinical strains (p < 0.001), achieving inhibition levels exceeding 90% in several cases, particularly for protease activity. Molecular docking analyses revealed that AzA interacts with key QS-related proteins (LasI, LasR, PqsD, and PqsR), showing moderate binding affinities (-5.3 to -6.5 kcal/mol) and stable interactions within conserved ligand-binding domains. These findings suggest a multitarget modulatory mechanism affecting interconnected QS pathways. Overall, this study demonstrates, for the first time, that AzA acts as a quorum sensing inhibitor in P. aeruginosa, attenuating virulence without directly affecting bacterial growth, highlighting its potential as a promising antivirulence therapeutic strategy.

Colistin resistance in Escherichia coli arises from outer membrane (OM) remodeling that reduces surface charge and thereby lowers drug binding affinity. In this study, we investigated the zeta potential of E. coli strains with colistin minimum inhibitory concentrations (MICs) ranging from 0.125 to 16 mg/L, following EDTA treatment to chelate divalent cations and unmask intrinsic surface charge. Zeta potential was measured across pH values from 3 to 7, revealing consistent pH-dependent trends and an average 18.5 mV reduction in surface charge with increasing MIC. At pH 7, zeta potential strongly correlated with colistin resistance (R2 = 0.919), and this correlation was further strengthened following exposure to sub-inhibitory colistin (1/8 MIC; R2 = 0.9975). Notably, resistant strains carrying mcr-1 or mcr-4 exhibited significant shifts toward less negative surface charges after sub-MIC exposure, whereas the susceptible parental strain remained unchanged. However, mcr-1 mRNA expression did not consistently increase under these conditions, highlighting a disconnect between transcriptional responses and phenotypic charge alterations. These findings suggest that regulatory pathways beyond mcr-1 transcription, including stress-induced lipid A remodeling, contribute to OM charge modulation. Overall, zeta potential profiling provides a rapid and sensitive readout of resistance-associated membrane alterations and complements molecular assays by capturing functional phenotypes. This approach offers a valuable research tool for dissecting colistin resistance mechanisms and may inform future strategies for monitoring bacterial adaptation to last-resort antibiotics.

BackgroundBiofilms are central to Salmonella pathogenesis, and targeting their formation is believed to produce less evolutionary pressure of growth inhibition than traditional antibacterials. In this study, we screened the Medicines for Malaria Venture (MMV) Pathogen Box library to identify anti-biofilm agents against S. enterica that possess drug-like properties. Methodology/ Principal FindingsA crystal-violet-based medium-throughput antibiofilm screen of Salmonella enterica serovar Typhimurium ATCC 14028 and a clinical Salmonella enterica serovar Elisabethville isolate was performed on polystyrene surfaces using the 400-compound Pathogen Box library. Compounds that inhibited biofilm formation by >30% and growth by <10% were identified as hits. Salmonella red-dry-rough and motility phenotypes were explored in mechanism of action studies on one hit compound. The Salmonella antibiofilm hit rate was 0.75% for this library. MMV688371 (benzamide) inhibited biofilm formation of S. Typhimurium ATCC 14028 by 33% without inhibiting growth. An ethambutol analogue (MMV687273) and auranofin (MMV688978) met the hit criteria against S. Elisabethville LLD035X. Auranofin showed concentration-dependent, growth-inhibition-independent antibiofilm activity against typhoidal and non-typhoidal Salmonella from Nigeria, and inhibited the motility of S. Elisabethville LLD035X at 5 {micro}M. At 5 {micro}M aurothioglucose, an auranofin gold (I) analogue, and non-gold analogue 1-Thio-beta-D-glucose tetraacetate, inhibited biofilm formation by 61.30% and 11.39%, respectively, pointing to essentiality of the gold (I) moiety for activity. Conclusions/ SignificanceStructurally diverse small molecules can inhibit biofilm formation by Salmonella, and motility inhibition is an important mechanism for this activity. Auranofin inhibits typhoidal and non-typhoidal Salmonella biofilm formation, with its gold content being required for these activities.