In vitro efficacy of synthetic antimicrobial peptide SET-M33 against poultry isolates with diverse antimicrobial resistance phenotypes

Antimicrobial resistance is an impactful One Health issue. One of its drivers is the extensive use of antibiotics in both human and animal production systems, and despite regulatory restrictions on antibiotic use in poultry farming, antimicrobial resistance remains a major challenge. Consequently, animals are at higher risk of harder-to-treat diseases and play a role as resistance reservoirs, highlighting the need for alternative antimicrobial strategies. Towards this end, antimicrobial peptides (AMPs) have emerged as promising candidates due to their broad-spectrum activity and lower propensity to induce resistance. However, the effectiveness of AMPs against poultry pathogens, and in particular multi drug-resistant strains, is largely unclear. To tackle this question, we evaluated the synthetic AMP SET-M33 against four species of clinically relevant pathogens in poultry, namely Escherichia coli, Salmonella enterica, Enterococcus faecalis and Enterococcus cecorum. Using a panel of 141 field isolates, we found that SET-M33 broadly inhibited bacterial growth at low micromolar concentrations (median MICs of 2.5 M and 5 M for Gram-negative and Gram-positive strains, respectively), including in multi drug-resistant isolates. To examine the potential impact of SET-M33 on the host, we established a new in vitro co-cultivation system using chicken intestinal organoids. We found that SET-M33 retains its antimicrobial activity in organoid-microbe co-cultures at concentrations that preserved host viability. These findings demonstrate the potential of SET-M33 as a new antimicrobial agent against pathogens in poultry.