7-<i>O</i>-Carboxylic Acid-Substituted 3-<i>O</i>-Alkyl Difluoroquercetin; An Aztreonam-Potentiating Agent Against Carbapenemase-Producing <i>Pseudomonas aeruginosa</i> Through Simultaneous Inhibition of Metallo-β-Lactamase and Efflux Pump

<b>Background/Objectives:</b> Previously, we reported that 3-<i>O</i>-alkyl difluoroquercetins (di-F-Q) potentiates the antimicrobial activity of aztreonam (ATM) against metallo-β-lactamase (MBL)-producing <i>P. aeruginosa</i> through simultaneous inhibition of MB...

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Main Authors: Seongyeon Lee, Taegum Lee, Mi Kyoung Kim, Joong Hoon Ahn, Seri Jeong, Ki-Ho Park, Youhoon Chong
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/13/12/1202
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Summary:<b>Background/Objectives:</b> Previously, we reported that 3-<i>O</i>-alkyl difluoroquercetins (di-F-Q) potentiates the antimicrobial activity of aztreonam (ATM) against metallo-β-lactamase (MBL)-producing <i>P. aeruginosa</i> through simultaneous inhibition of MBLs and efflux pumps. However, the ATM-potentiating activity of the 3-<i>O</i>-alkyl di-F-Q was observed only at high and potentially toxic concentrations (32 mg/L). <b>Methods:</b> As both MBLs and efflux pumps reside in the periplasm of Gram-negative bacteria, their inhibitors should accumulate in the periplasmic space. However, the outer membrane porins, the major entry pathway in Gram-negative bacteria, allow the passive diffusion of hydrophilic polar molecules across the outer membrane. Thus, we reasoned that the introduction of a polar substituent at 7-OH position of 3-<i>O</i>-alkyl di-F-Q would enhance its periplasmic concentration to result in potentiation of ATM at lower concentrations. <b>Results:</b> The title compound <b>5</b> exhibited inhibitory activity against NDM-1 as well as the efflux pump of <i>P. aeruginosa</i>, which resulted in synergistical potentiation of ATM. A combination of ATM (8 mg/L) and <b>5</b> (8 mg/L) inhibited 80% of the ATM-resistant CPPA, while ATM alone did not show any inhibition. In addition, only 4 mg/L of <b>5</b> was needed to reduce the MIC<sub>90</sub> of ATM four-fold in ATM-resistant CPPA (n = 15). The time–kill data further supported the effectiveness of the combined treatment of ATM with <b>5</b>, and the combination of ATM (1xMIC) with 8 mg/L of <b>5</b> showed bactericidal effects in every bacterial strain tested (PA-002, <i>bla</i><sub>IMP</sub>, PA-003, <i>bla</i><sub>VIM</sub>, PA-014, <i>bla</i><sub>GES</sub>, and PA-017, <i>bla</i><sub>NDM</sub>) by reducing the bacterial loads by 5.1 log<sub>10</sub>~8.9 log<sub>10</sub>. <b>Conclusions:</b> The title compound <b>5</b> exhibited inhibitory activity against NDM-1 as well as the efflux pump of <i>P. aeruginosa</i>, and the combined inhibitory activity resulted in synergistical potentiation of ATM. It should be noted that most CPPA isolates tested were sensitized to 8 mg/L of ATM upon combination with 4~8 mg/L of <b>5</b>.
ISSN:2079-6382