Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteria

Abstract Nitroxoline is a bacteriostatic quinoline antibiotic, known to form complexes with metals. Its clinical indications are limited to uncomplicated urinary tract infections, with a susceptibility breakpoint only available for Escherichia coli. Here, we test > 1000 clinical isolates and demo...

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Main Authors: Elisabetta Cacace, Manuela Tietgen, Meike Steinhauer, André Mateus, Tilman G. Schultze, Marina Eckermann, Marco Galardini, Vallo Varik, Alexandra Koumoutsi, Jordan J. Parzeller, Federico Corona, Askarbek Orakov, Michael Knopp, Amber Brauer-Nikonow, Peer Bork, Celia V. Romao, Michael Zimmermann, Peter Cloetens, Mikhail M. Savitski, Athanasios Typas, Stephan Göttig
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-58730-5
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author Elisabetta Cacace
Manuela Tietgen
Meike Steinhauer
André Mateus
Tilman G. Schultze
Marina Eckermann
Marco Galardini
Vallo Varik
Alexandra Koumoutsi
Jordan J. Parzeller
Federico Corona
Askarbek Orakov
Michael Knopp
Amber Brauer-Nikonow
Peer Bork
Celia V. Romao
Michael Zimmermann
Peter Cloetens
Mikhail M. Savitski
Athanasios Typas
Stephan Göttig
author_facet Elisabetta Cacace
Manuela Tietgen
Meike Steinhauer
André Mateus
Tilman G. Schultze
Marina Eckermann
Marco Galardini
Vallo Varik
Alexandra Koumoutsi
Jordan J. Parzeller
Federico Corona
Askarbek Orakov
Michael Knopp
Amber Brauer-Nikonow
Peer Bork
Celia V. Romao
Michael Zimmermann
Peter Cloetens
Mikhail M. Savitski
Athanasios Typas
Stephan Göttig
author_sort Elisabetta Cacace
collection DOAJ
description Abstract Nitroxoline is a bacteriostatic quinoline antibiotic, known to form complexes with metals. Its clinical indications are limited to uncomplicated urinary tract infections, with a susceptibility breakpoint only available for Escherichia coli. Here, we test > 1000 clinical isolates and demonstrate a much broader activity spectrum and species-specific bactericidal activity, including Gram-negative bacteria for which therapeutic options are limited due to multidrug resistance. By combining genetic and proteomic approaches with direct measurement of intracellular metals, we show that nitroxoline acts as a metallophore, inducing copper and zinc intoxication in bacterial cells. The compound displays additional effects on bacterial physiology, including alteration of outer membrane integrity, which underpins nitroxoline’s synergies with large-scaffold antibiotics and resensitization of colistin-resistant Enterobacteriaceae in vitro and in vivo. Furthermore, we identify conserved resistance mechanisms across bacterial species, often leading to nitroxoline efflux.
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spelling doaj-art-fb10e7a8b3304d74ba0b33c31b44c7cd2025-08-20T03:15:12ZengNature PortfolioNature Communications2041-17232025-04-0116111610.1038/s41467-025-58730-5Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteriaElisabetta Cacace0Manuela Tietgen1Meike Steinhauer2André Mateus3Tilman G. Schultze4Marina Eckermann5Marco Galardini6Vallo Varik7Alexandra Koumoutsi8Jordan J. Parzeller9Federico Corona10Askarbek Orakov11Michael Knopp12Amber Brauer-Nikonow13Peer Bork14Celia V. Romao15Michael Zimmermann16Peter Cloetens17Mikhail M. Savitski18Athanasios Typas19Stephan Göttig20Goethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection ControlGoethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection ControlGoethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection ControlEuropean Molecular Biology Laboratory, Genome Biology UnitGoethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection ControlEuropean Synchrotron Radiation Facility (ESRF)Institute for Molecular Bacteriology, TWINCORE Centre for Experimental and Clinical Infection Research, a joint venture between the Hannover Medical School (MHH) and the Helmholtz Centre for Infection Research (HZI)European Molecular Biology Laboratory, Genome Biology UnitEuropean Molecular Biology Laboratory, Genome Biology UnitGoethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection ControlEuropean Molecular Biology Laboratory, Genome Biology UnitEuropean Molecular Biology Laboratory, Structural and Computational Biology UnitEuropean Molecular Biology Laboratory, Genome Biology UnitEuropean Molecular Biology Laboratory, Structural and Computational Biology UnitEuropean Molecular Biology Laboratory, Structural and Computational Biology UnitInstituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de LisboaCluster of Excellence RESIST (EXC 2155), Hannover Medical School (MHH)European Synchrotron Radiation Facility (ESRF)European Molecular Biology Laboratory, Genome Biology UnitEuropean Molecular Biology Laboratory, Genome Biology UnitGoethe University Frankfurt, University Hospital, Institute for Medical Microbiology and Infection ControlAbstract Nitroxoline is a bacteriostatic quinoline antibiotic, known to form complexes with metals. Its clinical indications are limited to uncomplicated urinary tract infections, with a susceptibility breakpoint only available for Escherichia coli. Here, we test > 1000 clinical isolates and demonstrate a much broader activity spectrum and species-specific bactericidal activity, including Gram-negative bacteria for which therapeutic options are limited due to multidrug resistance. By combining genetic and proteomic approaches with direct measurement of intracellular metals, we show that nitroxoline acts as a metallophore, inducing copper and zinc intoxication in bacterial cells. The compound displays additional effects on bacterial physiology, including alteration of outer membrane integrity, which underpins nitroxoline’s synergies with large-scaffold antibiotics and resensitization of colistin-resistant Enterobacteriaceae in vitro and in vivo. Furthermore, we identify conserved resistance mechanisms across bacterial species, often leading to nitroxoline efflux.https://doi.org/10.1038/s41467-025-58730-5
spellingShingle Elisabetta Cacace
Manuela Tietgen
Meike Steinhauer
André Mateus
Tilman G. Schultze
Marina Eckermann
Marco Galardini
Vallo Varik
Alexandra Koumoutsi
Jordan J. Parzeller
Federico Corona
Askarbek Orakov
Michael Knopp
Amber Brauer-Nikonow
Peer Bork
Celia V. Romao
Michael Zimmermann
Peter Cloetens
Mikhail M. Savitski
Athanasios Typas
Stephan Göttig
Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteria
Nature Communications
title Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteria
title_full Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteria
title_fullStr Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteria
title_full_unstemmed Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteria
title_short Uncovering nitroxoline activity spectrum, mode of action and resistance across Gram-negative bacteria
title_sort uncovering nitroxoline activity spectrum mode of action and resistance across gram negative bacteria
url https://doi.org/10.1038/s41467-025-58730-5
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