Potentiation of Aminoglycoside Activity in Pseudomonas aeruginosa by Targeting the AmgRS Envelope Stress-Responsive

Keith Poole1, Christie Gilmour2, Maya A Farha3

  • 1Department of Biomedical and Molecular Sciences, Botterell Hall, Queen's University, Kingston, Ontario, Canada poolek@queensu.ca.

Insights

Rifampin potentiates specific aminoglycosides against Pseudomonas aeruginosa by targeting the AmgRS system, offering potential for combination therapies against resistant infections.

Area of Science:

  • Microbiology
  • Pharmacology
  • Molecular Biology

Background:

  • Aminoglycosides (AGs) are crucial antibiotics, but resistance in Pseudomonas aeruginosa is a growing concern.
  • The AmgRS two-component system (TCS) is vital for P. aeruginosa to resist AGs by mitigating membrane damage.
  • Understanding mechanisms to overcome AG resistance is critical for effective treatment strategies.

Purpose of the Study:

  • To identify agents that enhance the activity of paromomycin (PAR), a 4,5-linked AG, against P. aeruginosa.
  • To elucidate the mechanism by which rifampin (RIF) potentiates AG activity.
  • To explore the potential of RIF as an adjuvant therapy for AG-resistant P. aeruginosa infections.

Main Methods:

  • Conducted a screen to identify agents potentiating PAR activity.
  • Tested RIF's potentiation of various AGs in wild-type and mutant P. aeruginosa strains.
  • Investigated the role of the AmgRS TCS and RNA polymerase in RIF's potentiation effect.
  • Assessed RIF's impact on AmgRS-dependent gene expression and MexXY efflux system activity.

Main Results:

  • Rifampin (RIF) potentiated 4,5-linked AGs (e.g., paromomycin, neomycin) but not 4,6-linked AGs (e.g., amikacin, gentamicin).
  • Potentiation was dependent on the AmgRS TCS and functional RNA polymerase.
  • RIF reduced the expression of some AmgRS-dependent genes but did not impair membrane protection.
  • RIF reversed AG resistance in clinical isolates, partly by downregulating the MexXY efflux system.

Conclusions:

  • RIF potentiates specific AGs by interfering with the AmgRS TCS and RNA polymerase function in P. aeruginosa.
  • RIF's ability to overcome AmgRS-mediated resistance, including MexXY efflux, highlights its potential as an adjuvant.
  • Combination therapy with RIF and AGs may offer a strategy to treat challenging P. aeruginosa infections.

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