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Updated: Nov 2, 2025

High-throughput Screening of Chemical Compounds to Elucidate Their Effects on Bacterial Persistence
Published on: February 23, 2021
Macrophage-Produced Peroxynitrite Induces Antibiotic Tolerance and Supersedes Intrinsic Mechanisms of Persister
Jenna E Beam1, Nikki J Wagner1, John C Shook1
1Department of Microbiology and Immunology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.
Abstract:
Staphylococcus aureus is a leading human pathogen that frequently causes chronic and relapsing infections. Antibiotic-tolerant persister cells contribute to frequent antibiotic failure in patients. Macrophages represent an important niche during S. aureus bacteremia, and recent work has identified a role for oxidative burst in the formation of antibiotic-tolerant S. aureus. We find that host-derived peroxynitrite, the reaction product of superoxide and nitric oxide, is the main mediator of antibiotic tolerance in macrophages. Using a collection of S. aureus clinical isolates, we find that, despite significant variation in persister formation in pure culture, all strains were similarly enriched for antibiotic tolerance following internalization by activated macrophages. Our findings suggest that host interaction strongly induces antibiotic tolerance and may negate bacterial mechanisms of persister formation established in pure culture. These findings emphasize the importance of studying antibiotic tolerance in the context of bacterial interaction with the host and suggest that modulation of the host response may represent a viable therapeutic strategy to sensitize S. aureus to antibiotics.
Insights
Host immune cells, specifically macrophages, induce antibiotic tolerance in Staphylococcus aureus via peroxynitrite. This finding suggests targeting host responses could resensitize bacteria to antibiotics.
Area of Science:
- Microbiology
- Immunology
- Infectious Diseases
Background:
- Staphylococcus aureus is a major cause of persistent human infections.
- Antibiotic tolerance in persister cells contributes to treatment failures.
- Macrophages are a key host niche during S. aureus bacteremia.
Purpose of the Study:
- To identify the host-derived factors mediating antibiotic tolerance in S. aureus within macrophages.
- To investigate the role of oxidative burst products in S. aureus antibiotic tolerance.
- To determine if host-induced tolerance overrides bacterial persister formation mechanisms.
Main Methods:
- Exposure of S. aureus clinical isolates to activated macrophages.
- Analysis of bacterial antibiotic tolerance following host cell internalization.
- Identification of host-derived reactive nitrogen species involved in tolerance.
Main Results:
- Host-derived peroxynitrite, a product of superoxide and nitric oxide, is the primary mediator of S. aureus antibiotic tolerance within macrophages.
- All tested S. aureus clinical isolates showed similar enrichment for antibiotic tolerance after macrophage internalization, irrespective of in vitro persister levels.
- Host interaction significantly enhances S. aureus antibiotic tolerance, potentially masking intrinsic bacterial persister formation strategies.
Conclusions:
- Bacterial interaction with the host immune environment, particularly macrophages, is critical for inducing antibiotic tolerance.
- Peroxynitrite generated by host macrophages is a key factor driving S. aureus antibiotic tolerance.
- Modulating host immune responses may offer novel therapeutic strategies to overcome antibiotic tolerance in S. aureus infections.
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