Abstract

Carbon monoxide-releasing molecules (CORMs) are a promising class of new antimicrobials, with multiple modes of action that are distinct from those of standard antibiotics. The relentless increase in antimicrobial resistance, exacerbated by a lack of new antibiotics, necessitates a better understanding of how such novel agents act and might be used synergistically with established antibiotics. This work aimed to understand the mechanism(s) underlying synergy between a manganese-based photoactivated carbon monoxide-releasing molecule (PhotoCORM), [Mn(CO)3(tpa-κ3N)]Br [tpa=tris(2-pyridylmethyl)amine], and various classes of antibiotics in their activities towards Escherichia coli EC958, a multi-drug-resistant uropathogen. The title compound acts synergistically with polymyxins [polymyxin B and colistin (polymyxin E)] by damaging the bacterial cytoplasmic membrane. [Mn(CO)3(tpa-κ3N)]Br also potentiates the action of doxycycline, resulting in reduced expression of tetA, which encodes a tetracycline efflux pump. We show that, like tetracyclines, the breakdown products of [Mn(CO)3(tpa-κ3N)]Br activation chelate iron and trigger an iron starvation response, which we propose to be a further basis for the synergies observed. Conversely, media supplemented with excess iron abrogated the inhibition of growth by doxycycline and the title compound. In conclusion, multiple factors contribute to the ability of this PhotoCORM to increase the efficacy of antibiotics in the polymyxin and tetracycline families. We propose that light-activated carbon monoxide release is not the sole basis of the antimicrobial activities of [Mn(CO)3(tpa-κ3N)]Br.

Highlights

  • Carbon monoxide-releasing molecules (CORMs) were originally developed to deliver carbon monoxide (CO) safely in experimental and therapeutic settings [1], in recognition of mounting evidence that CO is an important signalling molecule [2] with opportunities for therapeutic exploitation [3]

  • These findings are predicted by the genome sequence, which shows that plasmid pEC958 includes genes for antibiotic resistance, including tetA and tetR, aac6¢-lb-cr [encoding aminoglycoside N(6¢)-acetyltransferase] and dhfrVII

  • Bacterial infections endanger human health worldwide, a threat that is compounded by the relentless spread of antimicrobial resistance (AMR) and the slow development of new antibiotics

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Summary

Introduction

Carbon monoxide-releasing molecules (CORMs) were originally developed to deliver carbon monoxide (CO) safely in experimental and therapeutic settings [1], in recognition of mounting evidence that CO is an important signalling molecule [2] with opportunities for therapeutic exploitation [3]. ~9 : 1), CO inhibits aerobic respiration [8]. CORM-2 and CORM-3 do inhibit aerobic respiration of E. coli [10,11,12], P. aeruginosa [13, 14] and other bacteria, mounting evidence is highlighting the multifaceted effects of CORMs, which cannot solely be due to CO [15, 16]. CORM-2 and CORM-3 are more potent inhibitors of growth and/or aerobic respiration than CO gas itself, implying that Ru(II) or some other decomposition products of the CORM enhance inhibition [10, 14]. Transcriptomic studies revealed diverse changes in gene expression, not limited to respiratory

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