Abstract

The rapid rise of bacterial resistance to traditional antibiotics combined with the decline in discovery of novel antibacterial agents has created a global public health crisis. Repurposing existing drugs presents an alternative strategy to potentially expedite the discovery of new antimicrobial drugs. The present study demonstrates that simvastatin, an antihyperlipidemic drug exhibited broad-spectrum antibacterial activity against important Gram-positive (including methicillin-resistant Staphylococcus aureus (MRSA)) and Gram-negative pathogens (once the barrier imposed by the outer membrane was permeabilized). Proteomics and macromolecular synthesis analyses revealed that simvastatin inhibits multiple biosynthetic pathways and cellular processes in bacteria, including selective interference of bacterial protein synthesis. This property appears to assist in simvastatin’s ability to suppress production of key MRSA toxins (α-hemolysin and Panton-Valentine leucocidin) that impair healing of infected skin wounds. A murine MRSA skin infection experiment confirmed that simvastatin significantly reduces the bacterial burden and inflammatory cytokines in the infected wounds. Additionally, simvastatin exhibits excellent anti-biofilm activity against established staphylococcal biofilms and demonstrates the ability to be combined with topical antimicrobials currently used to treat MRSA skin infections. Collectively the present study lays the foundation for further investigation of repurposing simvastatin as a topical antibacterial agent to treat skin infections.

Highlights

  • Bacteria Methicillin-resistant S. aureus (18) Vancomycin-resistant S. aureus (15) Methicillin-sensitive S. aureus (6) Vancomycin-intermediate S. aureus (3) Vancomycin-sensitive Enterococcus (9) Vancomycin-resistant Enterococcus (7) Listeria monocytogenes (6) Streptococcus pneumoniae (2) Bacillus anthracis (3)

  • Our study reveals that simvastatin has considerable promise for use as a therapeutic agent to treat MRSA skin infections and does warrant further investigation as a novel topical antibacterial agent

  • Given simvastatin exhibited good antibacterial activity against MRSA both in vitro and in vivo, we examined the possibility of using simvastatin with antimicrobials commonly used to treat skin infections

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Summary

Introduction

Bacteria (no. of strains screened) Methicillin-resistant S. aureus (18) Vancomycin-resistant S. aureus (15) Methicillin-sensitive S. aureus (6) Vancomycin-intermediate S. aureus (3) Vancomycin-sensitive Enterococcus (9) Vancomycin-resistant Enterococcus (7) Listeria monocytogenes (6) Streptococcus pneumoniae (2) Bacillus anthracis (3). Limited information is available regarding the mechanism by which statins exert their antibacterial effect, statins’ antimicrobial effect on Gram-negative pathogens, and potential applications for statins as novel antibacterial agents. Additional research is required to understand statins’ antibacterial spectrum of activity, their antibacterial mechanism of action, and to elucidate potential clinical applications in the management of bacterial infections. We aim to lay the foundation for utilizing statins as topical antibacterial agents by investigating the antibacterial activity of statins and their spectrum of activity on clinically-relevant Gram-positive and Gram-negative pathogens, elucidating the antibacterial mode of action of the most active statin (simvastatin), examining the effect of simvastatin on specific virulence factors (such as bacterial toxins and disruption of staphylococcal biofilms) and to validate the therapeutic efficacy of simvastatin in an appropriate animal model of S. aureus infection. Our study reveals that simvastatin has considerable promise for use as a therapeutic agent to treat MRSA skin infections and does warrant further investigation as a novel topical antibacterial agent

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