Abstract

Bacterial persisters are rare phenotypic variants that are temporarily tolerant to high concentrations of antibiotics. We have previously discovered that stationary-phase-cell subpopulations exhibiting high redox activities were less capable of producing proteins and resuming growth upon their dilution into fresh media. The redox activities of these cells were maintained by endogenous protein and RNA degradation, resulting in self-inflicted damage that transiently repressed the cellular functions targeted by antibiotics. Here, we showed that pretreatment of stationary-phase cells with an ATP synthase inhibitor, chlorpromazine hydrochloride (CPZ), significantly reduced stationary-phase-redox activities and protein degradation, and yielded cells that were more susceptible to cell death when exposed to antibiotics in fresh media. Leveraging this knowledge, we developed an assay integrating a degradable fluorescent protein system and a small library, containing FDA-approved drugs and antibiotics, to detect medically relevant drugs that potentially target persister metabolism. We identified a subset of chemical inhibitors, including polymyxin B, poly-L-lysine and phenothiazine anti-psychotic drugs, that were able to reduce the persistence phenotype in Escherichia coli. These chemical inhibitors also reduced Pseudomonas aeruginosa persistence, potentially verifying the existence of similar mechanisms in a medically relevant organism.

Highlights

  • Conventional therapies for infectious diseases target the mechanisms that enable the rapid growth of bacterial cell populations

  • Using a high-throughput screening approach and a small chemical library (Biolog Phenotype Arrays containing FDA-approved drugs and antibiotics), we further identify a subset of drugs that can reduce antibiotic-tolerant cells in Gram-negative bacteria by targeting their metabolism

  • We note that cells were not treated with antibiotics directly in stationary-phase cultures, as normal cells are intrinsically tolerant in these cultures to ampicillin whose mechanism of action requires cell growth

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Summary

Introduction

Conventional therapies for infectious diseases target the mechanisms that enable the rapid growth of bacterial cell populations. This can provide a clinical benefit, this benefit is usually short-lived for persistent and recurrent infections, and a large body of evidence suggests that small subpopulations of microbial cells invariably survive this initial selection pressure. The most abundant persister variants do not grow in the presence of antibiotics and are largely formed before or during the antibiotic treatments (Balaban et al, 2004; Lewis, 2007, 2010, 2012)

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