Abstract

Klebsiella pneumoniae (Kp), one of the most common causes of healthcare-associated infections, increases patient morbidity, mortality, and hospitalization costs. Kp must acquire nutrients from the host for successful infection; however, the host is able to prevent bacterial nutrient acquisition through multiple systems. This includes the innate immune protein lipocalin 2 (Lcn2), which prevents Kp iron acquisition. To identify novel Lcn2-dependent Kp factors that mediate evasion of nutritional immunity during lung infection, we undertook an InSeq study using a pool of >20,000 transposon mutants administered to Lcn2+/+ and Lcn2-/- mice. Comparing transposon mutant frequencies between mouse genotypes, we identified the Kp citrate synthase, GltA, as potentially interacting with Lcn2, and this novel finding was independently validated. Interestingly, in vitro studies suggest that this interaction is not direct. Given that GltA is involved in oxidative metabolism, we screened the ability of this mutant to use a variety of carbon and nitrogen sources. The results indicated that the gltA mutant has a distinct amino acid auxotrophy rendering it reliant upon glutamate family amino acids for growth. Deletion of Lcn2 from the host leads to increased amino acid levels in bronchioloalveolar lavage fluid, corresponding to increased fitness of the gltA mutant in vivo and ex vivo. Accordingly, addition of glutamate family amino acids to Lcn2+/+ bronchioloalveolar lavage fluid rescued growth of the gltA mutant. Using a variety of mouse models of infection, we show that GltA is an organ-specific fitness factor required for complete fitness in the spleen, liver, and gut, but dispensable in the bloodstream. Similar to bronchioloalveolar lavage fluid, addition of glutamate family amino acids to Lcn2+/+ organ lysates was sufficient to rescue the loss of gltA. Together, this study describes a critical role for GltA in Kp infection and provides unique insight into how metabolic flexibility impacts bacterial fitness during infection.

Highlights

  • Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and carbapenemresistant Enterobacteriaceae (CRE) pose a serious public health threat due to their extensive antibiotic resistance

  • The bacteria Klebsiella pneumoniae (Kp) is an important cause of infection in healthcare settings. These infections can be difficult to treat, as they frequently occur in chronically ill patients and the bacteria have the ability to acquire multiple antibiotic resistance markers

  • The bacterial factors that allow Kp to replicate in these different body sites are unclear

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Summary

Introduction

Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and carbapenemresistant Enterobacteriaceae (CRE) pose a serious public health threat due to their extensive antibiotic resistance. Klebsiella pneumoniae (Kp) is an environmentally ubiquitous member of the Enterobacteriaceae family that can acquire antibiotic resistance genes [1], and is a leading cause of ESBL-producing Enterobacteriaceae infections [2] and HAIs [3]. Mortality rates in patients infected with antibiotic resistant Kp often exceed 40% [4]. Reports of hypervirulent clones of Kp acquiring mobile antibiotic resistance genes are becoming more frequent [5,6], posing a significant global threat to human health. As the efficacy of antibiotics diminishes and therapeutic options for patients infected with antibiotic resistant strains of Kp become increasingly limited, a better understanding of how Kp establish productive infections is necessary for the development of novel diagnostics and interventions to combat these dangerous bacteria

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