PurposeThe rise of carbapenem-resistant Klebsiella pneumoniae (CRKP) has led to increased morbidity and mortality in clinical patients, highlighting the urgent need for effective antibacterial agents. MethodsWe obtained a synthetic compound, MTEBT-3, using hydrophobic triphenylamine as the skeleton and hydrophilic ammonium salts. We determined the MIC of MTEBT-3 using the macro-broth susceptibility testing method. We isolated a clinical CRKP strain ST3984 and performed synergistic antibiotic sensitivity tests, time-kill assays, and resistance evolution studies. Biofilm formation under sub-MIC conditions was evaluated using crystal violet staining and CLSM. Additionally, biofilm proteins and polysaccharides were quantified. We assessed the bactericidal mechanism of MTEBT-3 by examining the integrity of CRKP bacterial cell membranes and analyzing the transcription of virulence-regulating genes via quantitative real-time PCR. ResultsMTEBT-3 exhibited broad-spectrum antibacterial activity with a low resistance rate, achieving the MIC of 8 μg/mL. The compound displayed additive effects with meropenem and imipenem and synergistic effects with tigecycline. It maintained its efficacy over multiple bacterial generations, with no significant increase in resistance observed. Under sub-MIC conditions, the biomass of biofilms was significantly reduced, and the levels of proteins and polysaccharides within the biofilms were markedly lowered in a concentration-dependent manner. The bactericidal mechanism of MTEBT-3 involved disrupting the integrity of CRKP bacterial cell membranes, leading to increased permeability. Quantitative real-time PCR results showed that MTEBT-3 effectively suppressed the expression of key virulence genes, including fimH, wbbM, rmpA, and rmpA2, which are associated with biofilm formation and bacterial adhesion. ConclusionThe significant antimicrobial activity of MTEBT-3 against clinically isolated CRKP, along with its synergistic or additive effects with commonly used antibiotics, positions it as a promising candidate for treatment. Its ability to disrupt biofilm formation and reduce virulence factor expression further underscores its potential in managing CRKP infections.
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