Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States.
Vast Therapeutics, Durham, North Carolina 27703, United States.
ACS Infect Dis. 2021 Jan 8;7(1):23-33. doi: 10.1021/acsinfecdis.0c00337. Epub 2020 Dec 8.
Antibiotic resistance in bacteria is a major global threat and a leading cause for healthcare-related morbidity and mortality. Resistant biofilm infections are particularly difficult to treat owing to the protective biofilm matrix, which decreases both antibiotic efficacy and clearance by the host. Novel antimicrobial agents that are capable of eradicating resistant infections are greatly needed to combat the rise of antibiotic-resistant bacteria, particularly in patients with cystic fibrosis who are frequently colonized by multidrug-resistant species. Our research group has developed nitric oxide-releasing biopolymers as alternatives to conventional antibiotics. Here, we show that nitric oxide acts as a broad-spectrum antibacterial agent while also improving the efficacy of conventional antibiotics when delivered sequentially. Alone, nitric oxide kills a broad range of bacteria in planktonic and biofilm form without engendering resistance. In combination with conventional antibiotics, nitric oxide increases bacterial susceptibility to multiple classes of antibiotics and slows the development of antibiotic resistance. We anticipate that the use of nitric oxide in combination with antibiotics may improve the outcome of patients with refractory infections, particularly those that are multidrug-resistant.
细菌的抗生素耐药性是一个全球性的主要威胁,也是导致与医疗保健相关的发病率和死亡率的主要原因。由于保护性生物膜基质的存在,耐药生物膜感染尤其难以治疗,这降低了抗生素的疗效和宿主的清除率。为了对抗抗生素耐药细菌的兴起,迫切需要新型的能够根除耐药感染的抗菌药物,特别是在经常被多种耐药物种定植的囊性纤维化患者中。我们的研究小组已经开发出释放一氧化氮的生物聚合物,作为传统抗生素的替代品。在这里,我们表明一氧化氮作为一种广谱抗菌剂,当顺序递用时,还可以提高常规抗生素的疗效。单独使用时,一氧化氮可杀死浮游和生物膜形式的多种细菌,而不会产生耐药性。与传统抗生素联合使用时,一氧化氮可增加细菌对多种类抗生素的敏感性,并减缓抗生素耐药性的发展。我们预计,一氧化氮与抗生素联合使用可能会改善难治性感染患者的治疗效果,特别是那些对多种药物耐药的患者。