Patil Mrunal, Munteanu Tatiana, Brasseur Gaël, Ferreira Carolina, Costa Sofia Santos, Couto Isabel, Athar Mohd, Asunis Elisa, Vargiu Attilio Vittorio, Viveiros Miguel, DiGiorgio Carole, Brunel Frédéric, Raimundo Jean-Manuel, Camplo Michel, Siri Olivier, Bolla Jean-Michel
Aix Marseille Université, CNRS, CINaM UMR 7325, Campus de Luminy, Case 913, Cedex 09, Marseille, 13288, France.
Aix Marseille Université, INSERM, SSA, MCT, Marseille, 13385, France.
Adv Healthc Mater. 2025 Apr;14(11):e2404145. doi: 10.1002/adhm.202404145. Epub 2025 Mar 11.
Efflux-mediated antibiotic resistance poses a significant global threat, affecting diverse bacterial species. Clinicians recognize the danger of efflux mechanisms during antibiotic treatment, yet precise diagnostic tools remain unavailable. The antibiogram currently infers abnormal efflux pump activity in clinical isolates, which is subsequently confirmed through transcriptomic or genomic analysis. This study harnesses the colorimetric, fluorescence, and solubility properties of phenazinium derivatives to develop a rapid protocol for detecting bacterial efflux. Among several synthesized phenazinium compounds, the compound demonstrating differential MIC in Staphylococcus efflux mutants and exhibiting appropriate physicochemical properties is selected. A diagnostic protocol is developed using the selected compound to assess efflux levels, categorized as no, weak, or strong, through colorimetry and spectroscopy techniques. Testing on Gram-positive efflux mutants and clinical Staphylococcus isolates further validates the approach. In-silico docking analysis confirms the interaction between the chosen compound and the NorA efflux pump in S. aureus. Flow cytometry is employed to re-evaluate the detection assays. The developed molecule and protocol represent the first known method to evaluate efflux levels in any Gram-positive species through a streamlined and user-friendly process. This pioneering test significantly advances the epidemiological analysis of efflux mechanisms and enables more informed therapeutic decision-making, leading to more effective treatment.
外排介导的抗生素耐药性构成了重大的全球威胁,影响着多种细菌物种。临床医生认识到抗生素治疗过程中外排机制的危险性,但精确的诊断工具仍然无法获得。目前,抗菌谱可推断临床分离株中异常的外排泵活性,随后通过转录组学或基因组分析加以证实。本研究利用吩嗪鎓衍生物的比色、荧光和溶解性特性,开发了一种检测细菌外排的快速方法。在几种合成的吩嗪鎓化合物中,选择在金黄色葡萄球菌外排突变体中显示出不同最低抑菌浓度(MIC)且具有适当理化性质的化合物。使用所选化合物开发了一种诊断方法,通过比色法和光谱技术评估外排水平,分为无、弱或强。对革兰氏阳性外排突变体和临床金黄色葡萄球菌分离株进行测试进一步验证了该方法。计算机对接分析证实了所选化合物与金黄色葡萄球菌中NorA外排泵之间的相互作用。采用流式细胞术重新评估检测方法。所开发的分子和方法代表了第一种通过简化且用户友好的过程评估任何革兰氏阳性菌外排水平的已知方法。这项开创性测试显著推进了外排机制的流行病学分析,并有助于做出更明智的治疗决策,从而实现更有效的治疗。