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联合治疗在适应性实验室进化后可延缓抗菌药物耐药性。 (你提供的原文似乎不完整,“of”后面缺少具体内容)

Combination therapy delays antimicrobial resistance after adaptive laboratory evolution of .

作者信息

Petersen Maiken Engelbrecht, Khamas Amanda Batoul, Østergaard Lars Jørgen, Jørgensen Nis Pedersen, Meyer Rikke Louise

机构信息

Interdisciplinary Nanoscience Center, Aarhus University, Aarhus, Denmark.

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Antimicrob Agents Chemother. 2025 Apr 2;69(4):e0148324. doi: 10.1128/aac.01483-24. Epub 2025 Mar 14.

Abstract

Antibiotic resistance, driven by misuse and overuse of antibiotics, is one of the greatest threats against human health. The antimicrobial pressure during prolonged antibiotic treatment of chronic bacterial infections selects for resistance. While antibiotic combinations may reduce resistance emergence, antibiotic-tolerant persister cells can serve as a reservoir for resistance development. Therefore, targeting these cells with anti-persister drugs might provide a novel strategy for resistance prevention. In this study, we conducted 42 days of adaptive laboratory evolution using exposed to rifampicin, ciprofloxacin, daptomycin, and vancomycin, alone or in combination with the anti-persister drug mitomycin C. We monitored antibiotic susceptibility daily and assessed phenotypic changes in growth and biofilm formation in evolved strains. Whole-genome sequencing revealed mutations linked to antibiotic resistance and phenotypic shifts. Rifampicin resistance developed within a few days, while ciprofloxacin and daptomycin emerged in approximately 3 weeks. Treatments with vancomycin or mitomycin C resulted in minimal changes in susceptibility. While combination therapy delayed resistance, it did not fully prevent it. Notably, the combination of rifampicin with mitomycin C maintained rifampicin susceptibility throughout the long-term evolution experiment. Sub-inhibitory antibiotic treatments selected for both previously characterized and novel mutations, including unprecedented alterations in the nucleotide excision repair system and azoreductase following mitomycin C exposure. The delayed resistance development observed with combination therapy, particularly mitomycin C's ability to suppress rifampicin resistance, suggests potential therapeutic applications. Future studies should evaluate the clinical efficacy of anti-persister drugs in preventing resistance across different bacterial pathogens and infection models.

摘要

抗生素的滥用和过度使用导致的抗生素耐药性是对人类健康的最大威胁之一。慢性细菌感染长期使用抗生素治疗期间的抗菌压力会选择出耐药性。虽然联合使用抗生素可能会减少耐药性的出现,但具有抗生素耐受性的持留菌可作为耐药性发展的储存库。因此,用抗持留菌药物靶向这些细胞可能为预防耐药性提供一种新策略。在本研究中,我们对暴露于利福平、环丙沙星、达托霉素和万古霉素单独或与抗持留菌药物丝裂霉素C联合使用的菌株进行了42天的适应性实验室进化。我们每天监测抗生素敏感性,并评估进化菌株在生长和生物膜形成方面的表型变化。全基因组测序揭示了与抗生素耐药性和表型转变相关的突变。利福平耐药性在几天内就出现了,而环丙沙星和达托霉素耐药性大约在3周后出现。用万古霉素或丝裂霉素C治疗导致敏感性变化最小。虽然联合治疗延缓了耐药性,但并没有完全预防耐药性。值得注意的是,在长期进化实验中,利福平与丝裂霉素C的联合使用使利福平敏感性得以维持。亚抑菌浓度的抗生素治疗选择了先前已鉴定的和新的突变,包括丝裂霉素C暴露后核苷酸切除修复系统和偶氮还原酶前所未有的改变。联合治疗观察到的耐药性发展延迟,特别是丝裂霉素C抑制利福平耐药性的能力,提示了其潜在的治疗应用。未来的研究应评估抗持留菌药物在预防不同细菌病原体和感染模型中的耐药性方面的临床疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14b2/11963546/062bda4c64f2/aac.01483-24.f001.jpg

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