Gallium nitrate inhibits multidrug-resistant Acinetobacter baumannii isolated from bloodstream infection by disrupting multiple iron-dependent metabolic processes.

BACKGROUND

Acinetobacter baumannii is a major pathogen in hospitals, causing a notable rise in bloodstream infections among inpatients. Its growing resistance to multiple drugs limits treatment options. This study aims to examine the antibacterial effects of gallium nitrate [Ga(NO)] against A. baumannii and elucidate the underlying molecular mechanism.

METHODS

40 strains of A. baumannii with different antimicrobials susceptibility patterns were isolated from bloodstream infections. The in vitro antibacterial activity of Ga(NO) was analyzed by micro-dilution method and time-kill assay. The influence of ferric chloride/hemin on the antibacterial efficacy of Ga(NO) was investigated. Transcriptome sequencing was performed to elucidate the antibacterial mechanism of Ga(NO). A mouse infection model was conducted to assess its in vivo performance.

RESULTS

Ga(NO) exhibited a potent antibacterial effect in RPMI 1640 medium containing 10% human serum, with MICs ranging from 0.06 μg/mL to 0.125 μg/mL. The antibacterial activity of Ga(NO) was found to be dose- and time- dependent. However, the antibacterial effect of Ga(NO) was partially compromised in the presence of exogenous ferric chloride/hemin. Transcriptomics analysis revealed that Ga(NO) exerted its antibacterial effect by up-regulating the expression of genes associated with siderophore biosynthesis and transport, while simultaneously disrupting multiple iron-dependent metabolic processes. Ga(NO) treatment significantly reduced bacterial load in vivo using a neutropenic mouse thigh infection model.

CONCLUSION

This study sheds light on the antibacterial mechanisms of Ga(NO) against A. baumannii, suggesting its potential as a promising antibacterial drug for treating bloodstream infections caused by multidrug-resistant A. baumannii.