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Multiresistant uropathogenic extended-spectrum β-lactamase (ESBL)-producing Escherichia coli are susceptible to the carbon monoxide releasing molecule-2 (CORM-2).
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Dept Lab Med, Örebro University Hospital, Örebro, Sweden.
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2014 (English)In: Microbial Pathogenesis, ISSN 0882-4010, E-ISSN 1096-1208, Vol. 66, p. 29-35Article in journal (Refereed) Published
Abstract [en]

Carbon monoxide (CO) releasing molecules (CO-RMs) have been shown to inhibit growth of commensal Escherichia coli (E. coli). In the present study we examined the effect of CORM-2 on uropathogenic E. coli (UPEC) that produces extended-spectrum β-lactamase (ESBL). Viability experiments showed that CORM-2 inhibited the growth of several different ESBL-producing UPEC isolates and that 500 μM CORM-2 had a bactericidal effect within 4 h. The bactericidal effect of CORM-2 was significantly more pronounced than the effect of the antibiotic nitrofurantoin. CORM-2 demonstrated a low level of cytotoxicity in eukaryotic cells (human bladder epithelial cell line 5637) at the concentrations and time-points where the antibacterial effect was obtained. Real-time RT-PCR studies of different virulence genes showed that the expression of capsule group II kpsMT II and serum resistance traT was reduced and that some genes encoding iron acquisition systems were altered by CORM-2. Our results demonstrate that CORM-2 has a fast bactericidal effect against multiresistant ESBL-producing UPEC isolates, and also identify some putative UPEC virulence factors as targets for CORM-2. CO-RMs may be candidate drugs for further studies in the field of finding new therapeutic approaches for treatment of uropathogenic ESBLproducing E. coli.

Place, publisher, year, edition, pages
London: Elsevier, 2014. Vol. 66, p. 29-35
Keywords [en]
Carbon monoxide; CORM-2; Extended-spectrum β-lactamases; Uropathogenic E. coli; CTX-M
National Category
Microbiology in the medical area Immunology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-33229DOI: 10.1016/j.micpath.2013.12.003ISI: 000331853700005PubMedID: 24361394Scopus ID: 2-s2.0-84891068559OAI: oai:DiVA.org:oru-33229DiVA, id: diva2:690089
Note

Funding Agency:

Swedish Council for Working Life and Social Research, from the Faculty of Medicine and Health at Orebro University and Nyckelfonden at Orebro University Hospital

Available from: 2014-01-22 Created: 2014-01-22 Last updated: 2018-06-04Bibliographically approved
In thesis
1. Carbon monoxide and nitric oxide as antimicrobial agents: focus on ESBL-producing uropathogenic E.coli
Open this publication in new window or tab >>Carbon monoxide and nitric oxide as antimicrobial agents: focus on ESBL-producing uropathogenic E.coli
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Urinary tract infections (UTI) are common in humans and most often caused by uropathogenic Escherichia coli (E. coli). Extended-spectrum beta-lactamase (ESBL)-producing E. coli are increasing worldwide and they are frequently multidrug-resistant with limited treatment options. The overall aim of this thesis was to study the role of the host-derived factors nitric oxide (NO) and carbon monoxide (CO) as antimicrobial agents against ESBL-producing uropathogenic strains of E. coli (UPEC).

The NO-donor DETA/NO caused a temporary growth inhibition in ESBL-producing UPEC. The antibacterial effect of DETA/NO was improved when DETA/NO was combined with miconazole, a pharmacological inhibitor of NO-protective mechanisms. Combination treatment with DETA/NO, miconazole and polymyxin B nonapeptid prolonged the bacteriostatic effect in the majority of examined isolates. The CO-donor CORM-2 showed a pronounced antibacterial effect in ESBL-producing UPEC with a fast bactericidal effect. Moreover, CORM-2 was shown to reduce the bacterial viability of ESBL-producing UPEC grown under biofilm-like conditions and to decrease the bacterial colonization of human bladder epithelial cells. A microarray analysis was performed to define transcriptomic targets of CORM-2 after a single exposure and after repeated exposure to CORM-2. Many processes were affected by CORM-2, including a downregulation in energy metabolism and biosynthesis pathways and upregulation of the SOS response and DNA repair. Repeated exposure to CORM-2 did not change the gene expression patterns or fold changes and the growth inhibitory response to CORM-2 was not altered after repeated exposure.

In conclusion, NO- and CO-donors have antibacterial effects against ESBL-producing UPEC and may be interesting candidates for development of new antibiotics to treat UTI caused by multidrug-resistant uropathogens.

Abstract [en]

Populärvetenskaplig sammanfattning

Urinvägsinfektioner är vanligt förekommande och orsakas ofta av Escherichia coli (E. coli)-stammar. Runt om i världen märks en tilltagande antibiotikaresistens hos bakterier vilket har ökat behovet av att finna nya behandlingsmetoder. Speciellt svårbehandlade ar urinvägsinfektioner orsakade av E. coli som bildar beta-laktamas enzymer med utvidgat spektrum sa kallade ESBL-bildande E. coli. ESBL-bildande bakterier kan bryta ner de flesta antibiotika ur penicillingruppen, som cefalosporiner, samt är ofta resistenta mot flera andra antibiotika (multiresistenta). Spridning av ESBL-bildande E. coli sker inte enbart i sjukhusmiljö utan även ute i samhället.

Vid urinvägsinfektion spelar immunforsvaret en viktig roll. Förekomst av bakterier i urinblåsan medför att ett komplext vävnadsförsvar aktiveras. Målet for avhandlingen har varit att studera den bakteriehämmande effekten av de kroppsegna faktorerna kväveoxid (NO) och kolmonoxid (CO) och då speciellt mot multiresistenta ESBL-bildande E. coli som orsakar urinvägsinfektion. NO har tidigare visats ge en kortvarig bakteriehämmande effekt på uropatogena E. coli. Bakterier kan bilda enzymet flavohemoglobin som omvandlar toxiskt NO till harmlöst nitrat. I avhandlingsarbetet har effekterna av mikonazol, en substans som hämmar flavohemoglobin, i kombination med NO undersökts. Mikonazol visades forlänga den bakteriehämmande effekten av en NO-donator (DETA/NO).

CO binder framförallt till hemproteiner och är en effektiv hämmare av bakteriell cellandning. Resultaten i avhandlingen visar att CO-donatorn CORM-2 har en kraftfull bakteriedödande effekt. Effekten av CORM-2 är snabb och inom fyra timmar har en bakteriedödande effekt uppnåtts. Vidare visas att CORM-2 påverkar genuttrycket av vissa virulensfaktorer hos uropatogena E. coli. Uropatogena E. coli har förmåga att bilda skyddande biofilm och dessutom kan de invadera epitelceller i urinvägarna och på så sätt bilda skyddade miljöer inuti cellerna. I avhandlingen visas att CORM-2 minskar antalet levande bakterier i en biofilm och att CORM-2 har en hämmande effekt på bakterier som koloniserat humana epitelceller från urinblåsa. I microarray försök, där förändringar av hela genuttrycket hos bakterier studeras, visas att exponering av CORM-2 generellt leder till nedreglering av energimetabolism och biosyntes samt uppreglering av en SOS stressresponsvag och DNA reparation. Uttryck av gener som har visats ha samband med virulens, biofilm och antibiotikaresistens påverkades också. Den bakteriedödande effekten och känsligheten för CORM-2 kvarstår hos bakterier som exponerats upprepade gånger för CORM-2.

Sammanfattningsvis visar resultaten i avhandlingen att NO- och COdonatorer har bakteriehämmande effekter på ESBL-bildande uropatogener. NO- och CO-donatorer kan vara intressanta att vidareutveckla vid design av framtida antibiotika mot uropatogena multiresistenta ESBL-bildande E. coli.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2016
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 136
Keywords
biofilm, carbon monoxide, CORM-2, DETA/NO, extendedspectrum beta-lactamases, nitric oxide, urinary tract infection, uropathogenic Escherichia coli
National Category
Other Basic Medicine
Research subject
Biomedicine
Identifiers
urn:nbn:se:oru:diva-47478 (URN)978-91-7529-119-2 (ISBN)
Public defence
2016-04-08, Universitetssjukhuset, hörsal C1, Södra Grev Rosengatan, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2018-01-10Bibliographically approved

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Bang, Charlotte SahlbergKruse, RobertDemirel, IsakÖnnberg, AnnaSöderquist, BoPersson, Katarina

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