Bismuth antimicrobial drugs serve as broad-spectrum metallo-β-lactamase inhibitors

Nat Commun. 2018 Jan 30;9(1):439. doi: 10.1038/s41467-018-02828-6.

Abstract

Drug-resistant superbugs pose a huge threat to human health. Infections by Enterobacteriaceae producing metallo-β-lactamases (MBLs), e.g., New Delhi metallo-β-lactamase 1 (NDM-1) are very difficult to treat. Development of effective MBL inhibitors to revive the efficacy of existing antibiotics is highly desirable. However, such inhibitors are not clinically available till now. Here we show that an anti-Helicobacter pylori drug, colloidal bismuth subcitrate (CBS), and related Bi(III) compounds irreversibly inhibit different types of MBLs via the mechanism, with one Bi(III) displacing two Zn(II) ions as revealed by X-ray crystallography, leading to the release of Zn(II) cofactors. CBS restores meropenem (MER) efficacy against MBL-positive bacteria in vitro, and in mice infection model, importantly, also slows down the development of higher-level resistance in NDM-1-positive bacteria. This study demonstrates a high potential of Bi(III) compounds as the first broad-spectrum B1 MBL inhibitors to treat MBL-positive bacterial infection in conjunction with existing carbapenems.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Infective Agents / chemistry
  • Anti-Infective Agents / pharmacology*
  • Bismuth / chemistry
  • Bismuth / metabolism
  • Bismuth / pharmacology
  • Carbapenems / pharmacology
  • Catalytic Domain
  • Crystallography, X-Ray
  • Dogs
  • Drug Evaluation, Preclinical / methods
  • Evolution, Molecular
  • Female
  • Madin Darby Canine Kidney Cells / drug effects
  • Mice, Inbred BALB C
  • Microbial Sensitivity Tests
  • Organometallic Compounds / chemistry
  • Organometallic Compounds / pharmacology*
  • Peritonitis / drug therapy
  • Peritonitis / microbiology
  • Zinc / metabolism
  • beta-Lactam Resistance / drug effects
  • beta-Lactamase Inhibitors / pharmacology*
  • beta-Lactamases / chemistry
  • beta-Lactamases / metabolism*

Substances

  • Anti-Infective Agents
  • Carbapenems
  • Organometallic Compounds
  • beta-Lactamase Inhibitors
  • beta-Lactamases
  • beta-lactamase NDM-1
  • bismuth tripotassium dicitrate
  • Zinc
  • Bismuth