Collateral sensitivity constrains resistance evolution of the CTX-M-15 β-lactamase

Nat Commun. 2019 Feb 6;10(1):618. doi: 10.1038/s41467-019-08529-y.

Abstract

Antibiotic resistance is a major challenge to global public health. Discovery of new antibiotics is slow and to ensure proper treatment of bacterial infections new strategies are needed. One way to curb the development of antibiotic resistance is to design drug combinations where the development of resistance against one drug leads to collateral sensitivity to the other drug. Here we study collateral sensitivity patterns of the globally distributed extended-spectrum β-lactamase CTX-M-15, and find three non-synonymous mutations with increased resistance against mecillinam or piperacillin-tazobactam that simultaneously confer full susceptibility to several cephalosporin drugs. We show in vitro and in mice that a combination of mecillinam and cefotaxime eliminates both wild-type and resistant CTX-M-15. Our results indicate that mecillinam and cefotaxime in combination constrain resistance evolution of CTX-M-15, and illustrate how drug combinations can be rationally designed to limit the resistance evolution of horizontally transferred genes by exploiting collateral sensitivity patterns.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amdinocillin / pharmacology
  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Cefotaxime / pharmacology
  • Disease Models, Animal
  • Drug Combinations
  • Drug Resistance, Microbial / genetics*
  • Escherichia coli / drug effects
  • Escherichia coli / genetics
  • Female
  • Gene Transfer, Horizontal / drug effects
  • Mice
  • Mice, Inbred BALB C
  • Microbial Sensitivity Tests
  • Mutation
  • beta-Lactamases / drug effects*
  • beta-Lactamases / genetics
  • beta-Lactams

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • beta-Lactams
  • beta-lactamase CTX-M-15
  • beta-Lactamases
  • Cefotaxime
  • Amdinocillin