Journal
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
Volume 73, Issue 6, Pages 1611-1619Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jac/dky058
Keywords
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Funding
- US National Institutes of Health [R21/R33 AI111753]
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [R21AI111753, R33AI111753, T32AI007520] Funding Source: NIH RePORTER
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Background: Klebsiella pneumoniae is an opportunistic pathogen and many strains are multidrug resistant. KPC is one of the most problematic resistance mechanisms, as it confers resistance to most beta-lactams, including carbapenems. A promising platform technology for treating infections caused by MDR pathogens is the nucleic acid-like synthetic oligomers that silence bacterial gene expression by an antisense mechanism. Objectives: To test a peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) in a mouse model of K. pneumoniae infection. Methods: PPMOs were designed to target various essential genes of K. pneumoniae and screened in vitro against a panel of diverse strains. The most potent PPMOs were further tested for their bactericidal effects in broth cultures and in established biofilms. Finally, a PPMO was used to treat mice infected with a KPC-expressing strain. Results: The most potent PPMOs targeted acpP, rpmB and ftsZ and had MIC(75)s of 0.5, 4 and 4 mu M, respectively. AcpP PPMOs were bactericidal at 1-2% MIC and reduced viable cells and biofilm mass in established biofilms. In a mouse pneumonia model, therapeutic intranasal treatment with similar to 30 mg/kg AcpP PPMO improved survival by 89% and reduced bacterial burden in the lung by similar to 3 logs. Survival was proportional to the dose of AcpP PPMO. Delaying treatment by 2, 8 or 24 h post-infection improved survival compared with control groups treated with PBS or scrambled sequence (Scr) PPMOs. Conclusions: PPMOs have the potential to be effective therapeutic agents against KPC-expressing, MDR K. pneumoniae.
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