Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coli

ABSTRACTThe use of combination antibiotics has been useful in the treatment of multidrug-resistant bacterial infections. The synergistic effect of amoxicillin/clavulanate and aztreonam combination against Escherichia coli carrying New Delhi metallo-β-lactamase (NDM) was primarily due to clavulanate...

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Main Authors: Jiayuan Zhang, Hai Yang, Lei Zhang, Zhihua Lv, Mingming Yu, Sherwin K. B. Sy, Yuanchao Zhan
Format: Article
Language:English
Published: American Society for Microbiology 2023-12-01
Series:mSystems
Subjects:
Online Access:https://journals.asm.org/doi/10.1128/msystems.00758-23
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author Jiayuan Zhang
Hai Yang
Lei Zhang
Zhihua Lv
Mingming Yu
Sherwin K. B. Sy
Yuanchao Zhan
author_facet Jiayuan Zhang
Hai Yang
Lei Zhang
Zhihua Lv
Mingming Yu
Sherwin K. B. Sy
Yuanchao Zhan
author_sort Jiayuan Zhang
collection DOAJ
description ABSTRACTThe use of combination antibiotics has been useful in the treatment of multidrug-resistant bacterial infections. The synergistic effect of amoxicillin/clavulanate and aztreonam combination against Escherichia coli carrying New Delhi metallo-β-lactamase (NDM) was primarily due to clavulanate inhibiting aztreonam degradation. In the present study, we employed metabolomic analysis to investigate the downstream changes in E. coli after treatment with aztreonam and clavulanate. E. coli metabolomes were compared at 1 and 24 h following treatments with clavulanate (4 µg/mL) and aztreonam (4 µg/mL) alone and in combination. Excluding false positives, 198 metabolites were identified to be affected by antibiotic treatment. Aztreonam/clavulanate combination inhibited cell wall synthesis more aggressively at 1 h and 24 h than aztreonam alone. The purine and pyrimidine metabolism, the central carbon metabolism, and the amino acid metabolism were also disrupted resulting in a prolonged bactericidal effect. This study reveals the synergistic killing mechanism of clavulanate and aztreonam combination against E. coli harboring NDM and provides a theoretical basis for the combined use of aztreonam/clavulanate in the treatment of multidrug-resistant E. coli infection.IMPORTANCEMultidrug-resistant Escherichia coli is a major threat to the health care system and is associated with poor outcomes in infected patients. The combined use of antibiotics has become an important treatment method for multidrug-resistant bacteria. However, the mechanism for their synergism has yet to be explored.
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spelling doaj.art-9ab0f7638ec24897b4cf944f45cb7fc52023-12-21T14:02:34ZengAmerican Society for MicrobiologymSystems2379-50772023-12-018610.1128/msystems.00758-23Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coliJiayuan Zhang0Hai Yang1Lei Zhang2Zhihua Lv3Mingming Yu4Sherwin K. B. Sy5Yuanchao Zhan6Ocean University of China, Qingdao, ChinaDepartment of Pharmacy, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, ChinaDepartment of Laboratory Medicine, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, ChinaOcean University of China, Qingdao, ChinaOcean University of China, Qingdao, ChinaDepartment of Statistics, State University of Maringá, Maringá, Paraná, BrazilOcean University of China, Qingdao, ChinaABSTRACTThe use of combination antibiotics has been useful in the treatment of multidrug-resistant bacterial infections. The synergistic effect of amoxicillin/clavulanate and aztreonam combination against Escherichia coli carrying New Delhi metallo-β-lactamase (NDM) was primarily due to clavulanate inhibiting aztreonam degradation. In the present study, we employed metabolomic analysis to investigate the downstream changes in E. coli after treatment with aztreonam and clavulanate. E. coli metabolomes were compared at 1 and 24 h following treatments with clavulanate (4 µg/mL) and aztreonam (4 µg/mL) alone and in combination. Excluding false positives, 198 metabolites were identified to be affected by antibiotic treatment. Aztreonam/clavulanate combination inhibited cell wall synthesis more aggressively at 1 h and 24 h than aztreonam alone. The purine and pyrimidine metabolism, the central carbon metabolism, and the amino acid metabolism were also disrupted resulting in a prolonged bactericidal effect. This study reveals the synergistic killing mechanism of clavulanate and aztreonam combination against E. coli harboring NDM and provides a theoretical basis for the combined use of aztreonam/clavulanate in the treatment of multidrug-resistant E. coli infection.IMPORTANCEMultidrug-resistant Escherichia coli is a major threat to the health care system and is associated with poor outcomes in infected patients. The combined use of antibiotics has become an important treatment method for multidrug-resistant bacteria. However, the mechanism for their synergism has yet to be explored.https://journals.asm.org/doi/10.1128/msystems.00758-23metabolomicsEscherichia coliclavulanateaztreonamsynergy
spellingShingle Jiayuan Zhang
Hai Yang
Lei Zhang
Zhihua Lv
Mingming Yu
Sherwin K. B. Sy
Yuanchao Zhan
Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coli
mSystems
metabolomics
Escherichia coli
clavulanate
aztreonam
synergy
title Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coli
title_full Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coli
title_fullStr Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coli
title_full_unstemmed Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coli
title_short Comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug-resistant Escherichia coli
title_sort comparative metabolomics reveal key pathways associated with the synergistic activities of aztreonam and clavulanate combination against multidrug resistant escherichia coli
topic metabolomics
Escherichia coli
clavulanate
aztreonam
synergy
url https://journals.asm.org/doi/10.1128/msystems.00758-23
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