Antibiotics (Mar 2023)

Neutralizing Carbapenem Resistance by Co-Administering Meropenem with Novel β-Lactam-Metallo-β-Lactamase Inhibitors

  • Nakita Reddy,
  • Letisha Girdhari,
  • Mbongeni Shungube,
  • Arnoldus C. Gouws,
  • Byron K. Peters,
  • Kamal K. Rajbongshi,
  • Sooraj Baijnath,
  • Sipho Mdanda,
  • Thandokuhle Ntombela,
  • Thilona Arumugam,
  • Linda A. Bester,
  • Sanil D. Singh,
  • Anil Chuturgoon,
  • Per I. Arvidsson,
  • Glenn E. M Maguire,
  • Hendrik G. Kruger,
  • Thavendran Govender,
  • Tricia Naicker

DOI
https://doi.org/10.3390/antibiotics12040633
Journal volume & issue
Vol. 12, no. 4
p. 633

Abstract

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Virulent Enterobacterale strains expressing serine and metallo-β-lactamases (MBL) genes have emerged responsible for conferring resistance to hard-to-treat infectious diseases. One strategy that exists is to develop β-lactamase inhibitors to counter this resistance. Currently, serine β-lactamase inhibitors (SBLIs) are in therapeutic use. However, an urgent global need for clinical metallo-β-lactamase inhibitors (MBLIs) has become dire. To address this problem, this study evaluated BP2, a novel beta-lactam-derived β-lactamase inhibitor, co-administered with meropenem. According to the antimicrobial susceptibility results, BP2 potentiates the synergistic activity of meropenem to a minimum inhibitory concentration (MIC) of ≤1 mg/L. In addition, BP2 is bactericidal over 24 h and safe to administer at the selected concentrations. Enzyme inhibition kinetics showed that BP2 had an apparent inhibitory constant (Kiapp) of 35.3 µM and 30.9 µM against New Delhi Metallo-β-lactamase (NDM-1) and Verona Integron-encoded Metallo-β-lactamase (VIM-2), respectively. BP2 did not interact with glyoxylase II enzyme up to 500 µM, indicating specific (MBL) binding. In a murine infection model, BP2 co-administered with meropenem was efficacious, observed by the >3 log10 reduction in K. pneumoniae NDM cfu/thigh. Given the promising pre-clinical results, BP2 is a suitable candidate for further research and development as an (MBLI).

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