Azithromycin possesses biofilm–inhibitory activity and potentiates non-bactericidal colistin methanesulfonate (CMS) and polymyxin B against Klebsiella pneumonia

Olena V. Moshynets*, Taras P. Baranovskyi, Scott Cameron, Olga S. Iungin, Ianina Pokholenko, Robyn Jerdan, Aleksandr Kamyshnyi, Alexey A. Krikunov, Viktoria V. Potochilova, Kateryna L. Rudnieva, Andrew J. Spiers*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Novel antibiotic combinations may act synergistically to inhibit the growth of multidrug-resistant bacterial pathogens but predicting which combination will be successful is difficult, and standard antimicrobial susceptibility testing may not identify important physiological differences between planktonic free-swimming and biofilm-protected surface-attached sessile cells. Using a nominally macrolide-resistant model Klebsiella pneumoniae strain (ATCC 10031) we demonstrate the effectiveness of several macrolides in inhibiting biofilm growth in multi-well plates, and the ability of azithromycin (AZM) to improve the effectiveness of the antibacterial last-agent-of-choice for K. pneumoniae infections, colistin methanesulfonate (CMS), against biofilms. This synergistic action was also seen in biofilm tests of several K. pneumoniae hospital isolates and could also be identified in polymyxin B disc-diffusion assays on azithromycin plates. Our work highlights the complexity of antimicrobial-resistance in bacterial pathogens and the need to test antibiotics with biofilm models where potential synergies might provide new therapeutic opportunities not seen in liquid culture or colony-based assays.
Original languageEnglish
Article numbere0270983
Number of pages16
JournalPLoS One
Volume17
Issue number7
Early online date1 Jul 2022
DOIs
Publication statusPublished - 1 Jul 2022

Keywords

  • Bacterial biofilms
  • Antibiotics
  • Biofilms
  • Pneumonia
  • Klebisella pneumoniae
  • Polymyxins
  • MTT assay
  • Animal sociality

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