High potency of sequential therapy with only beta-lactam antibiotics
- Kiel University, Germany
- University of Kiel, Germany
- Borstel Research Centre, Germany
Abstract
Evolutionary adaptation is a major source of antibiotic resistance in bacterial pathogens. Evolution-informed therapy aims to constrain resistance by accounting for bacterial evolvability. Sequential treatments with antibiotics that target different bacterial processes were previously shown to limit adaptation through genetic resistance trade-offs and negative hysteresis. Treatment with homogeneous sets of antibiotics is generally viewed to be disadvantageous, as it should rapidly lead to cross-resistance. We here challenged this assumption by determining the evolutionary response of Pseudomonas aeruginosa to experimental sequential treatments involving both heterogenous and homogeneous antibiotic sets. To our surprise, we found that fast switching between only β-lactam antibiotics resulted in increased extinction of bacterial populations. We demonstrate that extinction is favored by low rates of spontaneous resistance emergence and low levels of spontaneous cross-resistance among the antibiotics in sequence. The uncovered principles may help to guide the optimized use of available antibiotics in highly potent, evolution-informed treatment designs.
Data availability
Sequencing data have been deposited at NCBI under the BioProject number: PRJNA704789. All other data is provided in the supplementary source data files.
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Cellular hysteresis as a principle to maximize the efficacy of antibiotic therapy - Results on extinction frequencieshttps://doi.org/10.1073/pnas.1810004115.
Article and author information
Author details
Hinrich Schulenburg
Funding
Deutsche Forschungsgemeinschaft (SCHU 1415/12)
- Hinrich Schulenburg
Deutsche Forschungsgemeinschaft (EXC 2167-390884018)
- Stefan Niemann
- Hinrich Schulenburg
Deutsche Forschungsgemeinschaft (GRK 2501)
- Stefan Niemann
- Hinrich Schulenburg
Max-Planck-Gesellschaft (IMPRS Stipend)
- Aditi Batra
Max-Planck-Gesellschaft (Fellowship)
- Hinrich Schulenburg
Leibniz-Gemeinschaft (EvoLUNG)
- Stefan Niemann
- Hinrich Schulenburg
Deutsche Forschungsgemeinschaft (project 407495230)
- Sören Franzenburg
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Copyright
© 2021, Batra et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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High potency of sequential therapy with only beta-lactam antibiotics
eLife 10:e68876.
https://doi.org/10.7554/eLife.68876
Further reading
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- Evolutionary Biology
- Epidemiology and Global Health
- Microbiology and Infectious Disease
- Genetics and Genomics
eLife is pleased to present a Special Issue to highlight recent advances in the growing and increasingly interdisciplinary field of evolutionary medicine.
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- Evolutionary Biology
Lineages of rod-shaped bacteria such as Escherichia coli exhibit a temporal decline in elongation rate in a manner comparable to cellular or biological aging. The effect results from the production of asymmetrical daughters, one with a lower elongation rate, by the division of a mother cell. The slower daughter compared to the faster daughter, denoted respectively as the old and new daughters, has more aggregates of damaged proteins and fewer expressed gene products. We have examined further the degree of asymmetry by measuring the density of ribosomes between old and new daughters and between their poles. We found that ribosomes were denser in the new daughter and also in the new pole of the daughters. These ribosome patterns match the ones we previously found for expressed gene products. This outcome suggests that the asymmetry is not likely to result from properties unique to the gene expressed in our previous study, but rather from a more fundamental upstream process affecting the distribution of ribosomal abundance. Because damage aggregates and ribosomes are both more abundant at the poles of E. coli cells, we suggest that competition for space between the two could explain the reduced ribosomal density in old daughters. Using published values for aggregate sizes and the relationship between ribosomal number and elongation rates, we show that the aggregate volumes could in principle displace quantitatively the amount of ribosomes needed to reduce the elongation rate of the old daughters.
