Oral Presentation Australian Society for Microbiology Annual Scientific Meeting 2024

Exploring the utility of zinc-ionophores for the treatment of Acinetobacter baumannii lung infection (103821)

David MP De Oliveira 1 , Ruby Heaton 1 , Ibrahim M El-deeb 2 , Hayden Whyte 1 , Gen (Tom) Li 1 , Olivia Bertolla 1 , Amanda J Cork 1 , Brian M Forde 1 , Maree T Smith 3 , Mark von Itzstein 2 , Mark J Walker 1
  1. Centre for Superbug Solutions, Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
  2. Institute for Glycomics, Griffith University, Gold Coast, QLD, Australia
  3. School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia

Antimicrobial resistance (AMR) is a growing source of morbidity, mortality, and economic and health-care costs. In Australia, 9.9% of patients admitted to hospital will acquire an AMR-associated hospital-acquired infection resulting in ~170,000 cases per year at an estimated economic burden of >$900 million annually. The innovative use of 8-hydroxyquinolone containing ionophores to break antibiotic resistance in clinically relevant AMR-associated bacteria has paved a therapeutic pathway to investigate ionophores as direct-acting antibiotics. With transformational consequences for the future clinical management of AMR infections, we have synthesised a suite of 8-hydroxyquinolone containing novel chemical entities (NCEs) which demonstrate potent direct-antimicrobial efficacy against the nosocomial AMR-associated pathogen Acinetobacter baumannii; a World Health Organization priority pathogen frequently associated with blood, urinary tract, wound and lung infections. Here, we have generated proof-of-principle data with our lead NCE drug-candidates. For carbapenem-resistant strains of A. baumannii, the lead NCEs induce a bactericidal effect, permeabilise the bacterial outer-membrane, exhibit low resistance emergence properties, dysregulate bacterial zinc and iron metal-ion homeostasis, exhibit favourable pharmacokinetic and toxicity profiles, and demonstrate therapeutic efficacy in vivo using a mouse model of A. baumannii lung infection. These NCEs represent a novel class of antibiotics and may serve to expand the repertoire of effective antibiotic therapies available for the treatment of carbapenem-resistant A. baumannii infection.