RESUMO
The rapid expansion of antibiotic-resistant bacterial diseases is a global burden on public health. It makes sense to repurpose and reposition already-approved medications for use as supplementary agents in synergistic combinations with existing antibiotics. Here, we demonstrate that the anthelmintic drug nitazoxanide (NTZ) synergistically enhances the effectiveness of the lipopeptide antibiotic polymyxin B in inhibiting gram-negative bacteria, including those resistant to polymyxin B. Mechanistic investigations revealed that nitazoxanide inhibited calcium influx and cell membrane depolarization, enhanced the affinity between polymyxin B and the extracellular membrane, and promoted intracellular ATP depletion and an increase in reactive oxygen species (ROS), thus enhancing the penetration and disruption of the Escherichia coli cell membrane by polymyxin B. The transcriptomic analysis revealed that the combination resulted in energy depletion by inhibiting both aerobic and anaerobic respiration patterns in bacterial cells. The increased bactericidal effect of polymyxin B on the E. coli ∆nuoC strain further indicates that NuoC could be a promising target for nitazoxanide. Furthermore, the combination of nitazoxanide and polymyxin B showed promising therapeutic effects in a mouse infection model infected with E. coli. Taken together, these results demonstrate the potential of nitazoxanide as a novel adjuvant to polymyxin B, to overcome antibiotic resistance and improve therapeutic outcomes in refractory infections.IMPORTANCEThe rapid spread of antibiotic-resistant bacteria poses a serious threat to public health. The search for potential compounds that can increase the antibacterial activity of existing antibiotics is a promising strategy for addressing this issue. Here, the synergistic activity of the FDA-approved agent nitazoxanide (NTZ) combined with polymyxin B was investigated in vitro using checkerboard assays and time-kill curves. The synergistic mechanisms of the combination of nitazoxanide and polymyxin B were explored by fluorescent dye, transmission electron microscopy (TEM), and transcriptomic analysis. The synergistic efficacy was evaluated in vivo by the Escherichia coli and mouse sepsis models. These results suggested that nitazoxanide, as a promising antibiotic adjuvant, can effectively enhance polymyxin B activity, providing a potential strategy for treating multidrug-resistant bacteria.
RESUMO
Coccidiostat and antibiotics are widely used in poultry industry, but their effects on cecum microbial community and metabolomics in chickens infected with coccidia have been rarely studied. In this study, we analyzed the changes of microbiota and metabolomic which associated with Eimeria tenella infection in 8 days of age chickens in the presence or absence of ethanamizuril, sulfachlorpyridazine or their combinations treatment for 3 consecutive days. 16S rRNA gene sequencing and LC-MS/MS analyses were used to profile the cecal microbiome and metabolome in each group of chickens on 7 days post-infection. The results showed that coccidial infection induced significant perturbations in the distribution of microbial taxonomy and the metabolism of physiological functional molecules in cecal contents. Ethanamizuril treatment seemed to transform microbiota into a steady state conducive to animal health, and sulfachlorpyridazine treatment alleviated the growth of potentially harmful bacteria such as Escherichia-Shigella. The change trends of metabolites such as n-carbamoylglutamic acid were consistent with the anticoccidial effect of ethanamizuril. The combinations of ethanamizuril and sulfachlorpyridazine at low-dose had little effect on gut microbiota, metabolism and anticoccidial effect. These data indicate that the cecal microbiota and metabolic status of chickens infected with E. tenella following ethanamizuril treatment could be used to monitor the response to drug efficacy. This study provides a new system approach to elucidate the microbiota, metabolic and therapeutic effects of the combination of coccidiostat and antibiotics in the context of avian coccidiosis.
