An anti-mycobacterial conjugated oligoelectrolyte effective against Mycobacterium abscessus

Abstract

Infections caused by nontuberculous mycobacteria have increased more than 50% in the past two decades and more than doubled in the elderly population. Mycobacterium abscessus (Mab), one of the most prevalent of these rapidly growing species, is intrinsically resistant to numerous antibiotics. Current standard-of-care treatments are not satisfactory, with high failure rate and notable adverse effects. We report here a potent anti-Mab compound from the flexible molecular framework afforded by conjugated oligoelectrolytes (COEs). A screen of structurally diverse, noncytotoxic COEs identified a lead compound, COE-PNH 2 , which was bactericidal against replicating, nonreplicating persisters and intracellular Mab.COE-PNH 2 had low propensity for resistance development, with a frequency of resistance below 1.25 × 10 −9 and showed no detectable resistance upon serial passaging. Mechanism of action studies were in line with COE-PNH 2 affecting the physical and functional integrity of the bacterial envelope and disrupting the mycomembrane and associated essential bioenergetic pathways. Moreover, COE-PNH 2 was well-tolerated and efficacious in a mouse model of Mab lung infection. This study highlights desirable in vitro and in vivo potency and safety index of this COE structure, which represents a promising anti-mycobacterial to tackle an unmet medical need.

Long-term Outcomes of Adjunctive Lung Resection for Nontuberculous Mycobacteria Pulmonary Disease

“…Yet, this fact highlights the limitation that reinfection remains unavoidable even after MABC eradication through adjunctive lung resection. Recent studies have reported immune or metabolic alterations related to the pathogenesis of NTM-PD [ 23–25 ]. Nevertheless, no decisive measures to prevent reinfection have been reported.…”