Molecular Basis for the Potent Inhibition of the Emerging Carbapenemase VCC-1 by Avibactam.

In 2016, we identified a new class A carbapenemase, VCC-1, in a nontoxigenic Vibrio cholerae strain that had been isolated from retail shrimp imported into Canada for human consumption. Shortly thereafter, seven additional VCC-1-producing V. cholerae isolates were recovered along the German coastline. These isolates appear to have acquired the VCC-1 gene (blaVCC-1) independently from the Canadian isolate, suggesting that blaVCC-1 is mobile and widely distributed. VCC-1 hydrolyzes penicillins, cephalothin, aztreonam, and carbapenems and, like the broadly disseminated class A carbapenemase KPC-2, is only weakly inhibited by clavulanic acid or tazobactam. Although VCC-1 has yet to be observed in the clinic, its encroachment into aquaculture and other areas with human activity suggests that the enzyme may be emerging as a public health threat. To preemptively address this threat, we examined the structural and functional biology of VCC-1 against the FDA-approved non-ß-lactam-based inhibitor avibactam. We found that avibactam restored the in vitro sensitivity of V. cholerae to meropenem, imipenem, and ertapenem. The acylation efficiency was lower for VCC-1 than for KPC-2 and akin to that of Pseudomonas aeruginosa PAO1 AmpC (k2/Ki = 3.0 × 103 M-1 s-1). The tertiary structure of VCC-1 is similar to that of KPC-2, and they bind avibactam similarly; however, our analyses suggest that VCC-1 may be unable to degrade avibactam, as has been found for KPC-2. Based on our prior genomics-based surveillance, we were able to target VCC-1 for detailed molecular studies to gain early insights that could be used to combat this carbapenemase in the future.

Synergistic activity of fosfomycin, ß-lactams and peptidoglycan recycling inhibition against Pseudomonas aeruginosa.

OBJECTIVES: To evaluate the interconnection between peptidoglycan (PG) recycling, fosfomycin susceptibility and synergy between fosfomycin and ß-lactams in Pseudomonas aeruginosa METHODS: Fosfomycin MICs were determined by broth microdilution and Etest for a panel of 47 PAO1 mutants defective in several components of PG recycling and/or AmpC induction pathways. PAO1 fosfomycin MICs were also determined in the presence of a 5 mM concentration of the NagZ inhibitor PUGNAc. Population analysis of fosfomycin susceptibility and characterization of the resistant mutants that emerged was also performed for selected strains. Finally, fosfomycin, imipenem and fosfomycin + imipenem killing curves were assessed. RESULTS: Mutants defective in AmpG, NagZ or all three AmpD amidases showed a marked increase in fosfomycin susceptibility (at least two 2-fold dilutions with respect to WT PAO1). Moreover, PAO1 fosfomycin MICs were consistently reduced from 48 to 24 mg/L in the presence of a 5 mM concentration of PUGNAc. Fosfomycin hypersusceptibility of the ampG, nagZ and triple ampD mutants was also clearly confirmed in the performed population analysis, although the emergence of resistant mutants, through GlpT mutations, was not avoided. Synergy between fosfomycin and imipenem was evidenced for the WT strain, the AmpC-hyperproducing strain (triple AmpD mutant) and the NagZ and AmpG mutants in killing curves. Moreover, regrowth of resistant mutants was not evidenced for the combination. CONCLUSIONS: PG recycling inhibitors are envisaged as useful adjuvants in the treatment of P. aeruginosa infections with ß-lactams and fosfomycin and therefore further development of these molecules is encouraged.

F2-isoprostanes in Fish mucus: A new, non-invasive method for analyzing a biomarker of oxidative stress.

F2-isoprostanes (F2-isoPs) are a reliable biomarker class for oxidative stress in vivo in animals. These compounds are traditionally measured in matrices like liver and plasma, however social and environmental pressures warrant the development of non-lethal and non-invasive methods to assess animal health. Therefore, this study aimed to develop a high-performance liquid chromatography tandem mass spectrometry (HPLC-ESI-MS/MS) method to separate and detect F2-isoPs in fish mucus. The method was developed and validated for four native F2-isoP isomers using Northern pike mucus (Esox lucius). Linearity was observed between 5 and 1000 pg/µL. The limits of detection of the four F2-IsoP isomers ranged from 0.63 to 2.0 ng/g. Recoveries ranged from 78 to 95%, and matrix effects were small (<10%). The between-day and within-day repeatability for all target analytes was lower than 20% RSD. Endogenous F2-isoPs were measured in the pike mucus (5.3-28.8 ng/g). A preliminary study of baseline F2-isoP concentrations in lake trout (Salvelinus namaycush) captured from five lakes at the IISD-Experimental Lakes Area in Northwestern Ontario, Canada, was also conducted to test the interspecies applicability of the method. Endogenous F2-isoPs were quantified in lake trout (6.3-132 ng/g). Lake trout samples displayed large variability within and between the different lakes, which suggests sampling methods may require adjustment for this species. This work developed a sensitive analytical method for measuring F2-isoPs in fish mucus, however several further studies are required to determine its ability to accurately measure oxidative stress in fish species.