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Cheminet G, de Lastours V, Poirel L, Chau F, Peoc'h K, Massias L, Fantin B, Nordmann P. Dimercaptosuccinic acid in combination with carbapenems against isogenic strains of Escherichia coli producing or not producing a metallo-β-lactamase in vitro and in murine peritonitis. J Antimicrob Chemother 2021; 75:3593-3600. [PMID: 32790873 DOI: 10.1093/jac/dkaa347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Carbapenemase-producing Enterobacterales represent a major therapeutic challenge. MBLs, requiring zinc at their catalytic site, could be inhibited by meso-dimercaptosuccinic acid (DMSA), a heavy metal chelator already widely used for treating lead intoxication. OBJECTIVES To evaluate the activity of carbapenems alone or combined with DMSA against MBL-producing Escherichia coli in a severe murine peritonitis model. METHODS Isogenic strains of wild-type E. coli CFT073 producing the MBLs NDM-1, VIM-2 and IMP-1, and the control serine carbapenemases OXA-48 and KPC-3 were constructed. MIC determinations and time-kill assays were performed for imipenem, meropenem and ertapenem alone or in combination with DMSA. Infected mice were treated intraperitoneally for 24 h with imipenem, DMSA or their combination. Bacterial counts in peritoneal fluid and spleen were assessed at 24 h. RESULTS DMSA in combination with each carbapenem caused a significant decrease in the MICs for all MBL-producing strains, in a concentration-dependent manner, but did not provide benefit against non-MBL strains. In mice infected with the NDM-1-producing strain, the combination of imipenem and DMSA significantly reduced bacterial counts in peritoneal fluid (P = 0.0006) and spleen (P < 0.0001), as compared with imipenem alone, with no benefit against the KPC-3-producing and CFT073 strains. DMSA concentrations in plasma of mice were comparable to those obtained in humans with a standard oral dose. CONCLUSIONS DMSA restores the activity of carbapenems against MBL-producing strains, and its combination with carbapenems appears to be a promising strategy for the treatment of NDM-producing E. coli infections.
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Affiliation(s)
- G Cheminet
- Université de Paris, IAME, UMR 1137 INSERM, F-75018 Paris, France
| | - V de Lastours
- Université de Paris, IAME, UMR 1137 INSERM, F-75018 Paris, France.,Médecine interne, Hôpital Beaujon, AP-HP Nord, Université de Paris, F-92110 Clichy, France
| | - L Poirel
- IAME, UMR 1137 Laboratoire Européen Associé INSERM, Université de Fribourg, Fribourg, Switzerland.,Microbiologie Médicale et Moléculaire, Département de Médecine, Faculté des Sciences et de Médecine, Centre de Référence des Résistances Emergentes aux Antibiotiques (NARA), Université de Fribourg, Fribourg, Switzerland
| | - F Chau
- Université de Paris, IAME, UMR 1137 INSERM, F-75018 Paris, France
| | - K Peoc'h
- Université de Paris, CRI, UMR 1149 INSERM, F-75018 Paris, France.,Laboratoire de biochimie, Hôpital Beaujon, AP-HP Nord, F-92110 Clichy, France
| | - L Massias
- Université de Paris, IAME, UMR 1137 INSERM, F-75018 Paris, France.,Laboratoire de pharmacologie et toxicologie, AP-HP Nord, Hôpital Bichat-Claude Bernard, F-75018 Paris, France
| | - B Fantin
- Université de Paris, IAME, UMR 1137 INSERM, F-75018 Paris, France.,Médecine interne, Hôpital Beaujon, AP-HP Nord, Université de Paris, F-92110 Clichy, France
| | - P Nordmann
- IAME, UMR 1137 Laboratoire Européen Associé INSERM, Université de Fribourg, Fribourg, Switzerland.,Microbiologie Médicale et Moléculaire, Département de Médecine, Faculté des Sciences et de Médecine, Centre de Référence des Résistances Emergentes aux Antibiotiques (NARA), Université de Fribourg, Fribourg, Switzerland
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