title: Phosphate-containing polyethylene glycol polymers prevent lethal sepsis by multidrug-resistant pathogens.
abstract: Antibiotic resistance among highly pathogenic strains of bacteria and fungi is a growing concern in the face of the ability to sustain life during critical illness with advancing medical interventions. The longer patients remain critically ill, the more likely they are to become colonized by multidrug-resistant (MDR) pathogens. The human gastrointestinal tract is the primary site of colonization of many MDR pathogens and is a major source of life-threatening infections due to these microorganisms. Eradication measures to sterilize the gut are difficult if not impossible and carry the risk of further antibiotic resistance. Here, we present a strategy to contain rather than eliminate MDR pathogens by using an agent that interferes with the ability of colonizing pathogens to express virulence in response to host-derived and local environmental factors. The antivirulence agent is a phosphorylated triblock high-molecular-weight polymer (here termed Pi-PEG 15-20) that exploits the known properties of phosphate (Pi) and polyethylene glycol 15-20 (PEG 15-20) to suppress microbial virulence and protect the integrity of the intestinal epithelium. The compound is nonmicrobiocidal and appears to be highly effective when tested both in vitro and in vivo. Structure functional analyses suggest that the hydrophobic bis-aromatic moiety at the polymer center is of particular importance to the biological function of Pi-PEG 15-20, beyond its phosphate content. Animal studies demonstrate that Pi-PEG prevents mortality in mice inoculated with multiple highly virulent pathogenic organisms from hospitalized patients in association with preservation of the core microbiome.
authors.affiliation: University of Chicago, Chicago, Illinois, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Zaborin
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Defazio
authors.forename: Matthew
authors.initials: M
authors.lastname: Kade
authors.forename: Brooke L Deatherage
authors.initials: BL
authors.lastname: Kaiser
authors.forename: Natalia
authors.initials: N
authors.lastname: Belogortseva
authors.forename: David G
authors.initials: DG
authors.lastname: Camp
authors.forename: Richard D
authors.initials: RD
authors.lastname: Smith
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Adkins
authors.forename: Sangman M
authors.initials: SM
authors.lastname: Kim
authors.forename: Alexandria
authors.initials: A
authors.lastname: Alverdy
authors.forename: David
authors.initials: D
authors.lastname: Goldfeld
authors.forename: Millicent A
authors.initials: MA
authors.lastname: Firestone
authors.forename: Joel H
authors.initials: JH
authors.lastname: Collier
authors.forename: Bana
authors.initials: B
authors.lastname: Jabri
authors.forename: Matthew
authors.initials: M
authors.lastname: Tirrell
authors.forename: Olga
authors.initials: O
authors.lastname: Zaborina
authors.forename: John C
authors.initials: JC
authors.lastname: Alverdy
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects / Q000472:pathogenicity; D000818:Animals; D001424:Bacterial Infections / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D002176:Candida albicans / Q000187:drug effects / Q000472:pathogenicity; D002177:Candidiasis / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D054697:Cytostatic Agents / Q000138:chemical synthesis / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D013293:Enterococcus faecalis / Q000187:drug effects / Q000472:pathogenicity; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000382:microbiology; D051379:Mice; D008810:Mice, Inbred C57BL; D010710:Phosphates / Q000737:chemistry; D011092:Polyethylene Glycols / Q000138:chemical synthesis / Q000494:pharmacology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000472:pathogenicity; D018805:Sepsis / Q000382:microbiology / Q000517:prevention & control*; D016019:Survival Analysis; D014774:Virulence
chemical_list: D054697:Cytostatic Agents; D010710:Phosphates; D011092:Polyethylene Glycols