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Identification and targeting of microbial putrescine acetylation in bloodstream infections.

Abstract
The growth of antimicrobial resistance (AMR) has highlighted an urgent need to identify bacterial pathogenic functions that may be targets for clinical intervention. Although severe bacterial infections profoundly alter host metabolism, prior studies have largely ignored alterations in microbial metabolism in this context. Performing metabolomics on patient and mouse plasma samples, we identify elevated levels of bacterially-derived N-acetylputrescine during gram-negative bloodstream infections (BSI), with higher levels associated with worse clinical outcomes. We discover that SpeG is the bacterial enzyme responsible for acetylating putrescine and show that blocking its activity reduces bacterial proliferation and slows pathogenesis. Reduction of SpeG activity enhances bacterial membrane permeability and results in increased intracellular accumulation of antibiotics, allowing us to overcome AMR of clinical isolates both in culture and in vivo. This study highlights how studying pathogen metabolism in the natural context of infection can reveal new therapeutic strategies for addressing challenging infections.
AuthorsJared R Mayers, Jack Varon, Ruixuan R Zhou, Martin Daniel-Ivad, Courtney Beaulieu, Amrisha Bholse, Nathaniel R Glasser, Franziska M Lichtenauer, Julie Ng, Mayra Pinilla Vera, Curtis Huttenhower, Mark A Perrella, Clary B Clish, Sihai D Zhao, Rebecca M Baron, Emily P Balskus
JournalbioRxiv : the preprint server for biology (bioRxiv) (Sep 21 2023) United States
PMID37790300 (Publication Type: Preprint)

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