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PLoS Biol. 2020 Jan 27;18(1):e3000612. doi: 10.1371/journal.pbio.3000612. eCollection 2020 Jan.

Molecular mechanisms of collateral sensitivity to the antibiotic nitrofurantoin.

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1
Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.

Abstract

Antibiotic resistance increasingly limits the success of antibiotic treatments, and physicians require new ways to achieve efficient treatment despite resistance. Resistance mechanisms against a specific antibiotic class frequently confer increased susceptibility to other antibiotic classes, a phenomenon designated collateral sensitivity (CS). An informed switch of antibiotic may thus enable the efficient treatment of resistant strains. CS occurs in many pathogens, but the mechanisms that generate hypersusceptibility are largely unknown. We identified several molecular mechanisms of CS against the antibiotic nitrofurantoin (NIT). Mutants that are resistant against tigecycline (tetracycline), mecillinam (β-lactam), and protamine (antimicrobial peptide) all show CS against NIT. Their hypersusceptibility is explained by the overexpression of nitroreductase enzymes combined with increased drug uptake rates, or increased drug toxicity. Increased toxicity occurs through interference of the native drug-response system for NIT, the SOS response, with growth. A mechanistic understanding of CS will help to develop drug switches that combat resistance.

Conflict of interest statement

The authors have declared that no competing interests exist.

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