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<p>The 20^th century introduction of antibiotics made once fatal infectious diseases readily treatable. This taken-for-granted therapy is now threatened by rising antibiotic resistance. The ability of pathogens to acquire numerous simultaneous resistance mechanisms has given rise to an alarming number of increasingly difficult to treat multi-drug resistant infections. When coupled with a sharp decline in development of novel antibiotic therapies, health practitioners today are left with limited therapeutic options. Several alternative methodologies have been employed to find novel therapeutics, including new techniques in natural product isolation and the production of semi-synthetic and synthetic antibiotics; however, there has been limited focus on targeting antibiotic resistance mechanisms directly to create synergistic therapies. We demonstrate the potential in using small molecules to target antibiotic kinases, thereby rescuing the antibiotic action of aminoglycosides and macrolides when used in combination. We conducted a thorough examination of these enzymes including: kinetic analysis; an assessment of phosphate donor specificity; and in-depth structural comparison, including a case study on the structure-function relationship of APH(4)-Ia. This analysis culminated in an intensive screening initiative of fourteen antibiotic kinases against a set of well defined protein kinase inhibitors. From this work, we have identified several inhibitors that have the potential for use in future combination therapeutics. This study illustrates the benefit of a structure-activity based approach to drug discovery, an important tool at a time when novel therapeutic strategies are required.</p> / Doctor of Philosophy (PhD)

Enterococcus faecalis are Gram-positive bacteria that colonize the gastrointestinal tracts of mammals, birds and invertebrates and are also found in sewage, soil, food and water. In addition to being commensal organisms, Enterococci can also cause nosocomial infections in humans including urinary tract infections, septicemia and endocarditis. Hospital-acquired infections often present a challenge in treatment due to the emergence of multi-drug resistant strains. Enterococcal plasmids may act as extremely stable reservoirs for resistance genes and other virulence factors. Pheromone responsive plasmids such as pCF10 mediate efficient transfer of genetic material within the species E. faecalis but may also be capable of transferring resistance genes across species and genus boundaries. Polymicrobial environments often found in nosocomial infections may expose plasmid-harboring enterococci to pathogenic species, poising cells for this type of promiscuous horizontal gene transfer of resistance determinants. Previous studies showed that prgW, which encodes the pCF10 replication initiation protein PrgW, is the minimal origin of replication for this plasmid. The replicon, which is usually limited to Enterococcal spp., can replicate in Lactococcus lactis if it is engineered to produce pre-cCF10. Three conserved cysteines (C78/C275/C307) are important for plasmid stability and allow for replication of the pCF10 replicon in L. lactis in the absence of pre-cCF10. PrgW has a predicted molecular weight of 38,635. Four polyclonal antibodies targeting PrgW at the N-terminus (aa 1-20), C-terminus (aa 314-333) and two internal regions (aa 64-80 and aa 250-271) were used in current experiments and retrospective studies. When PrgW was overexpressed in E. faecalis, four different apparent approximate molecular weights were detected by Western blotting (p40*, p36*, p24* and p18*), suggestive of processing. In Enterococci where the replicon is active, p36* was consistently detected by all four antisera; when PrgW was overexpressed in Streptococcus mutans where the replicon is non-functional, p49* and p40* were detected but p36* was not observed. PrgW p24* was detected by a mixture of the internally targeting antibodies as well as the C-terminal targeting antibody, but not the N-terminal targeting antibody, suggesting that the N-terminal domain of PrgW has been cleaved off in p24*. The p24* form may play a role in pCF10 stability. Mutations to three cysteines in PrgW (C78/C275/C307), which reduce the stability of pCF10, result in the loss of p24*. Enterococcal conjugative plasmids have been previously implicated in the transfer of antibiotic resistance genes. The pCF10 plasmid contains the conjugative transposon Tn925, which possesses the tetM tetracycline resistance gene. Proximity of donor and recipient cells is a key part of pheromone-responsive conjugation. Aggregation substance allows for formation of clumps of E. faecalis in liquid mating experiments. E. faecalis forms biofilms; in contrast to filter mating experiments, polymicrobial biofilms provide an in vitro model of a natural scenario during which horizontal gene transfer may occur. Rates of cross-genus genetic transfer of tetM between E. faecalis OG1RF(pCF10) donor cells and Staphylococcus aureus recipient cells growing on glass coverslips as mixed-species biofilm populations were determined to be 10-8 after pheromone induction of pCF10 conjugation. This biofilm transfer model also holds potential to test the efficacy of synthetic peptides in the reduction or even prevention of pCF10 transfer, and the consequential dissemination of antibiotic resistance determinants throughout the genus Enterococcus and beyond. / Microbiology and Immunology

Widespread antimicrobial resistance, particularly in Gram-negative pathogens, is a serious threat facing the global community. Aminoglycosides are inactivated by enzymes such as aminoglycoside N-acetyltransferase-3 (AAC(3)) and O-nucleotidyltransferase-2” (ANT(2”)), while the New Delhi metallo-b- lactamase-1 (NDM-1) degrades carbapenems. Inhibition of these enzymes should result in bacteria becoming once again susceptible to aminoglycosides and carbapenems. This thesis describes the development of inhibitors to these enzymes, in an effort to rescue the utility of aminoglycoside and carbapenem drug classes through adjuvant therapy. High-throughput screening of protein kinase libraries identified two AAC(3)-Ia inhibitors with a common 3-benzylidene-2-indolinone core. New methods for purification of AAC(3)-Ia and monitoring its activity were developed. A chemical library was built around this scaffold and assessed for SAR. It was found that the initial hit (Z)-methyl 3-(3,5-dibromo-4-hydroxybenzylidene)-2- oxoindoline-5-carboxylate was the most active against AAC(3)-Ia, and alterations to either the 3,5-dibromo-4-hydroxybenzyl warhead or methyl ester substituent resulted in a decrease in activity. Previous whole-cell screening had identified two protein kinase inhibitors with a biphenyl isonicotinamide scaffold as inhibitors of ANT(2”)-Ia. A convergent parallel synthesis was developed, involving Suzuki and amide couplings and protecting group strategies. This methodology was used to assemble a focused chemical library for SAR analysis. Stepwise removal of extraneous complexity from the initial hits yielded a selective ANT(2”)-Ia inhibitor which demonstrated in vivo synergy with gentamicin. Aspergillomarasmine A (AMA) is a natural product with activity against NDM-1. Several derivatives of AMA have been synthesized to assess SAR, but the specific contributions of individual carboxylic acids have yet to determined due to difficulties accessing position 6. A synthetic approach was developed via reductive amination using Garner’s aldehyde as a serine equivalent. This strategy was used to synthesize an AMA analog with a hydroxyl group in place of the carboxylic acid in position 6. Additionally, an imine-promoted isomeric resolution was discovered. / Thesis / Doctor of Philosophy (PhD) / Antibiotics, such as aminoglycosides and carbapenems, are losing their effectiveness against bacteria responsible for deadly diseases. This is often due to resistance enzymes such as aminoglycoside N-acetyltransferase-3 (AAC(3)) and O- nucleotidyltransferase-2” (ANT(2”)), which inactivate aminoglycosides, and the New Delhi metallo-b-lactamase-1 (NDM-1), which destroys carbapenems. If these enzymes are blocked, the antibiotics should work against bacteria again. In order to develop compounds that will inhibit these enzymes, sets of similar compounds are made and tested. Patterns of what chemical groups improve or worsen inhibitory activity are noted and used to make another set of compounds in an iterative process. This thesis describes the development of inhibitors of AAC(3)-Ia and ANT(2”)-Ia by this process. Additionally, a specific compound was made to test if a particular chemical group has a role in inhibiting NDM-1.

Foodborne illnesses caused by Listeria monocytogenes have long been associated with ready-to-eat (RTE) meats contaminated after the primary thermal process has been applied. It is believed that brine solutions used to chill cooked RTE products may serve as a reservoir for L. monocytogenes becoming a potential point of post-processing contamination for RTE meats. Re-circulating ultraviolet light (UV) systems are being used to inactivate L. monocytogenes in chill brines; however very little has been reported on the dose response of healthy and stressed L. monocytogenes to UV in brine solutions. The objectives of this research were to determine 1) minimum dose of UV required to inactivate L. monocytogenes in distilled water, fresh brine, undiluted spent brine, and diluted spent brine, 2) if adaptation to food processing stresses affects the dose response, and 3) if the acquisition of antibiotic resistance mechanisms provides resistance to ultraviolet light 4) effect of stress adaptation on survival in brine solutions. After UV exposure, populations were reduced as follows from greatest to least: water > fresh brine > 5% spent brine > 35% spent brine > 55% spent brine > 100% spent brine (P ≤ 0.05). There were no population differences between acid stressed and antibiotic resistant or healthy and heat shocked (P > 0.05). However, acid-stressed and sulfanilamide-resistant were more resistant to UV light than healthy and heat shocked L. monocytogenes (P ≤ 0.05). Survival in brine solutions (no UV) followed the trend, from greatest to least (P ≤ 0.05): sulfanilamide-resistant > acid-stressed > healthy > heat-shocked. Population estimates decreased from initial inoculation to final sampling for each cell type suspended in spent brine (P ≤ 0.05), but only healthy and heat- shocked cells suspended in fresh brine were significantly reduced (P ≤ 0.05). Knowledge of UV dosing required to control L. monocytogenes in brines used during RTE meat processing, and a greater understanding of the interactions that may influence dose will aid manufacturers in establishing appropriate food safety interventions for these products. / Ph. D.