Identification of a peroxidase inhibitor that enhances kanamycin activity

Background The threat of antimicrobial resistance calls for more efforts in basic science, drug discovery, and clinical development, particularly gram-negative carbapenem-resistant pathogens. Objectives and methods Whole-cell–based screening was performed to identify novel antibacterial agents against Acinetobacter baumannii ATCC19606. Spontaneously resistant mutant selection, whole-genome sequencing, and surface plasmon resonance were used for target identification and confirmation. Checkerboard titration assay was used for drug combination analysis. Results A small molecule named 6D1 with the chemical structure of 6-fluorobenzo[d]isothiazol-3(2H)-one was identified and exhibited activity against A. baumannii ATCC19606 strain (minimal inhibitory concentration, MIC = 1 mg/L). The mutation in the plasmid-derived ohrB gene that encodes a peroxidase was identified in spontaneously resistant mutants. Treatment of the bacteria with 6D1 resulted in increased sensitivity to peroxide such as tert -butyl hydroperoxide. The binding of 6D1 and OhrB was confirmed by surface plasmon resonance. Interestingly, the MIC of kanamycin against spontaneously resistant mutants decreased. Finally, we identified the effect of 6D1 on enhancing the antibacterial activity of kanamycin, including New Delhi metallo-β-lactamase (NDM-1)-producing carbapenem-resistant Klebsiella pneumoniae , but not in strains carrying kanamycin resistance genes. Conclusions In this study, we identified a peroxidase inhibitor that suppresses the growth of A. baumannii and enhances the antibacterial activity of kanamycin. We propose that peroxidase may be potentially used as a target for kanamycin adjuvant development.