After acquiring expertise in molecular and translational research during the mentored (K99) phase of this award, I now seek to develop a career transition to independence in the ROO phase in the area of molecular pathogenesis of antibiotic-resistant bacteria. The long term goals of this work are to translate in vitro and in vivo observations relating to virulence and pathogenesis into new useful strategies to combat severe multidrug resistant enterococcal infections. Enterococcus faeclum (Efm) have now become the third most common organism isolated from hospital Infections, emerging as one of the most difficult bacteria to eradicate due to the development of resistance to virtually all antibiotics used In clinical practice. Research performed during the mentored phase of this award confirmed and further characterized a large plasmid carried by clinical isolates of Efm, which confers increased virulence in experimental peritonitis and indicated that a gene (designated hylEfm and encoding a putative glycosyl hydrolase), which was the focus of the research during the mentored phase, was not sufficient to explain the increased lethality conferred by the plasmid carrying it. The current hypotheses for this work are that i) other genes in the hylEfm region may be essential, in conjunction with hylEfm, for pathogenesis In Efm and 11) blocking the hylEfm gene product, as part of an important gene cluster involved in virulence, in addittlon to antibiotics, could be a novel therapeutic strategy to treat Efm infections. Thus, the specific aims of this part of the award will be to: I) Define the role and contribution of the hylEfm region to virulence In Efm and Ii) Evaluate an antibody-antibiotic approach for Efm infections using anti-HylEfm antibodies as part of the therapeutic combination.
These aims will be addressed by using the tools developed during the mentored phase which included the application of the counterselection system PheS* for targeted mutagenesis to obtain non-polar mutations of genes in the hylEfm region, mRNA analysis to determine the patterns of In vitro and in vivo expression of this cluster and testing the mutants'phenotypes and response to therapies in animals models of Efm peritonitis, urinary tract infection and endocarditis.

Public Health Relevance

Antibiotic-resistant organisms are a major public health problem in US hospitals and multi-drug resistant E. faecium have become one of the leading causes of nosocomial infections with very limited options for treatment and no therapetic alternatives available In the foreseen future. The research proposes to understand the molecular mechanisms by which Efm causes diseases and develop novel ways to combat it.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Transition Award (R00)
Project #
5R00AI072961-03
Application #
7910413
Study Section
Special Emphasis Panel (NSS)
Program Officer
Huntley, Clayton C
Project Start
2008-06-15
Project End
2012-07-31
Budget Start
2010-08-01
Budget End
2012-07-31
Support Year
3
Fiscal Year
2010
Total Cost
$249,000
Indirect Cost
Name
University of Texas Health Science Center Houston
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800771594
City
Houston
State
TX
Country
United States
Zip Code
77225
Munita, Jose M; Tran, Truc T; Diaz, Lorena et al. (2013) A liaF codon deletion abolishes daptomycin bactericidal activity against vancomycin-resistant Enterococcus faecalis. Antimicrob Agents Chemother 57:2831-3
Munita, Jose M; Panesso, Diana; Diaz, Lorena et al. (2012) Correlation between mutations in liaFSR of Enterococcus faecium and MIC of daptomycin: revisiting daptomycin breakpoints. Antimicrob Agents Chemother 56:4354-9
Mishra, Nagendra N; Bayer, Arnold S; Tran, Truc T et al. (2012) Daptomycin resistance in enterococci is associated with distinct alterations of cell membrane phospholipid content. PLoS One 7:e43958
Arias, Cesar A; Murray, Barbara E (2012) The rise of the Enterococcus: beyond vancomycin resistance. Nat Rev Microbiol 10:266-78
Diaz, Lorena; Kiratisin, Pattarachai; Mendes, Rodrigo E et al. (2012) Transferable plasmid-mediated resistance to linezolid due to cfr in a human clinical isolate of Enterococcus faecalis. Antimicrob Agents Chemother 56:3917-22
Hall, Ashley D; Steed, Molly E; Arias, Cesar A et al. (2012) Evaluation of standard- and high-dose daptomycin versus linezolid against vancomycin-resistant Enterococcus isolates in an in vitro pharmacokinetic/pharmacodynamic model with simulated endocardial vegetations. Antimicrob Agents Chemother 56:3174-80
Arias, Cesar A; Panesso, Diana; McGrath, Danielle M et al. (2011) Genetic basis for in vivo daptomycin resistance in enterococci. N Engl J Med 365:892-900
Panesso, Diana; Montealegre, Maria C; Rincon, Sandra et al. (2011) The hylEfm gene in pHylEfm of Enterococcus faecium is not required in pathogenesis of murine peritonitis. BMC Microbiol 11:20
Kim, David S; Singh, Kavindra V; Nallapareddy, Sreedhar R et al. (2010) The fms21 (pilA)-fms20 locus encoding one of four distinct pili of Enterococcus faecium is harboured on a large transferable plasmid associated with gut colonization and virulence. J Med Microbiol 59:505-7
Panesso, Diana; Reyes, Jinnethe; Rincón, Sandra et al. (2010) Molecular epidemiology of vancomycin-resistant Enterococcus faecium: a prospective, multicenter study in South American hospitals. J Clin Microbiol 48:1562-9

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