Project description:Antibiotic resistance associated with the expression of the clinically significant carbapenemases, IMP, KPC, and NDM and OXA-48 in Enterobacteriaceae is emerging as a worldwide calamity to health care. In Australia, IMP-producing Enterobacteriaceae is the most prevalent carbapenemase-producing Enterobacteriaceae (CPE). Genomic characteristics of such carbapenemase-producing Enterobacteriaceae (CPE) are well described, but the corresponding proteome is poorly characterised. We have thus developed a method to analyse dynamic changes in the proteome of CPE under antibiotic pressure. Specifically, we have investigated the effect of meropenem at sub-lethal concentrations to develop a better understanding of how antibiotic pressure leads to resistance. Escherichia coli, producing either NDM, IMP or KPC type carbapenemase were included in this study, and their proteomes were analysed in growth conditions with or without meropenem.
Project description:<p><strong>Introduction:</strong> The degree of antimicrobial resistance demonstrated by carbapenemase-producing Enterobacteriaceae (CPE) represents a growing public health challenge. Conventional methods for detecting CPE involve culture-based techniques with lengthy incubation steps. There is a need to develop rapid and accurate methods for the detection of resistance, for implementation into clinical diagnostics.</p><p><strong>Objectives:</strong> With cellular phenotype closely linked to the metabolome, the acquisition of resistance should result in detectable differences in microbial metabolism. Accordingly, we sought to profile the metabolome of Enterobacteriaceae isolates belonging to both CPE and non-CPE groups to identify metabolites linked to CPE.</p><p><strong>Methods:</strong> We used liquid chromatography-mass spectrometry to profile the endo- and exometabolome of 32<em> Klebsiella pneumoniae</em> and <em>Escherichia coli </em>isolates to identify metabolites which could predict CPE in antibiotic-free conditions after 6 h of growth.</p><p><strong>Results:</strong> Using supervised machine learning and multivariate analysis algorithms (partial least squares-discriminant analysis, k-nearest neighbour and random forest), we identified 21 metabolite biomarkers which displayed high performance metrics for the prediction of CPE (AUROCs ≥ 0.845). Results revealed a range of alterations between the metabolomes of CPE and non-CPE isolates. Pathway analysis revealed enrichment of microbial pathways including arginine metabolism, ATP-binding cassette transporters, purine metabolism, biotin metabolism, nucleotide metabolism, and biofilm formation, providing mechanistic insight into the resistance phenotype of CPE.</p><p><strong>Conclusion: </strong>Our models demonstrates the ability to distinguish CPE from non-CPE in under 7 h using metabolite biomarkers, showing potential for the development of a targeted diagnostic assay.</p>