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Copper ions and coordination complexes as novel carbapenem adjuvants.

Djoko, Karrera Y. and Achard, Maud E. S. and Phan, Minh-Duy and Lo, Alvin W. and Miraula, Manfredi and Prombhul, Sasiprapa and Hancock, Steven J. and Peters, Kate M. and Sidjabat, Hanna and Harris, Patrick N. and Mitić, Nataša and Walsh, Timothy R. and Anderson, Gregory J. and Shafer, William M. and Paterson, David L. and Schenk, Gerhard and McEwan, Alastair G. and Schembri, Mark A. (2018) 'Copper ions and coordination complexes as novel carbapenem adjuvants.', Antimicrobial agents and chemotherapy., 62 (2). e02280-17.


Carbapenem-resistant Enterobacteriaceae are an urgent threat to global human health. These organisms produce β-lactamases with carbapenemase activity, such as the metallo-β-lactamase NDM-1, which is notable due to its association with mobile genetic elements and the lack of a clinically useful inhibitor. Here we examined the ability of copper to inhibit the activity of NDM-1 and explored the potential of a copper coordination complex as a mechanism to efficiently deliver copper as an adjuvant in clinical therapeutics. An NDM-positive Escherichia coli isolate, MS6192, was cultured from the urine of a patient with urinary tract infection. MS6192 was resistant to antibiotics from multiple classes, including diverse β-lactams (penicillins, cephalosporins, and carbapenems), aminoglycosides and fluoroquinolones. However, in the presence of copper (range 0-2 mM), the susceptibility of MS6192 to the carbapenems ertapenem and meropenem increased significantly. In standard checkerboard assays, copper decreased the MIC of ertapenem and meropenem against MS6192 in a dose-dependent manner, suggesting a synergistic mode of action. To examine the inhibitory effect of copper in the absence of other β-lactamases, the blaNDM-1 gene from MS6192 was cloned and expressed in a recombinant E. coli K-12 strain. Analysis of cell-free extracts prepared from this strain revealed copper directly inhibits NDM-1 activity, and this was further confirmed using purified recombinant NDM-1. Finally, delivery of copper at a low concentration of 10 μM using the FDA-approved coordination complex copper-pyrithione sensitised MS6192 to ertapenem and meropenem in a synergistic manner. Overall, this work demonstrates the potential use of copper-coordination complexes as novel carbapenemase adjuvants.

Item Type:Article
Full text:(AM) Accepted Manuscript
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Date accepted:06 November 2017
Date deposited:22 November 2017
Date of first online publication:25 January 2018
Date first made open access:01 August 2018

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