| Literature DB >> 31815194 |
Etthel M Windels1,2, Zacchari Ben Meriem3, Taiyeb Zahir1,2, Kevin J Verstrepen1,2, Pascal Hersen3, Bram Van den Bergh1,2, Jan Michiels1,2.
Abstract
When exposed to lethal doses of antibiotics, bacterial populations are most often not completely eradicated. A small number of phenotypic variants, defined as 'persisters', are refractory to antibiotics and survive treatment. Despite their involvement in relapsing infections, processes determining phenotypic switches from and to the persister state largely remain elusive. This is mainly due to the low frequency of persisters and the lack of reliable persistence markers, both hampering studies of persistence at the single-cell level. Here we present a highly effective persister enrichment method involving cephalexin, an antibiotic that induces extensive filamentation of susceptible cells. We used our enrichment method to monitor outgrowth of Escherichia coli persisters at the single-cell level, thereby conclusively demonstrating that persister awakening is a stochastic phenomenon. We anticipate that our approach can have far-reaching consequences in the persistence field, by allowing single-cell studies at a much higher throughput than previously reported.Entities:
Keywords: Antibiotics; Microbiology
Mesh:
Substances:
Year: 2019 PMID: 31815194 PMCID: PMC6884588 DOI: 10.1038/s42003-019-0672-3
Source DB: PubMed Journal: Commun Biol ISSN: 2399-3642
Fig. 1Cephalexin treatment followed by filtration enables highly efficient enrichment of antibiotic-tolerant cells. a Susceptible, exponential phase cells filament severely during treatment with cephalexin (50 µg/ml) before lysis occurs (scale bar: 20 µm). b Experimental set-up of our persister enrichment method. A culture in exponential phase is treated with cephalexin for 1 h to induce filamentation of susceptible cells. Next, the culture is vacuum filtered (pore size of 5 µm) to separate short, antibiotic-tolerant persisters from filamented, susceptible cells. After filtration, the culture is centrifuged to remove cephalexin and to increase the density of the resulting sample. c Microscopic visualization of a sample after cephalexin treatment and filtration demonstrates that it mainly consists of short cells that did not respond to the cephalexin treatment (scale bar: 20 µm). d Side scatter distributions of a sample before and after filtration confirm that filtration enriches for cells with the lowest side scatter values, presumably corresponding to the persisters of the culture (SSC: side scatter).
Fig. 2Cells isolated by cephalexin treatment and filtration are antibiotic-tolerant and regrow after treatment. a Time-kill curve of isolated cells treated with cephalexin (50 µg/ml) for 8 h in liquid medium (n = 5 biologically independent cultures). A uniphasic exponential curve was fitted onto the data with a killing rate (kp = 0.144) that is much lower than for susceptible cells (kn = 4.98; Supplementary Fig. 1a). The killing rate of persisters presumably reflects the rate of persister awakening in the presence of cephalexin (kp: killing rate of persisters). b Treatment of isolated cells with cephalexin (50 µg/ml) on an agarose pad supplemented with MHB shows that the majority of the cells is not affected by the antibiotic (scale bar: 10 µm). c Cells isolated by filtration start dividing on an agarose pad supplemented with MHB (scale bar: 10 µm). d Isolated cells display multidrug tolerance, a trait associated with persistence. Fraction of surviving cells after a 5-h treatment with cephalexin (50 µg/ml), aztreonam (0.64 µg/ml), cefsulodin (320 µg/ml), mecillinam (5 µg/ml), ampicillin (40 µg/ml), and ciprofloxacin (0.32 µg/ml), starting from an exponential phase culture or a sample consisting of isolated cephalexin persisters. For all tested antibiotics, isolated cells show a significantly higher tolerance as compared to exponential phase cells (cephalexin: p < 0.0001, n = 7 and n = 11 biologically independent cultures respectively; aztreonam: p = 0.004, n = 6 and n = 9; cefsulodin: p < 0.0001, n = 3 and n = 6; mecillinam: p < 0.0001, n = 5 and n = 9; ampicillin: p < 0.0001, n = 5 and n = 9; ciprofloxacin: p < 0.0001, n = 9 and n = 9). Whiskers represent 10–90 percentiles.
Fig. 3Single-cell analysis of isolated persisters in the mother machine reveals that persister awakening is a stochastic process. a Microscopic images of persisters dividing in the mother machine. The time until first division varies strongly among individual cells (left channel: short lag time; middle channel: medium lag time; right channel: long lag time; scale bar: 1 µm). b Single-cell distributions of persister awakening times measured in the mother machine, for the wild-type strain MG1655 (n = 174 cells) and the high-persistence strain hipA7 (n = 220 cells). An exponential distribution was fitted onto the binned data, revealing an awakening rate b that is similar for both strains. c Scatterplot of single-cell awakening times and growth rates of MG1655 and hipA7 persisters, exponential phase cells, and stationary phase cells. While awakening times show a large variation, growth rates cluster more tightly around the average value. Both parameters are not correlated.