# Identification of potentiators of antimicrobial activity against multidrug-resistant Burkholderia cepacia complex infections in cystic fibrosis

> **NIH NIH R21** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2021 · $262,500

## Abstract

Project Summary/Abstract
Pulmonary exacerbations are one of the most common manifestations of cystic fibrosis (CF), a life-limiting,
multisystem disease that affects 30,000 Americans. These exacerbations are often caused by highly drug-
resistant Gram-negative bacteria that colonize the lungs of people with CF. Among such organisms, the most
feared is the Burkholderia cepacia complex (Bcc). Bcc have extensive intrinsic antibiotic resistance and readily
acquire further resistance mechanisms under selective pressure during antibiotic treatment; pan-resistant strains
can emerge following repeated antibiotic courses. Bcc infection is associated with frequent hospitalizations and
increased mortality in people with CF, but there are no new antibiotics with activity against BCC in the
development pipeline, and alternative treatment strategies are urgently needed. The goal of the proposed
research is to identify known bioactive compounds that have activity against Bcc either alone or in combination
with antibiotics. This work will be carried out through two aims. In Aim 1, we will test 14,000 known bioactive
small molecules, including all FDA-approved drugs, both alone and in combination with six antibiotics commonly
used to treat Bcc (meropenem, ceftazidime, minocycline, levofloxacin, trimethoprim-sulfamethoxazole, and
tobramycin, each at an individually ineffective concentration), to identify compounds and compound/antibacterial
combinations that inhibit growth of a representative Bcc isolate. In Aim 2, we will further characterize the activity
of promising compounds identified in the screen using several complementary in vitro models. First, we will
perform spectrum-of-activity and dose-response testing of compounds and combinations against a collection of
30 Bcc isolates using inkjet printer-assisted checkerboard array synergy studies as well as time-kill synergy
studies. We will also evaluate the capacity of compounds to prevent the emergence of antibiotic resistance during
treatment. Then, in order to better approximate the environment in which bacteria live in the lungs of people with
CF, which is characterized by increased viscosity, high concentrations of mucin, albumin, amino acids, and free
DNA, and lower oxygen tension relative to standard in vitro antimicrobial susceptibility testing conditions, we will
test compounds and combinations using an artificial sputum medium in a microaerophilic environment. With this
approach, we will assess whether activity is maintained under conditions more closely resembling those in which
they would be used in clinical practice. When the project is completed, we expect to have identified a collection
of molecules with previously unrecognized activity against Bcc and to have determined which of these are most
likely to be clinically effective in people with CF. Identification of well-characterized compounds that have
potential therapeutic activity against Bcc will facilitate future evaluation in animal models ...

## Key facts

- **NIH application ID:** 10108485
- **Project number:** 1R21AI156039-01
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** Thea Brennan-Krohn
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $262,500
- **Award type:** 1
- **Project period:** 2021-03-01 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10108485

## Citation

> US National Institutes of Health, RePORTER application 10108485, Identification of potentiators of antimicrobial activity against multidrug-resistant Burkholderia cepacia complex infections in cystic fibrosis (1R21AI156039-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10108485. Licensed CC0.

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