Oral Presentation Australian Society for Microbiology Annual Scientific Meeting 2017

Antibiotic resistance and host immune evasion in Staphylococcus aureus mediated by a novel metabolic adaptation (#116)

Jhih-Hang Jiang 1 , Saruar Bhuiyan 1 , Hsin-Hui Shen 2 , David R Cameron 1 , Thusitha Rupasinghe 3 , Chun-Ming Wu 4 , Xenia Kostoulias 1 , Carmen Domene 5 , Alex Fulcher 6 , Malcolm McConville 7 , Benjamin Howden 8 , Graham Lieschke 9 , Anton Peleg 1 10
  1. Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, VIC, Australia
  2. Department of Materials Science and Engineering, Faculty of Engineering, Monash University, Clayton, VIC, Australia
  3. Metabolomics Australia, Bio21 Institute of Molecular Science and Biotechnology, Parkville, Victoria, Australia
  4. National Synchrotron Radiation Research Center, Hsinchu, Taiwan
  5. Department of Chemistry, King’s College London, London, UK
  6. Monash Micro Imaging, Monash University, Clayton, VIC, Australia
  7. Department of Biochemistry and Molecular Biology, Bio21 Institute of Molecular Science and Biotechnology, University of Melbourne, Parkville, VIC, Australia
  8. Melbourne Diagnostic Unit, University of Melbourne, Parkville, VIC, Australia
  9. Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, Australia
  10. Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia

Staphylococcus aureus is a notorious human bacterial pathogen that exhibits considerable capacity to develop resistance to antibiotics. We have observed that human infections caused by highly-drug resistant S. aureus are more prolonged, complicated and difficult to eradicate. Here, we describe a novel metabolic adaptation strategy used by clinical S. aureus strains that not only leads to resistance to the last-line antibiotic, daptomycin, but simultaneously impacts host innate immunity. This response was characterized by a change in anionic membrane phospholipid composition induced by point mutations in the phospholipid biosynthesis gene, cls2, encoding cardiolipin synthase. Single cls2 point mutations were sufficient for daptomycin resistance, antibiotic treatment failure and persistent infection. These clinically derived cls2 mutations caused a ‘gain-in-function’ in Cls2, leading to increased bacterial membrane cardiolipin and reduced phosphatidylglycerol, which was linked to changes in membrane structure. The cls2 point mutations also allowed S. aureus to escape from neutrophil chemotaxis, which was secondary to the reduction in bacterial membrane phosphatidylglycerol, a previously undescribed bacterial-driven chemoattractant. Together, these data illustrate a novel metabolic strategy used by S. aureus to promote persistent infection in the face of antibiotic and immune attack, and provide crucial insights into membrane-based therapeutic targeting of this troublesome pathogen.