Proven anti-virulence therapies in combating methicillin- and vancomycin-resistant Staphylococcus aureus infections

Front Cell Infect Microbiol. 2024 Aug 26:14:1403219. doi: 10.3389/fcimb.2024.1403219. eCollection 2024.

Abstract

Introduction: Despite years of efforts to develop new antibiotics for eradicating multidrug-resistant (MDR) and multi-virulent Methicillin-Resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Staphylococcus aureus (VRSA) infections, treatment failures and poor prognoses in most cases have been common. Therefore, there is an urgent need for new therapeutic approaches targeting virulence arrays. Our aim is to discover new anti-virulence therapies targeting MRSA and VRSA virulence arrays.

Methodology: We employed phenotypic, molecular docking, and genetic studies to screen for anti-virulence activities among selected promising compounds: Coumarin, Simvastatin, and Ibuprofen.

Results: We found that nearly all detected MRSA and VRSA strains exhibited MDR and multi-virulent profiles. The molecular docking results aligned with the phenotypic and genetic assessments of virulence production. Biofilm and hemolysin productions were inhibited, and all virulence genes were downregulated upon treatment with sub-minimum inhibitory concentration (sub-MIC) of these promising compounds. Ibuprofen was the most active compound, exhibiting the highest inhibition and downregulation of virulence gene products. Moreover, in vivo and histopathological studies confirmed these results. Interestingly, we observed a significant decrease in wound area and improvements in re-epithelialization and tissue organization in the Ibuprofen and antimicrobial treated group compared with the group treated with antimicrobial alone. These findings support the idea that a combination of Ibuprofen and antimicrobial drugs may offer a promising new therapy for MRSA and VRSA infections.

Conclusion: We hope that our findings can be implemented in clinical practice to assist physicians in making the most suitable treatment decisions.

Keywords: anti-virulence; coumarin; histopathological; ibuprofen; molecular docking; simvastatin.

MeSH terms

  • Animals
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Biofilms* / drug effects
  • Coumarins / pharmacology
  • Coumarins / therapeutic use
  • Disease Models, Animal
  • Drug Resistance, Multiple, Bacterial
  • Hemolysin Proteins / antagonists & inhibitors
  • Hemolysin Proteins / genetics
  • Hemolysin Proteins / metabolism
  • Humans
  • Ibuprofen / pharmacology
  • Ibuprofen / therapeutic use
  • Methicillin-Resistant Staphylococcus aureus* / drug effects
  • Methicillin-Resistant Staphylococcus aureus* / genetics
  • Methicillin-Resistant Staphylococcus aureus* / pathogenicity
  • Mice
  • Microbial Sensitivity Tests*
  • Molecular Docking Simulation*
  • Staphylococcal Infections* / drug therapy
  • Staphylococcal Infections* / microbiology
  • Vancomycin-Resistant Staphylococcus aureus* / drug effects
  • Virulence / drug effects
  • Virulence Factors* / genetics

Substances

  • Anti-Bacterial Agents
  • Virulence Factors
  • Ibuprofen
  • Coumarins
  • Hemolysin Proteins

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2024R153), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. Deanship of Scientific Research, Vice Presidency for Graduate Studies and Scientific Research, King Faisal University, Saudi Arabia [GrantA176].