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Antagonistic drug interactions protect commensal Bacteroidaceae from macrolides via an RND-type efflux pump
Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany; Cluster of Excellence EXC 2124 Controlling Microbes to Fight Infections, University of Tübingen, Tübingen, Germany; M3-Research Center for Malignome, University of Tübingen, Tübingen, Germany.
Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany; Cluster of Excellence EXC 2124 Controlling Microbes to Fight Infections, University of Tübingen, Tübingen, Germany; M3-Research Center for Malignome, University of Tübingen, Tübingen, Germany.
Interfaculty Institute for Microbiology and Infection Medicine Tübingen, University of Tübingen, Tübingen, Germany; Cluster of Excellence EXC 2124 Controlling Microbes to Fight Infections, University of Tübingen, Tübingen, Germany; M3-Research Center for Malignome, University of Tübingen, Tübingen, Germany.
Umeå University, Faculty of Science and Technology, Department of Chemistry. Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
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2025 (English)In: Gut microbes, ISSN 1949-0976, E-ISSN 1949-0984, Vol. 17, no 1, article id 2596806Article in journal (Refereed) Published
Abstract [en]

Antibiotics are essential to modern medicine, but their broad-spectrum activity can unintentionally disrupt the gut microbiota. This collateral damage may be alleviated by antagonistic drug interactions, in which specific compounds used in combination therapies selectively protect beneficial gut microbes from antibiotic activity. Using efflux pump inhibitors, transcriptomic and proteomic analyses, and targeted gene deletions, we show that a variety of non-antibiotic pharmaceuticals-from diverse therapeutic classes and at sub-inhibitory concentrations-can protect multiple Bacteroidales species from macrolide antibiotics. In Bacteroidaceae, this protection is mediated by a resistance-nodulation-division (RND)-type efflux pump, which is induced by the non-antibiotic drug but not by macrolides alone. Notably, protection persists even after the non-antibiotic drug is removed, and prolonged exposure results in stable macrolide resistance that is dependent on the RND-type efflux pump. Our findings illustrate how non-antibiotic drugs can inadvertently activate otherwise silent detoxification systems in gut microbes, uncovering resistance mechanisms that arise without antibiotic selection or gene transfer. While this can be harnessed to protect the microbiome during antibiotic therapy, it also reveals hidden resistance phenotypes that may escape detection in standard antimicrobial resistance assays.

Place, publisher, year, edition, pages
Taylor & Francis, 2025. Vol. 17, no 1, article id 2596806
Keywords [en]
antagonism, Bacteroidaceae, efflux pumps, non-antibiotic drugs
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-247634DOI: 10.1080/19490976.2025.2596806PubMedID: 41362921Scopus ID: 2-s2.0-105024145780OAI: oai:DiVA.org:umu-247634DiVA, id: diva2:2022305
Funder
German Research Foundation (DFG), CMFI EXC 2124The Kempe Foundations, CMFI EXC 2124Available from: 2025-12-16 Created: 2025-12-16 Last updated: 2025-12-16Bibliographically approved

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Pérez, LucíaMateus, André

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Pérez, LucíaMateus, André
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Department of ChemistryDepartment of Molecular Biology (Faculty of Medicine)Molecular Infection Medicine Sweden (MIMS)
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