Quantitative Examination of Antibiotic Susceptibility of Neisseria gonorrhoeae Aggregates Using ATP-utilization Commercial Assays and Live/Dead Staining

Summary

A simple ATP-measuring assay and live/dead staining method were used to quantify and visualize Neisseria gonorrhoeae survival after treatment with ceftriaxone. This protocol can be extended to examine the antimicrobial effects of any antibiotic and can be used to define the minimal inhibitory concentration of antibiotics in bacterial biofilms.

Abstract

The emergence of antibiotic resistant Neisseria gonorrhoeae (GC) is a worldwide health threat and highlights the need to identify individuals who fail treatment. This Gram-negative bacterium causes gonorrhea exclusively in humans. During infection, it is able to form aggregates and/or biofilms. The minimum inhibitory concentration (MIC) test is used for to determine susceptibility to antibiotics and to define appropriate treatment. However, the mechanism of the eradication in vivo and its relationship to laboratory results are not known. A method that examines how GC aggregation affects antibiotic susceptibility and shows the relationship between aggregate size and antibiotic susceptibility was developed. When GC aggregate, they are more resistant to antibiotic killing, with bacteria in the center surviving ceftriaxone treatment better than those in the periphery. The data indicate that N. gonorrhoeae aggregation can reduce its susceptibility to ceftriaxone, which is not reflected using the standard agar plate-based MIC methods. The method used in this study will allow researchers to test bacterial susceptibility under clinically relevant conditions.

Introduction

Gonorrhea is a common sexually transmitted infection (STI)¹. Neisseria gonorrhoeae (GC), a Gram-negative diplococcal bacterium, is the causative agent of this disease. Symptoms of genital infection can result in pain during urination, generalized genital pain, and urethral discharge. Infection is often asymptomatic^2,3,4,5, and this allows for extended colonization. These untreated infections are a major health concern, as they have the potential to facilitate transmission of the organism and this can lead to ....

Protocol

1. General maintenance of GC strains

1. Streak N. gonorrhoeae strains on GCK agar with 1% Kellogg supplements¹⁸ (Table 1, Table 2) from freezer stocks and incubate 37 °C with 5% CO₂ for 16-18 h. Use MS11 expressing phase-variable Opa (MS11Opa+), no Opa (MS11ΔOpa), or a truncated LOS (MS11ΔLgtE).
2. Carefully pick pili negative (colony without dark edge) or positive (colony with dark edge) colonies from each strain based on colony morphology¹⁹ using a dissecting light microscope and streak onto a new GCK plate.
3. Incubate at 37 °C with 5% CO<....

Results

Two methods were employed: an ATP utilization assay and a live/dead staining assay. The results can either be combined or individually used for examining bacterial survival within aggregates after antibiotic treatment. The ATP utilization assay has been shown to measure accurately viable bacteria in S. aureus biofilms^20,21. Here, MS11Opa+Pil+ strain was used to examine the role of GC aggregation in antibiotic susceptibili.......

Discussion

Bacteria can form biofilms during infection of the human body. Traditional MIC testing may not reflect the concentration needed to eradicate bacteria in a biofilm. To test antimicrobials effects on a biofilm, methods based on biofilm biomass as well as plating CFUs can be erroneous due to the impact of biofilm structure. For example, the plating method only works if the biofilm can be disrupted. Hence, the CFU obtained may be lower than the actual number of viable bacteria. Visualizing dead and live bacteria within the b.......

Materials

Name	Company	Catalog Number	Comments
100x Kellogg's supplement
Agar	United States Biological	A0930
BacTiter Assay	Promega	G8232
Ceftriaxone	TCI	C2226
Difco GC medium base	BD	228950
Ferric nitrate, nonahydrate	Sigma-Aldrich	254223-10G
Glucose	Thermo Fisher Scientific	BP350-1
L-glutamine Crystalline Powder	Fisher Scientific	BP379-100
BacLight live/dead staining	Invitrogen	L7012
MS11 Neisseria gonorrhoeae strain			kindly provided by Dr. Herman Schneider, Walter Reed Army Institute for Research
Potassium phosphate dibasic (K2HPO4)	Fisher Scientific	P290-500
Potassium phosphate monobasic (KH2PO4)	Fisher Scientific	BP329-1
Proteose Peptone	BD Biosciences	211693
Sodium chloride (NaCl)	Fisher Scientific	S671-10
Soluble Starch	Sigma-Aldrich	S9765
Thiamine pyrophosphate	Sigma-Aldrich	C8754-5G
Equipment
Petri Dishes	VWR	25384-302
8-well coverslip-bottom chamber	Thermo Fisher Scientific	155411
96-well tissue culture plates	Corning, Falcon	3370
Biosafety Cabinet (NU-425-600 Class II, A2 Laminar Flow Biohazard Hood)	Nuaire	32776
CO2 Incubator	Fisher Scientific	Model 3530
Confocal microscope equipped with live imaging chamber	Leica	SP5X
Corning  96 Well Black Polystyrene Microplate	Corning	3904
Glomax Illuminator	Promega	E6521
Pipette tips (0.1-10 µL)	Thermo Fisher Scientific	02-717-133
Pipette tips (1000 µL)	VWR	83007-382
Pipette tips (200 µL)	VWR	53509-007
Spectrophotometer Ultrospec 2000 UV	Pharmacia Biotech	80-2106-00
Sterile 15 ml conical tubes	VWR	21008-216
Sterile Microcentrifuge Tubes (1.7 mL)	Sorenson BioScience	16070
Sterile polyester-tipped applicators	Fisher Scientific	23-400-122
Sonicator	Kontes	Equivelent to 9110001