In situ identification of Gram-negative bacteria in human lungs using a topical fluorescent peptide targeting lipid A

Ahsan R. Akram, Sunay V. Chankeshwara, Emma Scholefield, Tashfeen Aslam, Neil McDonald, Alicia Megia-Fernandez, Adam Marshall, Bethany Mills, Nicolaos Avlonitis, Thomas H Craven, Annya M Smyth, David S. Collie, Calum Gray, Nik Hirani, Adam T. Hill, John R. Govan, Timothy Walsh, Christopher Haslett, Mark Bradley, Kevin Dhaliwal

Research output: Contribution to journalArticlepeer-review

Abstract

Respiratory infections in mechanically ventilated patients caused by Gram-negative bacteria are a major cause of morbidity. Rapid and unequivocal determination of the presence, localization, and abundance of bacteria is critical for positive resolution of the infections and could be used for patient stratification and for monitoring treatment efficacy. Here, we developed an in situ approach to visualize Gram-negative bacterial species and cellular infiltrates in distal human lungs in real time. We used optical endomicroscopy to visualize a water-soluble optical imaging probe based on the antimicrobial peptide polymyxin conjugated to an environmentally sensitive fluorophore. The probe was chemically stable and nontoxic and, after in-human intrapulmonary microdosing, enabled the specific detection of Gram-negative bacteria in distal human airways and alveoli within minutes. The results suggest that pulmonary molecular imaging using a topically administered fluorescent probe targeting bacterial lipid A is safe and practical, enabling rapid in situ identification of Gram-negative bacteria in humans.

Original languageEnglish
Article numbereaal0033
Number of pages12
JournalScience Translational Medicine
Volume10
Issue number464
Early online date24 Oct 2018
DOIs
Publication statusPublished - 24 Oct 2018

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