GENETIC PLATFORM TO INVESTIGATE THE FUNCTIONS OF BACTERIAL DRUG EFFLUX PUMPS

Information

  • Patent Application
  • 20230407243
  • Publication Number
    20230407243
  • Date Filed
    June 15, 2023
    10 months ago
  • Date Published
    December 21, 2023
    4 months ago
  • Inventors
    • Cox; Georgina
    • Teelucksingh; Tanisha
    • Thompson; Laura
  • Original Assignees
Abstract
The present disclosure provides an Escherichia coli strain comprising at least 20 of inactivated genes from acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. Also provided is a method for identifying a compound that is an antibacterial agent using an Escherichia coli strain disclosed herein. Further provided is a method for creating an Escherichia coli strain with one active efflux pump.
Description
INCORPORATION OF SEQUENCE LISTING

A computer readable form of the Sequence Listing “6580-P68227US01_SequenceListing.xml” (5,017,998 bytes), submitted via Patent Center and created on Aug. 4, 2023, is herein incorporated by reference.


FIELD

The present disclosure provides an Escherichia coli strain comprising inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. Also provided is a method for identifying a compound that is an antibacterial agent using an Escherichia coli strain disclosed herein. Further provided is a method for creating an Escherichia coli strain with one active efflux pump.


BACKGROUND

Gram-negative bacteria represent a serious challenge for antibacterial drug discovery efforts. The outer membrane (OM) is a formidable barrier for the entry of large and hydrophobic compounds, and the inner membrane (IM) reduces the influx of hydrophilic drugs. These two membranes augment the next line of defense, membrane-spanning efflux pumps, which effectively reduce the intracellular and periplasmic concentrations of compounds that have penetrated the cell. Synergy between influx retardation and active efflux contributes considerably to the intrinsic antibiotic resistome of Gram-negative pathogens.


Multidrug-resistance (MDR) efflux pumps, which typically extrude a wide range of structurally unrelated substances, have been particularly well studied. However, bacterial species harbor large networks of additional and often poorly characterized drug efflux pumps. For example, sequence annotation of the Escherichia coli K-12 genome highlighted the presence of 36 known or putative drug efflux pumps, which span five protein families: the ATP-binding cassette (ABC) superfamily, the resistance-nodulation-cell division (RND) superfamily, the major facilitator superfamily (MFS), the small multidrug resistance family (SMR), and the multi-antimicrobial extrusion (MATE) family. E. coli efflux pumps within the RND and ABC superfamilies complex with periplasmic adaptor proteins and the OM channel TolC. These tripartite complexes span the entire cell envelope. Certain MFS pumps, such as EmrB and EmrY, also form tripartite complexes with TolC. However, a majority of MFS members are single component pumps that extrude substrates to the periplasm. Efflux pumps from the MATE and SMR families are also single component efflux pumps. In the case of antibiotics with cytoplasmic targets, synergistic relationships are thought to exist between tripartite systems and single component IM pumps. In this instance, single component pumps extrude substrates to the periplasm, and tripartite assemblies then efflux to the exterior of the cell, which is often referred to as functional ‘interplay’.


Since efflux pumps are a major contributor to antibiotic resistance, delineating the substrate specificities and functions of these membrane-spanning proteins is critical for the development of strategies to compromise and/or circumvent these ancient resistance elements. In addition, while efflux pumps have largely been studied for their ability to extrude most classes of clinically important antibiotics, they are also increasingly associated with physiological functions. Indeed, conservation of the E. coli efflux system further supports such physiological functions. However, important questions remain regarding the physiological roles of these proteins. Overall, a major limitation hindering the study of bacterial efflux pumps has been the lack of a suitable genetic background. It is difficult to delineate the substrate specificities and functions of each pump due to the sheer number encoded within the genome, the differential expression of efflux pump-encoding genes, and functional redundancies. For example, in terms of functional redundancy, E. coli K-12 strains harbor six pumps that efflux tetracycline, which is proposed to provide a more robust and flexible defense mechanism.


SUMMARY

To address these limitations, inventors generated and thoroughly characterized an extensively efflux-deficient mutant strain of E. coli. This strain provides a simplified genetic background free of the masking effects and redundancies of promiscuous efflux pumps. While a growing body of literature associates drug efflux pumps with important physiological processes, which suggests their removal could be detrimental or infeasible, inventors successfully inactivated 35 IM efflux pumps comprising the E. coli drug efflux network, generating Efflux KnockOut-35 (EKO-35). Phenotypic profiling of this strain revealed the E. coli drug efflux network is dispensable under optimal growth conditions, with little impact on the cellular proteome in nutrient-rich conditions. Importantly, when EKO-35 is propagated under diverse growth conditions, inventors reveal distinct patterns of dispensability, which opens the way for future studies to investigate the efflux pumps responsible for these conditionally essential phenotypes. To the best of inventors' knowledge, EKO-35 represents the most efflux-deficient bacterial mutant to be reported.


In addition to the important biological insight gained through generation of EKO-35, this strain can also be used as a well-characterized simplified genetic background to study the functions of efflux pumps of interest. To demonstrate the utility of EKO-35, inventors constructed an efflux platform consisting of EKO-35 genomic integrations of genes encoding E. coli efflux pumps forming tripartite complexes with the OM channel TolC. Each strain was profiled against a curated collection of physicochemically diverse compounds, which enabled the inventors to summarize molecular properties contributing to transport in each of these proteins. Inventors also profiled the MexCD pump from Pseudomonas aeruginosa, showing that the platform can be used to study efflux pumps from other organisms. Through the introduction of a large non-selective pore into the OM of EKO-35 (EKO-35-Pore), inventors demonstrate the efflux platform can be additionally utilized to study the specificity of efflux pump inhibitors, and to explore efflux pump interplay. Overall, EKO-35, the developed efflux platform, and the important insight gained into physicochemical substrate specificities and efflux essentiality, will have widespread application for the study of bacterial drug efflux pumps.


Accordingly, provided herein is an Escherichia coli strain comprising at least 20 of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA.


In some embodiments, the strain comprises at least 25, at least 30 or more of the inactivated genes. In some embodiments, the strain comprises at least 34 of the inactivated genes. In some embodiments, strain comprises all 35 inactivated genes. In some embodiments, the Escherichia coli strain is deposited under International Depositary Authority of Canada (IDAC) accession number 310522-01 deposited on May 31, 2022, or IDAC accession number 070623-01 deposited on Jun. 7, 2023. In some embodiments, the Escherichia coli comprises a nucleic acid having the sequence as shown in SEQ ID NO: 255. In some embodiments, the strain further comprises an open variant of outer membrane ferric siderophore transporter FhuA. In some embodiments, the strain comprises at least one of reactivated acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, optionally under the control of a constitutive promoter. In some embodiments, one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated. In some embodiments, the inactivation comprises deletion of the gene, or introducing a mutation into the gene to ablate expression of the gene or eliminate efflux pump activity of the protein expressed by the gene. In some embodiments, acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA are genes encoding for efflux pumps. In some embodiments, the strain comprising at least 20 of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA is an efflux pump deficient strain. In some embodiments, the strain comprises all 35 inactivated genes is EKO-35.


Also provided is a method for identifying a compound that is an antibacterial agent, comprising

    • (a) i) contacting the compound with the Escherichia coli strain described herein and with wild-type Escherichia coli; and/or
    • ii) contacting the compound with the Escherichia coli strain described herein having reactivated genes and EKO-35; and/or
    • iii) contacting the compound with the Escherichia coli strain described herein having reactivated genes and an efflux pump deficiency strain described herein; and
    • (b) detecting viability of each of the Escherichia coli;
    • wherein the compound is identified as an antibacterial agent if the compound decreases viability of wild-type less than the Escherichia coli strain with efflux pump deficiency described herein;
    • optionally wherein the compound is identified as an antibacterial agent if the compound decreases viability of the Escherichia coli strain having reactivated efflux pump genes less than the Escherichia coli strain having at least 20 inactivated efflux pump genes;
    • optionally wherein the compound is identified as an antibacterial agent if the wild-type Escherichia coli or the Escherichia coli strain having reactivated efflux pump genes is resistant to the compound, and the compound decreases the viability of the Escherichia coli strain having at least 20 inactivated efflux pump genes.


In some embodiments, the decrease in viability of wild-type or the Escherichia coli strain described herein after contacting the compound is at most 10%, 20%, 30%, 40%, 50%, 60%, 70%, or 80%, or at least 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100%.


In some embodiments, the compound is identified as an antibacterial agent if the compound decreases the viability of efflux pump deficient Escherichia coli strain described herein at a faster rate than the decrease in viability of wild-type or the Escherichia coli strain comprising reactivated efflux pump genes.


In some embodiments, the compound decreases the viability of the Escherichia coli strain with one reactivated gene in EKO-35 is less than an efflux deficient strain disclosed herein, optionally Escherichia coli strain EKO-35, thereby identifying specificity of the compound for an efflux pump encoded by the reactivated gene, optionally the compound has a lower minimum inhibitory concentration (MIC) in the Escherichia coli strain of EKO-35 than EKO-35 with a reactivated efflux pump.


In some embodiments, the contacting comprises the Escherichia coli in a suitable culturing media for optimal Escherichia coli growth. In some embodiments, the contacting comprises incubating the Escherichia coli in nutrient-limiting culturing media. In some embodiments, the contacting comprises incubating the Escherichia coli for at least 24 h, 48 h, 72 h, or 96 h. In some embodiments, the culturing media is a media having a pH of about 2, about 3, about 4, or about 5.


Also provided is a method for creating an Escherichia coli strain producing one or more efflux pump, comprising reactivating one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA in an efflux deficient strain disclosed herein, optionally Escherichia coli strain EKO-35.


In some embodiments, the reactivation comprises introducing one or more of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, optionally by reversing the inactivation, optionally by re-introducing the gene back in genome with the same promoter or a different promoter, at the same locus or a different locus, optionally by introducing a knock down-resistant version of the gene.


Other features and advantages of the present disclosure will become apparent from the following detailed description. It should be understood, however, that the detailed description and the specific Examples while indicating preferred embodiments of the disclosure are given by way of illustration only, since various changes and modifications within the spirit and scope of the disclosure will become apparent to those skilled in the art from this detailed description.





BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments are described below in relation to the drawings in which:



FIG. 1A shows characterization of EKO-35 in Lysogeny broth (LB) at 37° C. FIG. 1A shows Western blot analysis of AcrB in the membranes of the E. coli K-12 wild-type and EKO-35 strains. AcrB and the AcrBD408A mutant were produced in equivalent amounts when the genes were integrated into the arabinose operon (araC) of EKO-35, with gene expression under the control of the constitutive PLacI promoter. AcrB band intensity was normalized to total protein using stain-free gels. Data represent mean values±s.d. of three independent biological replicates. P-values were calculated using a two-tailed Student's t-test (***P<0.001 and ****P<0.0001).



FIG. 1B shows characterization of EKO-35 in Lysogeny broth (LB) at 37° C. Measurement of EKO-35 growth kinetics revealed a marginal increase in the lag phase and generation time relative to the wild-type strain, which was assessed using three biological replicates (see Table 1).



FIG. 1C shows characterization of EKO-35 in Lysogeny broth (LB) at 37° C. Measuring the length of 50 cells of the wild-type K-12 and EKO-35 strains revealed no significant changes in cell length or morphology.



FIG. 1D shows characterization of the wild-type strain in Lysogeny broth (LB) at 37° C. FIG. 1D shows scanning electron microscopy of the wild-type strain during the mid-exponential phase of growth.



FIG. 1E shows characterization of EKO-35 in Lysogeny broth (LB) at 37° C. FIG. 1E shows scanning electron microscopy of EKO-35 during the mid-exponential phase of growth.



FIG. 1F shows characterization of EKO-35 in Lysogeny broth (LB) at 37° C. Principal component analysis revealed separation between the proteomes of EKO-35 (gray) and the wild-type strain (black) (Component 1, 40.6%), and slight biological variation (Component 2, 17.2%).



FIG. 1G shows characterization of EKO-35 in Lysogeny broth (LB) at 37° C. FIG. 1G shows volcano plot depicting significant changes in protein abundance in EKO-35 (gray), relative to the wild-type (black) strain's proteome. Statistical analysis was performed with four biological replicates using a Student's t-test (P-value 0.05, false discovery rate=0.05, S0=1).



FIG. 1H shows characterization of EKO-35 in Lysogeny broth (LB) at 37° C. FIG. 1H shows 1D-annotation enrichment of Uniprot Keywords enriched in EKO-35, relative to wild-type K-12 for proteins that were significantly (Student t-test, P-value false discovery rate=0.05) differentially abundant between wild-type and EKO-35.



FIG. 2A shows characterization of EKO-35 under nutrient-limitation at 37° C. The growth of EKO-35 was marginally impacted in M9 minimal glucose medium (see Table 1 for growth kinetics), which was assessed using three biological replicates. The strain entered the exponential phase of growth ˜5 h later than the wild-type strain.



FIG. 2B shows characterization of EKO-35 under nutrient-limitation at 37° C. Measuring the length of 50 cells of two biological replicates revealed EKO-35 cells were significantly longer under nutrient-limitation. P-values were calculated using a two-tailed Student's t-test (****P<0.0001).



FIG. 2C shows characterization of EKO-35 under nutrient-limitation at 37° C. FIG. 2C shows scanning electron microscopy of the wild-type strain during the mid-exponential phase of growth.



FIG. 2D shows characterization of EKO-35 under nutrient-limitation at 37° C. FIG. 2D shows scanning electron microscopy of EKO-35 during the mid-exponential phase of growth.



FIG. 2E shows characterization of EKO-35 under nutrient-limitation at 37° C. The growth of EKO-35 was not restored in amino acid-limited MOPS medium supplemented with iron, as determined using three biological replicates (see Table 1 for growth kinetics).



FIG. 2F shows characterization of EKO-35 under nutrient-limitation at 37° C. Principal component analysis separated EKO-35 (gray) from the wild-type (black) proteome (Component 1, 53.2%), and revealed slight biological variation (Component 2, 14%).



FIG. 2G shows characterization of EKO-35 under nutrient-limitation at 37° C. FIG. 2G shows 1 D-annotation enrichment of Uniprot Keywords enriched in EKO-35, relative to wild-type K-12 for proteins that exhibited significantly (Student t-test, P-value 0.05, false discovery rate=0.05) changes in abundance between wild-type and EKO-35.



FIG. 2H shows characterization of EKO-35 under nutrient-limitation at 37° C. FIG. 2H shows volcano plot illustrating significant changes in protein abundance of EKO-35 (gray), relative to the wild-type (black) strain. Statistical analysis was performed with four biological replicates using a Student's t-test (P-value 0.05, false discovery rate=0.05, S0=1).



FIG. 3A shows that the E. coli efflux system is contextually essential. FIG. 3A shows growth of the wild-type (K-12), EKO-35, ΔtolC, and EKO-35 araC::acrB strains in nutrient-rich medium under extreme acid and alkaline conditions. Data represent mean values±s.d. of three independent biological end-point readings after 18 h of growth. P-values were calculated by a two-tailed Student's t-test (****P<0.0001).



FIG. 3B shows that the E. coli efflux system is contextually essential. EKO-35 and EKO-35 araC::acrBD408A show a significant increase in biofilm formation in nutrient-rich (P=3.61×10−5 and P=3.52×10−8, respectively) conditions. Data represents mean values±the s.d. for six biological replicates (nutrient-rich) and three biological replicates (nutrient-limited).



FIG. 3C shows that the E. coli efflux system is contextually essential. EKO-35 and EKO-35 araC::acrBD408A show a significant increase in biofilm formation in nutrient-limited conditions (P=8.88×10−7 and P=6.23×10−7, respectively). Data represents mean values±the s.d. for six biological replicates (nutrient-rich) and three biological replicates (nutrient-limited).



FIG. 3D shows that the E. coli efflux system is contextually essential. Measurement of EKO-35 growth kinetics (Table 1) revealed a marginally extended lag phase in nutrient-rich medium (P=1.16×10−6).



FIG. 3E shows that the E. coli efflux system is contextually essential. Measurement of EKO-35 growth kinetics (Table 1) revealed no significant differences in nutrient-limited medium (P=0.187) at 25° C.



FIG. 3F shows that the E. coli efflux system is contextually essential. Under low oxygen (1%) conditions, in nutrient-rich medium, EKO-35 growth kinetics revealed significant changes (P=1.51×10−4) compared to the wild-type strain.



FIG. 3G shows that the E. coli efflux system is contextually essential. Supplementation of the nutrient-rich medium with 10 mM KNO3 further impacted EKO-fitness (P=2.02×10−4) compared to the wild-type strain, which was partially restored through expression of mdtEF (EKO-35 araC::mdtEF) (P=5.09×10−4).



FIG. 3H shows that the E. coli efflux system is contextually essential. The E. coli drug efflux system is essential for growth in nutrient-limited, low oxygen (5%) conditions. Expression of mdtEF in EKO-35 (EKO-35 araC::mdtEF) marginally restored fitness, exhibiting a significantly improved generation time (P=6.09×10−4) compared to EKO-35. All P-values were calculated using a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****P<0.0001). Growth kinetic statistics are shown in Table 1.



FIG. 4A shows EKO-35 and the efflux platform enabled summation of efflux substrate physicochemical properties. Minimum inhibitory concentration (MIC) assays were conducted for 52 compounds against non-porinated (−) and porinated (+) wild-type K-12, ΔtolC, and EKO-35 (see Table 10). Compounds that increased the resistance of at least one EKO-35 integrated strain by ≥4-fold are shown in the heat map. Strains were assessed in technical duplicate. MIC values of wild-type K-12, ΔtolC, and EKO-35+/−the pore were log 2 transformed and normalized to 100% for each compound tested, where dark gray on the heat map represents the highest MIC value and white represents the lowest MIC value (see key).



FIG. 4B shows EKO-35 and the efflux platform enabled summation of efflux substrate physicochemical properties. FIG. 4B shows MIC assays for 52 compounds against 10 strains of non-porinated (−) and porinated (+) EKO-35 with chromosomally integrated efflux genes (see Tables 13A and 13B, and 14). Fold changes in MIC values of each strain compared to EKO-35+/−the pore were log 2 transformed and normalized to 100% for each compound (see Tables 15A, 15B, 16A, and 16B). Dark gray on the heat map indicates the greatest fold change, and white indicates the lowest fold change (see key). Slashes represent 2-fold increases in MIC value, which falls within the acceptable error range and were not considered significant. Box plots show individual data points representing substrate compounds and the corresponding property value, with the center line indicating the median, and whiskers the minimum and maximum values. Physicochemical substrate ranges are also summarized in Table 17. Abbreviations: RIF, rifampicin; VAN, vancomycin; FOF, fosfomycin; AMP, ampicillin; OXA, oxacillin; CHL, chloramphenicol; PURO, puromycin; AZM, azithromycin; ERY, erythromycin; TET, tetracycline; LZD, linezolid; MIN, minocycline; FA, fusidic acid; CIP, ciprofloxacin; NOR, norfloxacin; NAL, nalidixic acid; NOV, novobiocin; TMP, trimethoprim; DXR, doxorubicins DNR, daunorubicin; EtBr, ethidium bromide; ACF, acriflavine; BZK, benzalkonium chloride; DC, deoxycholate; STDC, sodium taurodeoxycholate.



FIG. 4C shows EKO-35 and the efflux platform enabled summation of efflux substrate physicochemical properties. Molecular weight (MW) for each compound was calculated using DataWarrior (Version 5.5.0). Box plots show individual data points representing substrate compounds and the corresponding property value, with the center line indicating the median, and whiskers the minimum and maximum values. Physicochemical substrate ranges are also summarized in Table 17.



FIG. 4D shows EKO-35 and the efflux platform enabled summation of efflux substrate physicochemical properties. Lipophilicity (log P) for each compound was calculated using DataWarrior (Version 5.5.0). Box plots show individual data points representing substrate compounds and the corresponding property value, with the center line indicating the median, and whiskers the minimum and maximum values. Physicochemical substrate ranges are also summarized in Table 17.



FIG. 4E shows EKO-35 and the efflux platform enabled summation of efflux substrate physicochemical properties. Aqueous solubility (log S) for each compound was calculated using DataWarrior (Version 5.5.0). Box plots show individual data points representing substrate compounds and the corresponding property value, with the center line indicating the median, and whiskers the minimum and maximum values. Physicochemical substrate ranges are also summarized in Table 17.



FIG. 4F shows EKO-35 and the efflux platform enabled summation of efflux substrate physicochemical properties. Polar Surface Area (PSA) for each compound was calculated using DataWarrior (Version 5.5.0). Box plots show individual data points representing substrate compounds and the corresponding property value, with the center line indicating the median, and whiskers the minimum and maximum values. Physicochemical substrate ranges are also summarized in Table 17.



FIG. 5A shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. FIG. 5A shows bar charts depicting fractional inhibitory concentration index (FICI) values of phenylalanine-arginine-β-naphthylamide (PAβN) in combination with oxacillin and novobiocin. The FICI represents the ΣFIC of each drug. The FIC for each drug was determined by dividing the MIC of each drug in combination, by the MIC of each drug alone. ΣFIC=FICA+FICB=(CA/MICA)+(CB/MICB). Synergy (FICI<0.5), additive (FICI>0.5-1.0), indifferent (FICI>1.0-2.0), and antagonistic (FICI>2.0), as highlighted on each bar chart. Related to Tables 18A, 18B, 19A and 19B.



FIG. 5B shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. FIG. 5B shows bar charts depicting fractional inhibitory concentration index (FICI) values of phenylalanine-arginine-8-naphthylamide (PAβN) in combination with fusidic acid and ciprofloxacin. The FICI represents the ΣFIC of each drug. The FIC for each drug was determined by dividing the MIC of each drug in combination, by the MIC of each drug alone. ΣFIC=FICA+FICB=(CA/MICA)+(CB/MICB). Synergy (FICI<0.5), additive (FICI>0.5-1.0), indifferent (FICI>1.0-2.0), and antagonistic (FICI>2.0), as highlighted on each bar chart. Related to Tables 18A, 18B, 19A and 19B.



FIG. 5C shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. FIG. 5C shows bar charts depicting fractional inhibitory concentration index (FICI) values of phenylalanine-arginine-β-naphthylamide (PAM) in combination with erythromycin and linezolid. The FICI represents the ΣFIC of each drug. The FIC for each drug was determined by dividing the MIC of each drug in combination, by the MIC of each drug alone. ΣFIC=FICA+FICB=(CA/MICA)+(CB/MICB). Synergy (FICI<0.5), additive (FICI>0.5-1.0), indifferent (FICI>1.0-2.0), and antagonistic (FICI>2.0), as highlighted on each bar chart. Related to Tables 18A, 18B, 19A and 19B.



FIG. 5D shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. Bar charts depicting fractional inhibitory concentration index (FICI) values of 1-(1-naphthylmethyl)-piperazine (NMP) in combination with oxacillin and ethidium bromide. The FICI represents the ΣFIC of each drug. The FIC for each drug was determined by dividing the MIC of each drug in combination, by the MIC of each drug alone. ΣFIC=FICA+FICB=(CA/MICA)+(CB/MICB). Synergy (FICI<0.5), additive (FICI>0.5-1.0), indifferent (FICI>1.0-2.0), and antagonistic (FICI>2.0), as highlighted on each bar chart. Related to Tables 18A, 18B, 19A and 19B.



FIG. 5E shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. FIG. 5E shows bar charts depicting fractional inhibitory concentration index (FICI) values of 1-(1-naphthylmethyl)-piperazine (NMP) in combination with fusidic acid and ciprofloxacin. The FICI represents the ΣFIC of each drug. The FIC for each drug was determined by dividing the MIC of each drug in combination, by the MIC of each drug alone. ΣFIC=FICA+FICB=(CA/MICA)+(CB/MICB). Synergy (FICI<0.5), additive (FICI>0.5-1.0), indifferent (FICI>1.0-2.0), and antagonistic (FICI>2.0), as highlighted on each bar chart. Related to Tables 18A, 18B, 19A and 19B.



FIG. 5F shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. Bar charts depicting fractional inhibitory concentration index (FICI) values of 1-(1-naphthylmethyl)-piperazine (NMP) in combination with erythromycin and linezolid. The FICI represents the ΣFIC of each drug. The FIC for each drug was determined by dividing the MIC of each drug in combination, by the MIC of each drug alone. ΣFIC=FICA+FICB=(CA/MICA)+(CB/MICB). Synergy (FICI<0.5), additive (FICI>0.5-1.0), indifferent (FICI>1.0-2.0), and antagonistic (FICI>2.0), as highlighted on each bar chart. Related to Tables 18A, 18B, 19A and 19B.



FIG. 5G shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. The efflux pump platform identified instances of interplay between pumps with acriflavine (EKO-35). All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****P<0.0001).



FIG. 5H shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. Interplay was maintained in porinated EKO-35 (EKO-35-Pore) with acriflavine, pGDP-2 harboring emrE is denoted as pEmrE. All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****p<0.0001).



FIG. 5I shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. The efflux pump platform identified instances of interplay between pumps with ethidium bromide (EKO-35). All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****p<0.0001).



FIG. 5J shows EKO-35 and the efflux platform can be used to assess efflux pump inhibitor specificities and efflux pump interplay. Interplay was maintained in porinated EKO-35 (EKO-35-Pore) with ethidium bromide, pGDP-2 harboring emrE is denoted as pEmrE All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****P<0.0001).



FIG. 6 shows genotype of EKO-35 as determined by next-generation Illumine sequencing. Deleted and/or inactivated efflux-encoding genes are shown as black arrows. Secondary genomic mutations incurred in non-efflux encoding genes are shown as white arrows.



FIG. 7 shows susceptibility testing to confirm the AcrBD408A mutant (EKO-35 araC::acrBD408A) is inactive despite being produced in equivalent amounts to AcrB (FIG. 1A) when the genes were integrated into the arabinose operon (araC gene) of EKO-35, with gene expression under the control of the constitutive PLacI promoter. Data points represent the mean of four technical replicates ±s.d.



FIG. 8A shows profiling EKO-35 with ASKA constructs expressing pitA in nutrient-rich Lysogeny broth (left) and M9 minimal glucose medium (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 8B shows profiling EKO-35 with ASKA constructs expressing yjfC in nutrient-rich Lysogeny broth (left) and M9 minimal glucose medium (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 8C shows profiling EKO-35 with ASKA constructs expressing tufA in nutrient-rich Lysogeny broth (left) and M9 minimal glucose medium (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 8D shows profiling EKO-35 with ASKA constructs expressing rspA in nutrient-rich Lysogeny broth (left) and M9 minimal glucose medium (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 8E shows profiling EKO-35 with ASKA constructs expressing wcaC in nutrient-rich Lysogeny broth (left) and M9 minimal glucose medium (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 8F shows profiling EKO-35 with ASKA constructs expressing gyrB in nutrient-rich Lysogeny broth (left) and M9 minimal glucose medium (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 9A shows the growth of EKO-35 at acidic and alkaline pH is not restored through plasmid-based complementation of genes in EKO-35 harboring nonsynonymous genomic mutations. EKO-35 growth is significantly reduced at pH 5.0.



FIG. 9B shows the growth of EKO-35 at acidic and alkaline pH is not restored through plasmid-based complementation of genes in EKO-35 harboring nonsynonymous genomic mutations. EKO-35 growth is significantly reduced at pH 5.5. ASKA plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL chloramphenicol. Data represent mean values±s.d. of three independent biological end-point readings after 18 h of growth. P-values were calculated by a two-tailed Student's t-test (****P<0.0001) relative to EKO-35 pCA24N,



FIG. 9C shows the growth of EKO-35 at acidic and alkaline pH is not restored through plasmid-based complementation of genes in EKO-35 harboring nonsynonymous genomic mutations. EKO-35 growth is significantly reduced at pH 8.5. ASKA plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL chloramphenicol. Data represent mean values±s.d. of three independent biological end-point readings after 18 h of growth. P-values were calculated by a two-tailed Student's t-test (****P<0.0001) relative to EKO-35 pCA24N,



FIG. 9D shows the growth of EKO-35 at acidic and alkaline pH is not restored through plasmid-based complementation of genes in EKO-35 harboring nonsynonymous genomic mutations. EKO-35 growth is significantly reduced at pH 9.0. ASKA plasmids were induced with 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL chloramphenicol. Data represent mean values±s.d. of three independent biological end-point readings after 18 h of growth. P-values were calculated by a two-tailed Student's t-test (****P<0.0001) relative to EKO-35 pCA24N,



FIG. 10A shows plasmid-based complementation of genes in EKO-35 harboring genomic mutations alters biofilm formation in wild-type E. coli. Expression of rspA significantly increased biofilm formation in wild-type E. coli, whilst expression of pitA, tufA, gyrB, and yjfC significantly lowers biofilm formation. ASKA plasmids were induced using 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values±s.d. of three independent biological end-point readings after 24 h and 48 h of growth in nutrient-rich and -limited media, respectively. P-values were calculated by a two-tailed Student's t-test (****P<0.0001).



FIG. 10B shows plasmid-based complementation of genes in EKO-35 harboring genomic mutations alters biofilm formation in EKO-35. Expression of rspA significantly increased biofilm formation in EKO-35 in nutrient-rich Lysogeny broth, whilst expression of pitA, tufA, gyrB, and yjfC significantly lowers biofilm formation. ASKA plasmids were induced using 0.1 mM IPTG and plasmid selection for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL in Lysogeny broth. Data represent mean values±s.d. of three independent biological end-point readings after 24 h and 48 h of growth in nutrient-rich and -limited media, respectively. P-values were calculated by a two-tailed Student's t-test (****P<0.0001).



FIG. 11A shows profiling of EKO-35 in low oxygen environments with ASKA constructs expressing pitA in nutrient-rich Lysogeny broth with 10 mM KNO3 (1% oxygen) (left) and M9 minimal glucose medium (5% oxygen) (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid maintenance for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL chloramphenicol in lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 11B shows profiling of EKO-35 in low oxygen environments with ASKA constructs expressing yjfC in nutrient-rich Lysogeny broth with 10 mM KNO3 (1% oxygen) (left) and M9 minimal glucose medium (5% oxygen) (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid maintenance for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL chloramphenicol in lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 11C shows profiling of EKO-35 in low oxygen environments with ASKA constructs expressing tufA in nutrient-rich Lysogeny broth with 10 mM KNO3 (1% oxygen) (left) and M9 minimal glucose medium (5% oxygen) (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid maintenance for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL chloramphenicol in lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 11D shows profiling of EKO-35 in low oxygen environments with ASKA constructs expressing rspA in nutrient-rich Lysogeny broth with 10 mM KNO3 (1% oxygen) (left) and M9 minimal glucose medium (5% oxygen) (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid maintenance for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL chloramphenicol in lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 11E shows profiling of EKO-35 in low oxygen environments with ASKA constructs expressing wcaC in nutrient-rich Lysogeny broth with 10 mM KNO3 (1% oxygen) (left) and M9 minimal glucose medium (5% oxygen) (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid maintenance for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL chloramphenicol in lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 11F shows profiling of EKO-35 in low oxygen environments with ASKA constructs expressing gyrB in nutrient-rich Lysogeny broth with 10 mM KNO3 (1% oxygen) (left) and M9 minimal glucose medium (5% oxygen) (right). Solid symbols represent empty vector controls while open symbols represent ASKA expressing constructs. Plasmids were induced with 0.1 mM IPTG and plasmid maintenance for EKO-35 was achieved using 1 μg/mL chloramphenicol in M9 minimal glucose medium and 4 μg/mL chloramphenicol in lysogeny broth. Data represent mean values of three independent biological replicates.



FIG. 12 shows structures of synthetic compounds determined to be substrates for efflux. Compounds were visualized using Chem Prime 20.1 (Version 20.1.0.112). EKO-35 was susceptible to compounds 4, 5, 11, 13, 16, and 18.



FIG. 13A shows results from assessing the susceptibility of EKO-35 harboring ASKA plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC. Strains were profiled against benzalkonium chloride. MICs were determined i, without (left) and with chloramphenicol (right) to maintain ASKA plasmids. All plasmids were induced with 0.1 mM IPTG. 25 μg/mL and 4 μg/mL chloramphenicol was used to maintain ASKA plasmids in wild-type E. coli and EKO-35, respectively. Strains were assessed in technical duplicate.



FIG. 13B shows results from assessing the susceptibility of EKO-35 harboring ASKA plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC. Strains were profiled against novobiocin. MICs were determined without (left) and with chloramphenicol (right) to maintain ASKA plasmids. All plasmids were induced with mM IPTG. 25 μg/mL and 4 μg/mL chloramphenicol was used to maintain ASKA plasmids in wild-type E. coli and EKO-35, respectively. Strains were assessed in technical duplicate.



FIG. 13C shows results from assessing the susceptibility of EKO-35 harboring ASKA plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC. Strains were profiled against trimethoprim. MICs were determined without (left) and with chloramphenicol to maintain ASKA plasmids. All plasmids were induced with 0.1 mM IPTG. 25 μg/mL and 4 μg/mL chloramphenicol was used to maintain ASKA plasmids in wild-type E. coli and EKO-35, respectively. Strains were assessed in technical duplicate.



FIG. 13D shows results from assessing the susceptibility of EKO-35 harboring ASKA plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC. Strains were profiled against synthetic 2. MICs were determined without (left) and with chloramphenicol (right) to maintain ASKA plasmids. All plasmids were induced with mM IPTG. 25 μg/mL and 4 μg/mL chloramphenicol was used to maintain ASKA plasmids in wild-type E. coli and EKO-35, respectively. Strains were assessed in technical duplicate.



FIG. 13E shows results from assessing the susceptibility of EKO-35 harboring ASKA plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC. Strains were profiled against synthetic 14. MICs were determined without (left) and with chloramphenicol (right) to maintain ASKA plasmids. All plasmids were induced with mM IPTG. 25 μg/mL and 4 μg/mL chloramphenicol was used to maintain ASKA plasmids in wild-type E. coli and EKO-35, respectively. Strains were assessed in technical duplicate.



FIG. 13F shows results from assessing the susceptibility of EKO-35 harboring ASKA plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC. Strains were profiled against synthetic 19. MICs were determined without (left) and with chloramphenicol (right) to maintain ASKA plasmids. All plasmids were induced with mM IPTG. 25 μg/mL and 4 μg/mL chloramphenicol was used to maintain ASKA plasmids in wild-type E. coli and EKO-35, respectively. Strains were assessed in technical duplicate.



FIG. 14A shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding AcrEF, were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. Susceptibility testing revealed no changes in the resistance levels of the wild-type or single gene deletion backgrounds, except for ΔacrB (FIG. 14C). EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 14B shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding AcrD were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. Susceptibility testing revealed no changes in the resistance levels of the wild-type or single gene deletion backgrounds, except for ΔacrB (FIG. 14C). EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 14C shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding AcrB were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 14D shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding MdtEF were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. Susceptibility testing revealed no changes in the resistance levels of the wild-type or single gene deletion backgrounds, except for ΔacrB (FIG. 14C). EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 14E shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding MdtBC were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. Susceptibility testing revealed no changes in the resistance levels of the wild-type or single gene deletion backgrounds, except for ΔacrB (FIG. 14C). EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 14F shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding MacAB were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. Susceptibility testing revealed no changes in the resistance levels of the wild-type or single gene deletion backgrounds, except for ΔacrB (FIG. 14C). EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 14G shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding MacAB were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. Susceptibility testing revealed no changes in the resistance levels of the wild-type or single gene deletion backgrounds, except for ΔacrB (FIG. 14C). EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 14H shows heat maps depicting susceptibility levels of strains expressing efflux pump-encoding genes. Each strain was tested in technical duplicate and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Genes encoding MexCD were chromosomally integrated into the wild-type strain, a single gene deletion mutant, and EKO-35. Susceptibility testing revealed no changes in the resistance levels of the wild-type or single gene deletion backgrounds, except for ΔacrB (FIG. 14C). EKO-35 was highly susceptible to all compounds tested, revealing susceptibility profiles similar to ΔtolC, and integration of efflux genes into this strain conferred resistance to the known substrates.



FIG. 15A shows susceptibility and growth profiling of porinated wild-type (WT) K-12, ΔtolC, and EKO-35 strains. FIG. 15A shows heatmap depicting vancomycin susceptibility of the porinated strains. Each strain was tested in technical duplicate and MIC values were normalized to 100%, where dark gray represents the highest MIC value, and white represents the lowest value (see key). Susceptibility of the WT K-12, ΔtolC, and EKO-35 strains+/−the pore was assessed for 52 compounds.



FIG. 15B shows susceptibility and growth profiling of porinated wild-type (WT) K-12, ΔtolC, and EKO-35 strains. FIG. 15B shows growth profiling of WT K-12-Pore and EKO-35-Pore in LB at 37° C. Measurement of growth kinetics revealed the pore did not significantly impact the length of the lag phase (P>0.05) or generation time (P>0.05) compared to the parental strains, which was assessed using three biological replicates. Susceptibility of the WT K-12, ΔtolC, and EKO-35 strains+/−the pore was assessed for 52 compounds.



FIG. 15C shows molecular weight for each compound that resulted in a 4-fold or greater increase in susceptibility compared to the wild-type strain presented as individual data points in the box plots, the line through the center of each box indicates the median, and whiskers the minimum and maximum values. Molecular weights (MW) were calculated using DataWarrior (Version 5.5.0).



FIG. 15D shows lipophilicity for each compound that resulted in a 4-fold or greater increase in susceptibility compared to the wild-type strain presented as individual data points in the box plots, the line through the center of each box indicates the median, and whiskers the minimum and maximum values. Lipophilicities (log P) were calculated using DataWarrior (Version 5.5.0).



FIG. 15E shows aqueous solubility for each compound that resulted in a 4-fold or greater increase in susceptibility compared to the wild-type strain presented as individual data points in the box plots, the line through the center of each box indicates the median, and whiskers the minimum and maximum values. Aqueous solubilities (log S) were calculated using DataWarrior (Version 5.5.0).



FIG. 15F shows polar surface area for each compound that resulted in a 4-fold or greater increase in susceptibility compared to the wild-type strain presented as individual data points in the box plots, the line through the center of each box indicates the median, and whiskers the minimum and maximum values. Polar Surface Areas (PSA) were calculated using DataWarrior (Version 5.5.0).



FIG. 15G shows physicochemical properties calculated using DataWarrior (Version 5.5.0). FIG. 15G shows summary of the physicochemical properties ranges for each strain. Medians are indicated in parentheses.



FIG. 16A shows heat maps depicting aminoglycoside susceptibility of the wild-type K-12 strain and an ΔacrD mutant expressing the chromosomally integrated acrD gene (araC::acrD) using kanamycin in cation-adjusted Mueller Hinton II Broth (MHB II). The cell inoculum used was 104 cells/mL to replicate susceptibility testing conditions used in previous studies. Each strain was assessed using three technical replicates and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key).



FIG. 16B shows heat maps depicting aminoglycoside susceptibility of the wild-type K-12 strain and an ΔacrD mutant expressing the chromosomally integrated acrD gene (araC::acrD) using kanamycin in Lysogeny broth (LB). The cell inoculum used was 104 cells/mL to replicate susceptibility testing conditions used in previous studies. Each strain was assessed using three technical replicates and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key).



FIG. 16C shows heat maps depicting aminoglycoside susceptibility of the wild-type K-12 strain and an ΔacrD mutant expressing the chromosomally integrated acrD gene (araC::acrD) using gentamicin in MHB II. The cell inoculum used was 104 cells/mL to replicate susceptibility testing conditions used in previous studies. Each strain was assessed using three technical replicates and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key).



FIG. 16D shows heat maps depicting aminoglycoside susceptibility of the wild-type K-12 strain and an ΔacrD mutant expressing the chromosomally integrated acrD gene (araC::acrD) using gentamicin in LB. The cell inoculum used was 104 cells/mL to replicate susceptibility testing conditions used in previous studies. Each strain was assessed using three technical replicates and MIC values were normalized to 100% for each compound tested, where dark gray represents the highest MIC value, and white represents the lowest value (see key).



FIG. 17A shows EKO-35 and the efflux platform can be used to assess efflux pump interplay. Interplay was not observed for novobiocin in EKO-35. pGDP-2 harboring emrE is denoted as pEmrE. All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****P<0.0001).



FIG. 17B shows EKO-35 and the efflux platform can be used to assess efflux pump interplay. Interplay was not observed for novobiocin in EKO-35-Pore pGDP-2 harboring emrE is denoted as pEmrE. All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****P<0.0001).



FIG. 17C shows EKO-35 and the efflux platform can be used to assess efflux pump interplay. Interplay was not observed for novobiocin in EKO-35. pGDP-2 harboring emrE is denoted as pEmrE. All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****P<0.0001).



FIG. 17D shows EKO-35 and the efflux platform can be used to assess efflux pump interplay. Interplay was not observed for novobiocin in EKO-35-Pore. pGDP-2 harboring emrE is denoted as pEmrE. All integrated strains were transformed with the empty vector (pGDP-2). Genes encoding AcrB, AcrEF, AcrD, and MdtEF were integrated into the arabinose operon (araC) of EKO-35. Related to Table 20. Data represent mean MIC values for which the OD600nm value >0.100, ±s.d. of three independent biological replicates. P-values were calculated by a two-tailed Student's t-test (*P<0.05, **P<0.01, ***P<0.001, ****P<0.0001).



FIG. 18 shows a graphical depiction of K-12, EKO-35, EKO-35 Pore, EKO-35 araC::X, and EKO-35 araC::X Y:pGDP of the present disclosure.



FIG. 19 show phenotypic analysis of EKO-35v2 in nutrient-rich conditions. Measurement of growth kinetics of EKO-35v1 (Example 1) and EKO-35v2 was assessed using n=3 biological replicates (Table 25).





DETAILED DESCRIPTION

Unless otherwise indicated, the definitions and embodiments described in this and other sections are intended to be applicable to all embodiments and aspects of the present disclosure herein described for which they are suitable as would be understood by a person skilled in the art.


In understanding the scope of the present disclosure, the term “comprising” and its derivatives, as used herein, are intended to be open ended terms that specify the presence of the stated features, elements, components, groups, integers, and/or steps, but do not exclude the presence of other unstated features, elements, components, groups, integers and/or steps. The foregoing also applies to words having similar meanings such as the terms, “including”, “having” and their derivatives. The term “consisting” and its derivatives, as used herein, are intended to be closed terms that specify the presence of the stated features, elements, components, groups, integers, and/or steps, but exclude the presence of other unstated features, elements, components, groups, integers and/or steps. The term “consisting essentially of”, as used herein, is intended to specify the presence of the stated features, elements, components, groups, integers, and/or steps as well as those that do not materially affect the basic and novel characteristic(s) of features, elements, components, groups, integers, and/or steps.


As used herein, the singular forms “a”, “an” and “the” include plural references unless the content clearly dictates otherwise.


The term “nucleic acid”, “nucleic acid molecule” or its derivatives, as used herein, is intended to include unmodified DNA or RNA or modified DNA or RNA. For example, the nucleic acid molecules of the disclosure can be composed of single- and double-stranded DNA, DNA that is a mixture of single- and double-stranded regions, single- and double-stranded RNA, and RNA that is a mixture of single- and double-stranded regions, hybrid molecules comprising DNA and RNA that may be single-stranded or, more typically double-stranded or a mixture of single- and double-stranded regions. In addition, the nucleic acid molecules can be composed of triple-stranded regions comprising RNA or DNA or both RNA and DNA. The nucleic acid molecules of the disclosure may also contain one or more modified bases or DNA or RNA backbones modified for stability or for other reasons. “Modified” bases include, for example, tritiated bases and unusual bases such as inosine. A variety of modifications can be made to DNA and RNA; thus “nucleic acid molecule” embraces chemically, enzymatically, or metabolically modified forms. The term “polynucleotide” shall have a corresponding meaning.


As used herein, the term “inactivation of a gene”, or a derivative thereof, refers to reduction or elimination in the activity of the protein encoded by a gene due to the reduction or elimination of the gene expression via mutation induced by one or more methods selected from the group consisting of deletion of all or a part of the corresponding gene, substitution of a part of the nucleotide sequence, or deletion or insertion of one or more base pairs into the nucleotide sequence.


As used herein, the term “reactivation”, or a derivative thereof, when relating to a gene, refers to increase or reintroduction in the activity of the protein encoded by a gene due to the increase or reintroduction of the gene expression via mutation induced by one or more methods selected from the group consisting of insertion of all or a part of the corresponding gene, substitution of a part of the nucleotide sequence, or deletion or insertion of one or more base pairs into the nucleotide sequence. Reactivation or reactivated includes restoring the gene as prior to inactivation, with previous promoter or with a different promoter, whether it a constitutive or conditional promoter. Reactivation can include tunable expression to control the level of the restored gene, including overexpression, returning to previous level or under-expressing as compared to previous levels. The reactivation, including reintroduction, can be at the same locus or at a different locus of the bacterial strain's genome. The reactivation, including reintroduction, of gene can include introduction of mutation that affect the function of the gene, for example, efflux pump function, including interaction with compounds or other genes. In some embodiments, reactivation of a gene comprises reintroduction of a gene. In some embodiments, reactivation of a gene occurs at the same locus, or at a different locus in a bacterial strain's genome. In some embodiments, reintroduction of a gene occurs at the same locus, or at a different locus in a bacterial strain's genome.


As used herein, the term “polypeptide” encompasses both peptides and proteins, and fragments thereof of peptides and proteins, unless indicated otherwise. In one embodiment, the therapeutic agent is a polypeptide.


The term “promoter,” as used herein, refers to a nucleotide sequence that directs the transcription of a gene or coding sequence to which it is operably linked.


The term “operably linked”, as used herein, refers to an arrangement of two or more components, wherein the components so described are in a relationship permitting them to function in a coordinated manner. For example, a transcriptional regulatory sequence or a promoter is operably linked to a coding sequence if the transcriptional regulatory sequence or promoter facilitates aspects of the transcription of the coding sequence. The skilled person can readily recognize aspects of the transcription process, which include, but not limited to, initiation, elongation, attenuation and termination. In general, an operably linked transcriptional regulatory sequence is joined in cis with the coding sequence, but it is not necessarily directly adjacent to it.


A “segment” of a nucleotide sequence is a sequence of contiguous nucleotides. A segment can be at least about 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 60, 85, 100, 110, 120, 130, 145, 150, 160, 175, 200, 250, 300, 350, 400, 450, 500 or more contiguous nucleotides.


A “fragment” of an amino acid sequence is a sequence of contiguous amino acids. A segment can be at least about 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 60, 85, 100, 110, 120, 130, 145, 150, 160, 175, 200, 250, 300, 350, 400, 450, 500 or more contiguous amino acids.


The term “antibacterial agent” as used herein refers to a microbial inhibiting agent, including anything that reduces virulence or modifies efflux pump activity, with or without the action of other compounds and adjuvants. For example, an antibacterial agent can be an efflux pump inhibitor.


The term “viability” as used herein refers to measurement known to the skilled person in assessing health of bacteria. Methods known in the art can be used to determine viability. Viability can be determined as a percentage over a control or as a minimal inhibitory concentration (MIC) when it is being affected by a compound, for example, an antibacterial agent such as an efflux pump inhibitor. Viability can also be determined relatively, for example, by comparing the rate of killing or inhibition of growth of the bacterial strain or wild-type bacteria described herein.


Composition and Method of the Disclosure

The present disclosure provides an Escherichia coli strain that is deficient in efflux pump activity. Accordingly, provided herein is an Escherichia coli strain comprising at least 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, or of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the strain comprises at least 20 of the inactivated genes. In some embodiments, the strain comprises at least 21 of the inactivated genes. In some embodiments, the strain comprises at least 22 of the inactivated genes. In some embodiments, the strain comprises at least 23 of the inactivated genes. In some embodiments, the strain comprises at least 24 of the inactivated genes. In some embodiments, the strain comprises at least 25 of the inactivated genes. In some embodiments, the strain comprises at least 26 of the inactivated genes. In some embodiments, the strain comprises at least 27 of the inactivated genes. In some embodiments, the strain comprises at least 28 of the inactivated genes. In some embodiments, the strain comprises at least 29 of the inactivated genes. In some embodiments, the strain comprises at least 30 of the inactivated genes. In some embodiments, the strain comprises at least 31 of the inactivated genes. In some embodiments, the strain comprises at least 32 of the inactivated genes. In some embodiments, the strain comprises at least 33 of the inactivated genes. In some embodiments, the strain comprises at least 34 of the inactivated genes. In some embodiments, strain comprises all 35 inactivated genes. EKO-35v1 and EKO-35v2 are examples of EKO-35. In some embodiments, the Escherichia coli strain is EKO-35v1. In some embodiments, the Escherichia coli strain is EKO-35v2. In some embodiments, the Escherichia coli strain is deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01. In some embodiments, the Escherichia coli strain is deposited under IDAC accession number 310522-01. In some embodiments, the Escherichia coli strain is deposited under IDAC accession number 070623-01. In some embodiments, the strain further comprises an open variant of outer membrane ferric siderophore transporter FhuA. In some embodiments, the strain further comprises deletion of tolC gene. In some embodiments, the strain comprises at least one of reactivated acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, optionally under the control of a constitutive promoter. In some embodiments, one of reactivated acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the inactivation comprises deletion of the gene, or introducing a mutation into the gene to ablate expression of the gene or eliminate efflux pump activity of the protein expressed by the gene. In some embodiments, acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA are genes encoding for efflux pumps. In some embodiments, the strain comprising at least 20 of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA is an efflux pump deficient strain. In some embodiments, the strain comprises all 35 inactivated genes is EKO-35. In some embodiments, the strain comprises a nucleic acid comprising at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.1%, 99.2%, 99.3%, 99.4%, 99.5%, 99.6%, 99.7%, 99.8%, 99.9%, 99.91%, 99.92%, 99.93%, 99.94%, 99.95%, 99.96%, 99.97%, 99.98%, 99.99%, 99.999%, or 99.9999% sequence identity as any nucleotide sequence described herein. In some embodiments, the strain comprises a nucleic acid comprising 100% sequence identity as any nucleotide sequence described herein. In some embodiments, the strain comprises a nucleic acid comprising at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.1%, 99.2%, 99.3%, 99.4%, 99.5%, 99.6%, 99.7%, 99.8%, 99.9%, 99.91%, 99.92%, 99.93%, 99.94%, 99.95%, 99.96%, 99.97%, 99.98%, 99.99%, 99.999%, or 99.9999% sequence identity as the nucleotide sequence as shown in SEQ ID NO: 255. In some embodiments, the strain comprises a nucleic acid comprising at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.1%, 99.2%, 99.3%, 99.4%, 99.5%, 99.6%, 99.7%, 99.8%, 99.9%, 99.91%, 99.92%, 99.93%, 99.94%, 99.95%, 99.96%, 99.97%, 99.98%, 99.99%, 99.999%, or 99.9999% sequence identity as the nucleotide sequence as shown in SEQ ID NO: 255, and having least 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, or 35 of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the strain comprises a nucleic acid comprising 100% sequence identity as the nucleotide sequence as shown in SEQ ID NO: 255.


The molecular tools for inactivating and reactivating genes are known in the art. In some embodiments, the reactivation of gene comprises reintroducing gene under control of a constitutive promoter.


Also provided is a method for identifying a compound that is an antibacterial agent, comprising

    • (a) i) contacting the compound with the Escherichia coli strain described herein and with wild-type Escherichia coli; and/or
    • ii) contacting the compound with the Escherichia coli strain described herein having reactivated genes and EKO-35; and/or
    • iii) contacting the compound with the Escherichia coli strain described herein having reactivated genes and an efflux pump deficiency strain described herein; and
    • (b) detecting viability of each of the Escherichia coli;
    • wherein the compound is identified as an antibacterial agent if the compound decreases viability of wild-type less than the Escherichia coli strain with efflux pump deficiency described herein;
    • optionally wherein the compound is identified as an antibacterial agent if the compound decreases viability of the Escherichia coli strain having reactivated efflux pump genes less than the Escherichia coli strain having at least 20 inactivated efflux pump genes;
    • optionally wherein the compound is identified as an antibacterial agent if the wild-type Escherichia coli or the Escherichia coli strain having reactivated efflux pump genes is resistant to the compound, and the compound decreases the viability of the Escherichia coli strain having at least 20 inactivated efflux pump genes, or EKO-35.


In some embodiments, the antibacterial agent is a microbial inhibiting agent that reduces virulence or modifies efflux pump activity, with or without the action of other compounds and adjuvants. In some embodiments, the antibacterial agent is an efflux pump inhibitor.


In some embodiments, the decrease in viability of wild-type or the Escherichia coli strain described herein after contacting the compound is at most 10%, 20%, 30%, 40%, 50%, 60%, 70%, or 80%, or at least 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100%.


In some embodiments, the compound is identified as an antibacterial agent if the compound decreases the viability of efflux pump deficient Escherichia coli strain described herein at a faster rate than the decrease in viability of wild-type or the Escherichia coli strain comprising reactivated efflux pump genes.


In some embodiments, the compound decreases the viability of the Escherichia coli strain with one reactivated gene in an efflux deficient strain disclosed herein, optionally Escherichia coli strain EKO-35, is less than the efflux deficient strain disclosed herein, optionally Escherichia coli strain EKO-35, identifying specificity of the compound for an efflux pump encoded by the reactivated gene, optionally the compound has a lower minimum inhibitory concentration (MIC) in the Escherichia coli strain of EKO-35 than EKO-35 with a reactivated efflux pump.


The skilled person recognizes optimal conditions to carry out methods for identifying antibacterial agent or growth condition for the E. coli strain described herein. For example, optimal aeration can include broth cultures grown with aeration at 220 rpm. For example, for growth profiling, microtiter plates can be incubated at 37° C. or 25° C. with continuous linear shaking at 600 rpm. Other optimal conditions, as well as nutrient-limited conditions, are described in the Example.


In some embodiments, the contacting comprises the Escherichia coli in a suitable culturing media for optimal Escherichia coli growth. In some embodiments, the contacting comprises incubating the Escherichia coli in nutrient-limiting culturing media. In some embodiments, the contacting comprises incubating the Escherichia coli for at least 24 h, 48 h, 72 h, or 96 h. In some embodiments, the culturing media is a media having a pH of about 2, about 3, about 4, or about 5.


Also provided is a method for identifying a compound that is an antibacterial agent, comprising

    • (a) i) contacting the compound with an Escherichia coli strain of comprising at least 20 of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA (Strain A), or the Escherichia coli strain deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01, or an Escherichia coli comprising a nucleic acid having the sequence as shown in SEQ ID NO: 255, and with wild-type Escherichia coli; and/or
    • ii) contacting the compound with Strain A or the Escherichia coli strain deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01, or an Escherichia coli comprising a nucleic acid having the sequence as shown in SEQ ID NO: 255, and an Escherichia coli strain comprising inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, wherein at least one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated (Strain B); and/or
    • iii) contacting the compound with Strain A or the Escherichia coli strain deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01, or an Escherichia coli comprising a nucleic acid having the sequence as shown in SEQ ID NO: 255, and an Escherichia coli strain comprising inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, wherein one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated (Strain C); and
    • (b) detecting viability of each of the Escherichia coli;
    • wherein the compound is identified as an antibacterial agent if the compound decreases viability of wild-type less than Strain A or the Escherichia coli strain deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01, or comprising or an Escherichia coli a nucleic acid having the sequence as shown in SEQ ID NO: 255;
    • optionally wherein the compound is identified as an antibacterial agent if the compound decreases viability of Strain B, less than Strain A or the Escherichia coli strain deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01, or an Escherichia coli comprising a nucleic acid having the sequence as shown in SEQ ID NO: 255;
    • optionally wherein the compound is identified as an antibacterial agent if the wild-type Escherichia coli or Strain B is resistant to the compound, and the compound decreases the viability of Strain A or the Escherichia coli strain deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01, or an Escherichia coli comprising a nucleic acid having the sequence as shown in SEQ ID NO: 255.


Also provided is a method for creating an Escherichia coli strain producing one or more efflux pump, comprising reactivating one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA in the Escherichia coli strain EKO-35.


In some embodiments, the reactivation comprises introducing one or more of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, optionally by reversing the inactivation, optionally by re-introducing the gene back in genome with the same promoter or a different promoter, at the same locus or a different locus, optionally by introducing a knock down-resistant version of the gene.


Also provided is a method for creating an efflux pump deficiency E. coli strain, the method comprises inactivating at least 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, or 35 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 20 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 21 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 22 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 23 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 24 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 25 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 26 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 27 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 28 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 29 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 30 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 31 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 32 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 33 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating at least 34 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating all 35 genes of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA. In some embodiments, the method comprises inactivating genes in the following order: ΔyajR; mdtO; ydhC; emrE; yojI; mdtD, sugE; ynfM, emrD, ydeF; mdlA, emrY; mdtK, bcr; mdtG; mdtH, mdlB, macB, yddA; fsr; ydiM; yieO; mdfA; mdtM; mdtJ; emrB, mdtB, mdtL; yebQ, cusA; mdtF; ydeA; acrF; acrD, and acrB.


EXAMPLES

The following non-limiting Examples are illustrative of the present disclosure:


Example 1. Development and Utilization of EKO-35
Materials and Methods
Strains, Plasmids, and Growth Conditions

Bacterial strains and plasmids used in this disclosure are provided in Table 2. E. coli K-12 str. BW25113, the parental strain of the Keio Collection (Baba, T. et al., 2006) was used as the background for generation of EKO-35. Specifically, an ΔacrB mutant from the Keio Collection was used as the first deletion mutant. E. coli TOP10 or E. coli DH5a strains were used as routine cloning hosts. E. coli strains for resistance cassette amplification were obtained from the Keio Collection, P. aeruginosa PAO1 was provided by Dr. Cezar Khursigara (University of Guelph). An E. coli K-12 str. BW25113 harboring the fhuA ΔC/Δ4L gene under the control of the constitutive synthetic promoter BBa_J23104 was used as a source for the ‘Pore’ (Johnson, J. W. et al., 2022). Plasmids for CRISPR-Cas9 mediated counterselection, pCas and pTargetF, were purchased from Addgene (Jiang, Y. et al., 2015). Plasmids for the λ-Red recombinase system, pKD46 and pCP20 (Datsenko, K. A. & Wanner, B. L, 2000), and expression of efflux genes, pINT2 and pGDP2 were used (Cox, G. et al., 2017). Strains were routinely grown in Lysogeny broth (LB) (Bioshop) at 37° C. or For optimal aeration, broth cultures were grown with aeration at 220 rpm. For growth profiling, microtiter plates were incubated at 37° C. or 25° C. with continuous linear shaking at 600 rpm. For susceptibility testing, microtiter plates were grown at 37° C. with continuous linear shaking at 900 rpm. Ampicillin (100 μg/mL) (Bioshop), kanamycin (50 μg/mL) (Sigma-Aldrich), spectinomycin (50 μg/mL) (Bioshop), and gentamicin (10 μg/mL) (BioBasic) were used at the listed concentrations for selection of resistance markers. For nutrient-limited conditions, strains were grown in M9 (Bioshop) supplemented with 2 mM MgSO4 (Bioshop), 0.1 mM CaCl2) (Bioshop) and glucose (w/v) (Bioshop). To profile growth in amino acid-limited medium supplemented with iron, MOPS medium (TEKNOVA) was utilized. Buffered “low-salt” medium was prepared (Lewinson, O. et al., 2014) with 100 mM of the appropriate buffer [pH 5.0, homopiperazine-N,N=-bis-2-(ethanesulfonic acid) (HOMOPIPES), pH 5.5 to 6.5, 2-(N-morpholino)ethanesulfonic acid (MES); pH 7.0 to 7.5, 3-(N-morpholino)propanesulfonic acid (MOPS)]. For profiling growth at pH 8.0 to 9.0, 1,3-bis(tris(hydroxymethyl)methylamino)propane (Bis-tris propane) was used at 50 mM due to toxicity at higher concentrations. Susceptibility testing was conducted in cation-adjusted Mueller Hinton II Broth (MHB II) (BD Difco).









TABLE 1







Measurement of growth kinetics revealed statistically significant


differences between EKO-35 and the wild-type strain. Generation


time and the duration of the lag phase for each strain are


shown in minutes. The measurements represent the mean +


standard deviation for three biological replicates.











Generation
Lag



Strain
time (min)
phase (min)
Final OD600nm










Nutrient-rich medium at 37° C.










K-12
26.54 ± 0.454
204.8 ± 2.969
0.741 ± 0.066


EKO-35
28.33 ± 0.911
265.8 ± 3.285
0.725 ± 0.048


P-value
4.00 × 10−2
1.83 × 10−5
0.178*







Nutrient-rich medium at 25° C.










K-12
83.06 ± 6.06  
592.3 ± 6.536
0.979 ± 0.0172


EKO-35
171.51 ± 13.08 
809.5 ± 4.40 
1.082 ± 0.0029


P-value
4.44 × 10−4
1.16 × 10−6
5.13 × 10−4







Nutrient-rich medium at 37° C. with 1% O2










K-12
24.85 ± 1.263
185.0 ± 5.122
0.525 ± 0.009


EKO-35
37.15 ± 0.849
279.7 ± 9.516
0.452 ± 0.008


P-value
1.51 × 10−4
1.10 × 10−4
4.98 × 10−4







Nutrient-rich medium with KNO3 supplementation at 37° C. with 1% O2










K-12
26.87 ± 1.035
209.0 ± 2.165
0.502 ± 0.007


EKO-35
43.52 ± 1.962
315.4 ± 4.048
0.293 ± 0.004


EKO-35
30.10 ± 1.137
276.0 ± 6.187
0.331 ± 0.006


araC::MdtEF


P-value
2.02 × 10−4
2.30 × 10−6
1.83 × 10−6



aP-value

5.09 × 10−4
7.70 × 10−4
6.47 × 10−4







Nutrient-limited medium at 37° C.










K-12
 56.5 ± 3.020
841.1 ± 7.401
0.585 ± 0.030


EKO-35
52.05 ± 1.058
1137.8 ± 9.803 
0.492 ± 0.004


P-value
0.074*
1.95 × 10−6
6.13 × 10−3







Amino acid-limited medium supplemented with iron at 37° C.










K-12
58.40 ± 1.779
848.6 ± 17.19
0.688 ± 0.118


EKO-35
70.45 ± 1.875
1242.9 ± 29.68 
0.818 ± 0.006


P-value
1.27 × 10−3
0.913*
0.130*







Nutrient-limited medium at 25° C.










K-12
219.42 ± 26.09 
2603.55 ± 64.90 
0.591 ± 0.056


EKO-35
231.27 ± 18.49 
2539.27 ± 82.34 
0.666 ± 0.173


P-value
9.18 × 10−2
1.87 × 10−1
3.41 × 10−1







Nutrient-limited medium at 37° C. with 5% O2










K-12
80.79 ± 3.885
1541.2 ± 26.27 
0.321 ± 0.002


EKO-35
134.70 ± 2.331 
2420.9 ± 36.30 
0.314 ± 0.010


EKO-35
114.94 ± 2.603 
2133.09 ± 71.84 
0.375 ± 0.006


araC::MdtEF


P-value
3.27 × 10−5
5.09 × 10−6
0.29* 



aP-value

6.09 × 10−4
5.06 × 10−3
8.40 × 10−4





* non-significant P-values.


Statistical significance was assessed using a two-tailed Student's t-test (P-value ≤ 0.05).



aP-value for EKO-35 compared to EKO-35 araC::MdtEF














TABLE 2







Strains and plasmids used in this Example.










Genotype or Description
Source











Strains










E. coli K-12 str.

The parental strain of the KEIO collection
Baba, T. et


BW25113

al. (2006)



E. coli TOP10

Cloning host, mcrA deficient for increased
Thermo



efficiency in foreign DNA uptake
Fisher




Scientific



E. coli DH5a

Cloning host, endA deficient for high quality
Thermo



DNA preparations
Fisher




Scientific



E. coli EKO-35

BW25113 efflux deficient derivative (AacrB;
This



acrD; acrF; mdtF; macB; emrB; mdtL; mdtK;
disclosure



bcr; ydeA; mdtM; yddA; yebQ; emrE; mdtD;



sugE; ynfM; emrD; ydeF; mdtJ; ydiM; mdtB;



mdIA; emrY; mdfA; fsr; mdtG; mdtH; yieO;



mdlB, mdtO, yojI, yajR, ydhC; cusA)



E. coli δtolC

BW25113 derivative from the KEIO collection
Baba, T. et




al. (2006)



E. coli pore

BW25115 attTn7::mini-Tn7T (Gmr-PBBa_J23104-
Johnson, J.



fhuA AC/A4L)
W. et al.




(2022)



P. aeruginosa PAO1

Derivative of the Australian PAO isolate
Stover, C.




K. et al.




(2000)







Plasmids









pKD46
Ampr, temperature sensitive, arabinose-
Datsenko,



induced expression of the A-Red recombinase
K. A. &



for homologous recombination
Wanner, B.




L. (2000)


pCP20
Ampr, temperature sensitive: permissive
Cherepanov



(30° C.), non-permissive (42° C.). Contains flp
P. P. &



from Saccharomyces cerevisiae for resistance
Wackernag



cassette removal
el, W.




(1995)


pCas
Kanr, temperature sensitive permissive (30° C.),
Jiang, Y. et



non-permissive (37° C.), arabinose-induced
al. (2015)



expression of the λ-Red recombinase for



homologous recombination. Constitutive



expression of Cas-9


pTargetF
Specr, modifiable by PCR to contain N20
Jiang, Y. et



sequence recognizable by Cas-9
al. (2015)


pTargetF-emrE
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within emrE


pTargetF-mdtD
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtD


pTargetF-sugE
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within sugE


pTargetF-ynfM
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within ynfM


pTargetF-emrD
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within emrD


pTargetF-ydeF
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within ydeF


pTargetF-mdtJ
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtIJ


pTargetF-ydiM
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within ydiM


pTargetF-mdtB
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtB


pTargetF-mdIA
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdlA


pTargetF-emrY
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within emrY


pTargetF-mdfA
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdfA


pTargetF-fsr
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within fsr


pTargetF-mdtG
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtG


pTargetF-mdtH
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtH


pTargetF-yieO
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within yieO


pTargetF-mdlB
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdlB


pTargetF-mdtO
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtO


pTargetF-yojH
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within yojH


pTargetF-yojI
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within yojI


pTargetF-yajR
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within yajR


pTargetF-ydhC
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within ydhC


pTargetF-cusA
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within cusA


PINT2
Ampr, enables chromosomal integration into
Cox, G. et



the arabinose operon via homologous
al. (2017)



recombination. Genes of interest are ligated



into the MCS, downstream of a Kanr resistance



cassette


pINT2-acrB
Ampr, contains acrB for chromosomal
This



integration
disclosure


pINT2-acrB D408A
Ampr, contains acrBD408A for chromosomal
This



integration
disclosure


PINT2-acrD
Ampr, contains acrD for chromosomal
This



integration
disclosure


PINT2-acrEF
Ampr, contains acrEF for chromosomal
This



integration
disclosure


PINT2-mdtEF
Ampr, contains mdtEF for chromosomal
This



integration
disclosure


PINT2-emrKY
Ampr, contains emrKY for chromosomal
This



integration
disclosure


pINT2-mdtBC
Ampr, contains mdtBC for chromosomal
This



integration
disclosure


PINT2-macAB
Ampr, contains macAB for chromosomal
This



integration
disclosure


pINT2-emrAB
Ampr, contains emrAB for chromosomal
This



integration
disclosure


PINT2-mexCD
Ampr, contains mexCD from P. aeruginosa
This



PAO1 for chromosomal integration
disclosure


pGDP2
KanR, low-copy number plasmid that enables
Cox, G. et



constitutive expression from PLacl constitutive
al. (2017)



promoter. Genes of interest are ligated into the



MCS, downstream of a Kanr resistance



cassette


pGDP2-emrE
KanR, low-copy number plasmid contains emrE
This



for constitutive expression
disclosure









Generation of an Efflux Deficient Strain

Generation of EKO-35 was achieved using a combination of the λ-Red recombinase system (Datsenko, K. A. & Wanner, B. L., 2000) and CRISPR-Cas9 counter-selection (Jiang, Y. et al., 2015). The efflux genes were inactivated in the order denoted in Table 3. All PCR reactions and restriction enzyme digests were prepared according to manufacturers' guidelines. Amplicons were purified using a GeneJET PCR purification kit (Thermo Fisher Scientific) according to manufacturer's guidelines. The 2×GB-AMP™ high-fidelity PaCeR™ polymerase Master Mix (GeneBio Systems Inc) and Taq 2× polymerase Master Mix (FroggaBio) were used according to the manufacturer's suggested guidelines.


For λ-Red recombineering, electrocompetent cells of the mutant strain of interest were transformed with 50 ng of pKD46 (Datsenko, K. A. & Wanner, B. L., 2003). A broth culture was grown to the mid exponential phase (OD600 nm˜0.5) in the presence of 2 mM arabinose and ampicillin to induce recombinase expression. Utilizing the PaCeR™ high-fidelity polymerase, and primers annealing 50 base pairs (bp) upstream and downstream of the gene of interest (Table 4), kanamycin resistance cassettes were amplified from the respective Keio strain. Amplicon size (1500 bp) was verified via gel electrophoresis and the remaining PCR product was purified. Recombinase induced electrocompetent cells were transformed with 250 ng of each amplicon (Bio-Rad MicroPulser, Ec1 setting, 1 mm electroporation cuvette (Fisher)). The cells were recovered and grown overnight on selective agar (LB with kanamycin) to identify gene disruptions. Successful gene knockouts were transformed with pCP20 (Table 2 “Strains and Plasmid)). A single colony was then inoculated into 3 mL of LB containing ampicillin and incubated at 30° C. to induce removal of the resistance cassette. Cassette removal was confirmed using PCR and primers annealing 250 bp upstream and downstream of the gene of interest (Table 4). Amplicon size (500 bp) for successful cassette removal was verified via gel electrophoresis. Efflux genes inactivated using the λ-Red recombinase system are indicated in Table 3.


For CRISPR-Cas9-mediated counterselection, the methodology described by Jiang et al. was modified for high-throughput screening of mutants (Jiang, Y. et al., 2015). CRISPR guide software (Benchling) was employed for selection of appropriate N20 sequences. pTargetF was modified via PCR to introduce an N20 for the gene of interest (Table 4). Amplicon size (2100 bp) was verified via gel electrophoresis, and the remaining PCR product was purified. To enable rapid screening of positive mutants and to disrupt the target gene, ssDNA repair oligos (˜100 bp in length) were designed to contain an AseI restriction site and three tandem stop codons (Table 4). All ssDNA repair oligos were purchased through Integrated DNA Technologies (IDT). Electrocompetent cells of the mutant strain of interest were transformed with 50 ng of pCas. A broth culture of each strain was grown to the mid exponential phase (OD600 nm˜0.5) in the presence of kanamycin and 10 mM arabinose to induce recombinase expression. To recombinase induced electrocompetent cells, 100 ng of pTargetF that was modified to contain the desired N20 sequence, and 2000 ng of repair ssDNA targeting the gene of interest were electroporated (Bio-Rad MicroPulser, Ec1 setting, 1 mm electroporation cuvette (Fisher)). The cultures were recovered in LB at 30° C. and propagated on selective agar (LB with kanamycin and spectinomycin) to identify successful gene disruptions. For high-throughput screening of colonies, Taq polymerase was used with primers annealing to the target region of each gene (Table 4). The amplicons were digested with AseI and successfully inactivated genes were identified via gel electrophoresis by digestion relative to a wild-type negative control. Insertion of the three tandem stop codons into the gene of interest was verified using Sanger sequencing at the Advanced Analysis Centre (AAC) (University of Guelph). Genes disrupted using CRISPR-Cas9-mediated counter selection are indicated in Table 3.









TABLE 3







Gene inactivation during the generation of EKO-35. For genes


inactivated using CRISPR-Cas9 mediated counter selection,


the location of the inserted stop codons are noted.













Gene

Stop Codon




Size

Placement



Gene
(bp)
KO Method
(bp)
















acrB
3150
λ-Red
N/A



acrD
3114
λ-Red
N/A



acrF
3105
λ-Red
N/A



mdtF
3114
λ-Red
N/A



macB
1947
λ-Red
N/A



emrB
1539
λ-Red
N/A



mdtL
1176
λ-Red
N/A



mdtK
1374
λ-Red
N/A



bcr
1191
λ-Red
N/A



ydeA
1191
λ-Red
N/A



mdtM
1233
λ-Red
N/A



yddA
1686
λ-Red
N/A



yebQ
1374
λ-Red
N/A



emrE
333
CRISPR-Cas9
93



mdtD
1416
CRISPR-Cas9
26



sugE
318
CRISPR-Cas9
93



ynfM
1254
CRISPR-Cas9
115



emrD
1185
CRISPR-Cas9
206



ydeF
1188
CRISPR-Cas9
43



mdtJ
366
CRISPR-Cas9
98



ydiM
1215
CRISPR-Cas9
124



mdtB
3123
CRISPR-Cas9
160



mdlA
1773
CRISPR-Cas9
69



emrY
1539
CRISPR-Cas9
41



mdfA
1233
CRISPR-Cas9
116



fsr
1221
CRISPR-Cas9
242



mdtG
1227
CRISPR-Cas9
276



mdtH
1209
CRISPR-Cas9
136



yieO
1428
CRISPR-Cas9
177



mdlB
1782
CRISPR-Cas9
72



mdtO
2052
CRISPR-Cas9
75



yojH*
1647
CRISPR-Cas9
187



yojI
1644
CRISPR-Cas9
25



yajR
1365
CRISPR-Cas9
47



ydhC
1212
CRISPR-Cas9
90



cusA
3144
CRISPR-Cas9
400







*YojH was repaired due to lack of supporting evidence of efflux pump activity.













TABLE 4







Primers and oligonucleotides used in this Example.











SEQ ID


Primer
Sequence (5′-3′)
NO:





AcrB Seq Up
CTGAAACAAGAGAACGGCAAAGGC
 1





AcrB Seq
CTTACTGACCTGGACTTGCCCTCTCG
 2


Low







AcrD 50 Up
CGCTACAGTGAAGCAAGTCAAGC
 3





AcrD 50 Low
CCGCTGAGCAGGTTCTTAATCG
 4





AcrD Seq Up
CGCTGACTTTTTCACAACCTTCCG
 5





AcrD Seq
GTCCCCCGGAGGTAGTCATCGCAGC
 6


Low







AcrF 50 Up
GGTTAAAGCCACTACCGATACCCC
 7





AcrF 50 Low
GAAGGGAGCGGGAACTATAGAAAGC
 8





AcrF Seq Up
GAGGCTGAAGCAATCCGTAGAGC
 9





AcrD Seq
GATACTGTATCGTTAAAAAGAGCGCG
10


Low







MdtF KO Up
GCACGAGCAATTTCCTCCAGCCAGG
11





MdtF KO
GGTTGTTGAGTGGTGAATGGTTAGC
12


Low







MdtF 200 Up
GATGTCGTGCAGCTACGCGAAAT
13





MdtF 200
ACGAATGGCTGGAGTGGTTTC
14


Low







MacB KO Up
CGATACCGATGTTGAGATTGTCAAAGG
15





MacB KO
GCATAGCTCTTCTGTCTCATTGTGTAC
16


Low







MacB 200 Up
ATGTGCTGACGATCCCTCTGTC
17





MacB 200
TTCGCTCATTATTCCACCATTCAG
18


Low







EmrB KO Up
GGCACCTGTCAATAAACTGATCG
19





EmrB KO
GCACATCTAGTCAGTAAACTATCTTCAC
20


Low







EmrB 200 Up
CGTTCAGCGTCTGCCTGTGCG
21





EmrB 200
GCGGCAATGGAAGACGTGCTG
22


Low







MdtL KO Up
GGCAACTCGCCTGATCCTCCTTC
23





MdtL KO
ATCCGCTTCGCCGCTTTGGTTAC
24


Low







MdtL 200 Up
CATTCTCTTTGGTATAACCGTG
25





MdtL 200
TTTGCTCCATGCTGACCAT
26


Low







MdtK KO Up
TTCACTGGAGAATTAATAAATCC
27





MdtK KO
GACGGGATTGGCGCAACGCTCC
28


Low







MdtK 200 Up
GAAATCAGTTAAGACATTCTGTTC
29





MdtK 200
CATGTGCAACTGAAAGTGAAAC
30


Low







Bcr KO Up
GGAATGATAGATTTGTGGTTGAC
31





Bcr KO Low
CGGTGAATATCGTCCGTTAACTG
32





Bcr 200 Up
CCTCTATGGCTCTGATTTAAGTA
33





Bcr 200 Low
GTTATCATCAGGTGAAACGCAT
34





YdeA KO Up
GAAAGAATCAGCGTCAGAGAAA
35





YdeA KO
ATTAACGGCATCCTGGAAATC
36


Low







YdeA 200 Up
CACGAAGACCCTGGTGAAA
37





YdeA 200
CGCCGCCGCTGATCTTT
38


Low







MdtM KO Up
GCCCTTCTCACCTGCCT
39





MdtM KO
GCGTAACGACAAAGGTAGCAG
40


Low







MdtM 250 Up
CAGCGTAACGACAAAGGTAGCAG
41





MdtM 200
ACCACCGCAAACCAGTC
42


Low







YddA KO Up
CATCAGTAAATCATTGCCATAG
43





YddA KO
GACGCCAGGAATAAGAAC
44


Low







YddA 250 Up
TGTCGGGTGTTTCGTCAT
45





YddA 250
TCGCTGATATTGCCATTC
46


Low







YebQ KO Up
TAGTTACAATTCTGCGACATCC
47





YebQ KO
CGCTCAGTGAGTTTGTTCAT
48


Low







YebQ 200 Up
CACGGAAGATACAGAATCAGG
49





YebQ 200
CAGCTATGAACCGCAAGAA
50


Low







EmrE N20 Up
AGTTTTCAGAAGGTTTTACAGTTTTAGAGCTAGAAATAGCA
51




AG







EmrE N20
TGTAAAACCTTCTGAAAACTACTAGTATTATACCTAGGACT
52


Low

GAG







EmrE ssDNA
ATA ACA AAT AAT TGT ACC AAC AGA TGG CCA
53


Repair
TAA TTA TTA TTA ATT TGT AAA ACC TTC TGA




AAA CTT CAT TAA GGT TGT ACC AAT GAC CTT




TAT TAT TAC TGC






EmrE 200 Up
CGGTTCGCTACCAGAGAAGAATG
54





EmrE 200
CATGGTGACACCTGCTAACGTATGC
55


Low







MdtD N20 Up
CCACAATCCACAATTGCCAAGTTTTAGAGCTAGAAATAGCA
56



AG






MdtD N20
TTGGCAATTGTGGATTGTGGACTAGTATTATACCTAGGACT
57


Low

GAG







MdtD ssDNA
TG TCC AGC GAC TGC ATA AAG AAG CCG AAA GCC
58


Repair
ACA ATC CAC AAT TGC CAA TTA TTA TTA ATT




GGT GCT GTC GGG AAG ATC TGT CAT TTA CTC




GGT TAC CGT TTG TTT AGG TT






MdtD 200 Up
CGCCCGATTATGATGACTAC
59





MdtD 200
CTGAAAGACAAAGCGATCATTG
60


Low







SugE N20 Up
CGTCAAACGACTAAAGCCGTGTTTTAGAGCTAGAAATAGCA
61




AG







SugE N20
CGTCAAACGACTAAAGCCGTACTAGTATTATACCTAGGACT
62


Low

GAG







SugE ssDNA
GAC AAT CAT CGC CGT CAC AGT AAT AAC ACT
63


Repair
CGG CGT CAA ACG ACT AAA GCC GTG TTA TTA





TTA ATT ATA TTT CAG GCC AAC GGC CCA TAC





CAC TTC CAG CAG ACC AGC AAT AAC TAA GAT






SugE 200 Up
CGCAGCAACGAAAGCGCA
64





YnfM N20 Up
TCCGGCAGAGAACAGCGCCAGTTTTAGAGCTAGAAATAGCA
65




AG







YnfM N20
TGGCGCTGTTCTCTGCCGGAACTAGTATTATACCTAGGACT
66


Low

GAG







YnfM ssDNA
CTG CAC ACA ATA GAG AAG TGC AAA TGT TGC
67


Repair
CAG TCC GGC AGA GAA CAG CGC CAG TTA TTA





TTA ATT GAC GCG CAT AAA TTG CGG CGT ACC





GCG TTT AAT AAA TTG ATT TGG CTG AGA AAT






YnfM 200 Up
GTTGCGAAATATTCAGGC
68





YnfM 200
AAAGCAGTAGAATAACTGC
69


Low







EmrD N20
TCACCGGTCGGCGGCCCACGGTTTTAGAGCTAGAAATAGCA
70


Up

AG







EmrD N20
CGTGGGCCGCCGACCGGTGAACTAGTATTATACCTAGGACT
71


Low

GAG







EmrD ssDNA
CGT TGC CAG CAT AAA AAT GGA CAT TCC GAC
72


Repair
GAG GAT CAC CGG TCG GCG GCC CAC GCG TTA




TTA TTA ATT GGA AAT CGG GCC ATA AAA CAG




CTG TGA GAC ACC GTA AGT CAG CAG ATA AGC




GCC






EmrD 200 Up
CGATGCTGACGCATCTTATCCGCCC
73





EmrD 200
GGTGCGGGCAGATATCAGTCGTATC
74


Low







YdeF N20 Up
GATGGTTAATAACAACGACGGTTTTAGAGCTAGAAATAGCA
75




AG







YdeF N20
CGTCGTTGTTATTAACCATCACTAGTATTATACCTAGGACT
76


Low

GAG







YdeF ssDNA
AAT GGT CAT AAA TGG CAG CGT AGC GCC GCG
77


Repair
TCC GAT GGT TAA TAA CAA CGA CGA TTA TTA





TTA ATT AAG AAG GGC GCT GGT AGA GCG TCG





TAG GGA TAA GTT CAT






YdeF 250 Up
CTGATGGTTAATCCATACCCCAGC
78





YdeF Check
GATGCTCTGCATTACCAACAGCGTG
79


Internal







MdtJ N20 Up
AGCGTCAGTGAGGGAAATGGGTTTTAGAGCTAGAAATAGCA
80




AG







MdtJ N20
CCATTTCCCTCACTGACGCTACTAGTATTATACCTAGGACT
81


Low

GAG







MdtJ ssDNA
CGA CAG AGA AAT CAT CAC CAG CAT TAA AAT
82


Repair
AAA TTA TTA TTA ATT GCC ATT TCC CTC ACT




GAC GCT CGC CCA TTT CAT TGA CAG CGT ACC




GGT






MdtJ 200 Up
CAATGCATAAGCGACAGACAAGTCG
83





MdtJ 200
CATCCGCGATGACGAGAAGCAACAC
84


Low







YdiM N20 Up
GATAACTATCGAGACACCCGGTTTTAGAGCTAGAAATAGCA
85




AG







YdiM N20 Up
CGGGTGTCTCGATAGTTATCACTAGTATTATACCTAGGACT
86




GAG







YdiM ssDNA
CAA GAC ACT TAA TCG ACC AAT GCC CAG CGA
87


Repair
TGA GAT AAC TAT CGA GAC ACC CGC TTA TTA





TTA ATT ATT AGT CTG CCA AAG TGT CTC CAG





CGA GGC CAT ATT CAG






YdiM Check
CAAGTGTGCCATTCCTGATCGTG
88


Up







YdiM Check
GAACCCACGGTGTAGATACTGAG
89


Up







MdtB N20 Up
GTAGAGCGTGACCACCTGAAGTTTTAGAGCTAGAAATAGCA
90




AG







MdtB N20
TTCAGGTGGTCACGCTCTACACTAGTATTATACCTAGGACT
91


Low

GAG







MdtB ssDNA
AAC GGC AGA GGT CAT GAC ATC CGG GCT GGC
92


Repair
ACC TGG GTA GAG CGT GAC CAC CTG AAT TTA





TTA TTA ATT CGG ATA GTC CAC TTC CGG CAG





CGC CGA AAC GGG CAG






MdtB 200 Up
GTCAGAAAGTGGTGATCCGTGCAG
93





MdtB Check
GATCGCTCGGCAACAAGTTGGTCG
94


Low







MdIA N20 Up
CATCGCGATAATGACAAGCAGTTTTAGAGCTAGAAATAGCA
95




AG







MdIA N20
GCTTGTCATTATCGCGATGACTAGTATTATACCTAGGACTG
96


Low

AGT







MdIA ssDNA
ACC AAC CAC TTT TGG CGG AAC CAG TTG CAG
97


Repair
CAT CGC GAT AAT GAC AAG CAA TTA TTA TTA





ATT GAC AGC CCC GAG ATA GCG ACG CCA TTC





CCG ACG GAA ATA CCA GCT






MdIA 300 Up
GTCACGGTGGTTACCGAAATGCCAG
98





MdIA Check
GCGTTAAACTGCCCTGCACCAC
99


Internal







EmrY N20 Up
ACTCCGGCACCATTAACCGGGTTTTAGAGCTAGAAATAGCA
100




AG







EmrY N20
CCGGTTAATGGTGCCGGAGTACTAGTATTATACCTAGGACT
101


Low

GAG







EmrY ssDNA
TTG CAT AAA TGT CGC TAA TGA CAA TGC AAT
102


Repair
AGT GAC GCA CCA TAA CGT TTA TTA TTA ATT




ACC GGT TAA TGG TGC CGG AGT TGA TTT AGT




GAT TGC CAT






EmrY 200 Up
AGCGCAGAACAACTGCGTAATA
103





EmrY 200
GTACGGGTTGAAGTTTCTCTTG
104


Low







MdfA N20 Up
GGCAACGATATGATTCAACCGTTTTAGAGCTAGAAATAGCA
105




AG







MdfA N20
GGTTGAATCATATCGTTGCCACTAGTATTATACCTAGGACT
106


Low

GAG







MdfA ssDNA
AAT GCC CGC CTG ATA TTG TTC CAC CAC GGC
107


Repair
CAA CAT TTA TTA TTA ATT GGG TTG AAT CAT




ATC GTT GCC GAT ATA GGT TGA AAA TTC GTA




AAG CAC CAG ACA






MdfA_200_U
ATCGTCTTATTTCCCTCAAGC
108


p







MdfA_200_L
ATGTGCCGAGTGGATACAAAGT
109


OW







Fsr N20 Up
TCGCTACTGCAACCAGTGGTGTTTTAGAGCTAGAAATAGCA
110




AG







Fsr N20 Up
ACCACTGGTTGCAGTAGCGAACTAGTATTATACCTAGGACT
111




GAG







Fsr ssDNA
CGA CCA TGG CAT CGG ATA TTT ATC GGT CCA
112


Repair
GTA TTA TTA TTA ATT GAC CAC TGG TTG CAG




TAG CGA AGA GGC GAG CTG GAA GGT GAG GGT




TAT CAT GCC AAT CTG






Fsr Check
GGTTAACAGCGCTAACGCCACG
113


Up







Fsr Check
GTGGCGTGATGCATTCCGTCTC
114


Low







MdtG N20 Up
ATGCTATTACGCTCTGCCCTGTTTTAGAGCTAGAAATAGCA
115




AG







MdtG N20
AGGGCAGAGCGTAATAGCATACTAGTATTATACCTAGGACT
116


Low

GAG







MdtG ssDNA
GAT ATT TTG TGC CAG CCC CAT CAA CAC CAT
117


Repair
CAC GAT GCC CAT TTA TTA TTA ATT GAG GGC




AGA GCG TAA TAG CAT GAG TTT TCG GCC TTT




ACG GTC GGC GAG TCC ACC CCA AAA CGG






MdtG Check
GGCATTGAACTGTTGCACATTCGC
118


Up







MdtG Check
CATGATGGCACCAGAGCAGTATATG
119


Low







MdtH N20 Up
GAGAGCAATACCGACCATGAGTTTTAGAGCTAGAAATAGCA
120




AG







MdtH N20
TCATGGTCGGTATTGCTCTCACTAGTATTATACCTAGGACT
121


Low

GAG







MdtH ssDNA
GAA AAT ACC CAG ACC TTG CTG AAT AAA TTG
122


Repair
GCG TAG ACC GAG AGC AAT ACC GAC CAT GAC




TTA TTA TTA ATT GGC CCA GCC CAT TTG ATC




AAC GAA GCG GAT AGA






MdtH Check
GCGTCGTCGTTGAGCAGAACATG
123


Up







MdtH Check
GTCGGTCTGTGGTTAAGCGCAC
124


Low







YieO N20 Up
CATCAGTTATACGCTGACGGGTTTTAGAGCTAGAAATAGCA
125




AG







YieO N20
CCGTCAGCGTATAACTGATGACTAGTATTATACCTAGGACT
126


Low

GAG







YieO ssDNA
GCG ATC GGC TAG CCA TCC GCT TAC CGG AAT
127


Repair
AAG CAT TTA TTA TTA ATT CAC CGT CAG CGT




ATA ACT GAT GAT GGC TGA TTG CAT CGC GAG




AGG AGA ACG ATT AAG






YieO Check
CGTCAATTACCAGCGACACAGTG
128


Up







YieO Check
CGTGCATGGAGAATATAGAGAAGC
129


Internal







MdIB N20 Up
ATCAGGACCGCAATCCCCAGGTTTTAGAGCTAGAAATAGCA
130




AG







MdIB N20
CTGGGGATTGCGGTCCTGATACTAGTATTATACCTAGGACT
131


Low

GAG







MdIB ssDNA
ACT GAC TTC TGC CGC CGC CGC AAC CCA CAT
132


Repair
CAT CAG GAC CGC AAT CCC CAG TTA TTA TTA





ATT TTT ACG CCA CGG CGA ACC GTA CGC TAA





CAG GCG CTT GAG AGT






MdIB Check
CTTGATGATGCGCTTTCGGCGGTG
133


Up







MdIB Check
CGCCATATAGTGTGAACGACTGGCC
134


Internal







MdtO N20 Up
TTCATGAAGAGTTAAGCGAGGTTTTAGAGCTAGAAATAGCA
135




AG







MdtO N20
CTCGCTTAACTCTTCATGAAACTAGTATTATACCTAGGACT
136


Low

GAG







MdtO
GAG TTG CAC GGT CTG CGG CAC GCG ACC TGG
137


SSDNA
TCG TTA TTA TTA ATT CTC GCT TAA CTC TTC



Repair
ATG AAA GAA CGC CAG CAG CCT GAC CAC CGG




TAA TGG CAG GGA GTT






MdtO Check
CGTAGCGCATATAGTCTGGATTGG
138


Internal







MdtO Check
GAGGGTAAAGTGGATTCGATTGGC
139


Up







YojH N20 Up
TGAATGGTCGATGACCATGGGTTTTAGAGCTAGAAATAGCA
140




AG







YojH N20
CCATGGTCATCGACCATTCAACTAGTATTATACCTAGGACT
141


Low

GAG







YojH ssDNA
GCC GTT CGA ACT CTC CTG CGC GAC ACC CTC
142


Repair
CAG GCG TTA TTA TTA ATT CAC CAT GGT CAT




CGA CCA TTC AGG CTC CAG CTC GCG TAA ATA




GGT CCC CAA CGT






YojH Check
CACTGACGACTTCAGTACCCAGACG
143


Internal







YojH Check
CTTAAGTGTTACCGTTGATGCCGC
144


Up







YojI N20 Up
AACTTCTTGTACTTGTCTGGGTTTTAGAGCTAGAAATAGCA
145




AG







YojI N20 Low
GCCAGACAAGTACAAGAAGTTACTAGTATTATACCTAGGAC
146




TGAG







YojI ssDNA
TAG CGC CAT CAC ACT GAT AAA TGG CCA GCG
147


Repair
ATA CTG TTA TTA TTA ATT CCA GAC AAG TAC




AAG AAG TTC CAT GCA GAA AAC CCG GAC AAT




GAA TTA CAG CCC GCA GTT






YojI Check
GTCGCGGCAACGTTGGTATCAG
148


Internal







YojI Check
GCTGCATCAGGATAAAGACGAACCG
149


Up







YajR N20 Up
GGTGAGAGGCGCGCGACCTGGTTTTAGAGCTAGAAATAGCA
150




AG







YajR N20
CAGGTCGCGCGCCTCTCACCACTAGTATTATACCTAGGACT
151


Low

GAG







YajR ssDNA
GCC CAG CAT GCG CAA CGA GAA TAC GGT CCC
152


Repair
TTA TTA TTA ATT CCA GGT CGC GCG CCT CTC




ACC TGG CGT CAT TTT ATA ATC GTT cat TAC




CAC CTC TGT TTT AAA TTC






YajR Check
GTTGCTGATGACAGAATCTGGGCGC
153


Up







YajR Check
CCATTCCGGACTCACGATTAAGTACG
154


Internal







YdhC N20 Up
TTGCAGGTCGGCCTGTATGGGTTTTAGAGCTAGAAATAGCA
155




AG







YdhC N20
CCATACAGGCCGACCTGCAAACTAGTATTATACCTAGGACT
156


Low

GAG







YdhC
AAG GAA CAG ACT AAG GCT GGC ACT GAC AGC
157


SSDNA
AGA



Repair
CGC AGG CGT TTG CAG GTC GGC CTG TAT GGC




TTA TTA TTA ATT GAA AGC AGG CAG ATA CAT




ATC GGT TGC CAG AAA






YdhC Check
CACATCACGGTGCCGTCGTTCAAAG
158


Up







YdhC Check
CCGGTTTACGACCATAACGGTCGG
159


Internal







CusA N20 Up
ATAGATCCAGCCAACACCCGGTTTTAGAGCTAGAAATAGCA
160




AG







CusA N20
CGGGTGTTGGCTGGATCTATACTAGTATTATACCTAGGACT
161


Low

GAG







CusA ssDNA
CAG ATC GTG CTT ACC GCT GCG ATC CAC CAG
162


Repair
TGC ATA TTC ATA GAT CCA GCC AAC ACC CGT




TTA TTA TTA ATT ATC TGG CCC CAG CTC GGC




GCT GAC TCC






CusA 200 Up
GGTGATTACCGTTGATGCCGAC
163





CusA Check
GAGAAACCAGTCCTGTAATGAGCG
164


Internal







fhuA 40 Up
TGTCACATGGAGTTGGCAGG
165





glmS 3680
CTTACCATGTCGCGCTGATC
166


Low







pstS 520 Up
CAGGTAGCTGGTGAAGACGAAG
167





F1B
CAGGCGCTTTTCGTAATTCATC
168





F4B
CCCACCATTCAGAGAAGAAACC
169





F1C
CCATCAAAAAACCAGGCTTGAG
170





F4C
GCATTCTGTAACAAAGCGGGAC
171





pLac-Fwd
GCTCAACGGCCTCAACCTAC
172





pINT-Rev
CCAACTCAGCTTCCTTTCGG
173





PolB-Fwd
CAGTTCGAAATCAAGCGAGGAG
174





AcrB Ndel
GGAATTCCATATGAACAAAAACAGAGGGTTTACG
175


Up







AcrB XhoI
CCGCTCGAGTCAATGATGATCGACAGTATG
176


Low







AcrBD408A
CCTGTTGGTGGATGCCGCCATCGTTGT-
177


Fwd







AcrBD408A
CCACAACGATGGCGGCATCCACCAACAGG
178


Rev







AcrD Ndel
GCTCATATGGCGAATTTCTTTATTGATCG
179


Up







AcrD XhoI
TATCTCGAGTTATTCCGGGCGCGGCTTCA
180


Low







AcrE Ndel
GGAATTCCATATGACGAAACATGCCAGGTTTTTCC
181


Up







AcrF XhoI
CCGCTCGAGTTATCCTTTAAAGCAACGGCG
182


Low







EmrA Ndel
GGAATTCCATATGAGCGCAAATGCGGAGAC
183


Up







EmrB XhoI
CCGCTCGAGTTAGTGCGCACCGCCTC
184


Low







EmrK NdeI
GGAATTCCATATGGAACAGATTAATTCAAATAAAAAACATT
185


Up
C






EmrY BamHI
CCGGGATCCTCACCCAACGCCTTTCGCT
186


Low







MdtE Ndel
GACCATATGAACAGAAGAAGAAAGCT
187


Up







MdtF XhoI
ATACTCGAGTTACGCTTTTTTAAAGCGG
188


Low







MdtB Ndel
GTCCATATGCAGGTGTTACCCCCGAGCAGC
189


Up







MdtC XhoI
GTTCTCGAGTTACTCGGTTACCGTTTGTTTAG
190


Low







MacA Ndel
GGAATTCCATATGAAAAAGCGGAAAACCG
191


Up







MacB XhoI
CCGCTCGAGTTACTCTCGTGCCAGAGC
192


Low







EmrE Ndel
GTACCATATGAACCCTTATATTTATC
193


Up







EmrE XhoI
GTACCTCGAGTTAATGTGGTGTGCTTCG
194


Low







MdtK Ndel
GTCCATATGGTGCAGAAGTATATCAGTGAAG
195


Up







MdtK XhoI
GTCCTCGAGTTAGCGGGATGCTCGTTGCAG
196


Low







MexC Ndel
GGAATTCCATATGGCTGATTTGCGTGCAATA
197


Up







MexD HindIII
CTATAAGCTTTCACTCCCCGGCCGAA
198


Low









Whole Genome Sequencing of EKO-35 and EKO-35-Pore

Genomic DNA was extracted using the One-4-All Genomic DNA Miniprep Kit (BioBasic), according to the manufacturer's guidelines. Quality of the extracted gDNA was assessed using gel electrophoresis. Illumina DNA library preparation was performed using an Illumina Nextera kit by the Microbial Genome Sequencing Center (Pennsylvania, USA), which was followed by Illumina sequencing on a NextSeq 2000 platform. Analysis of the raw reads was performed using Geneious Prime 2021.0.2 (Kearse, M. et al., 2012). Low quality reads were trimmed using an in-suite BBDuk plug-in. Raw wild-type reads were assembled to an NCBI reference genome (Accession No. CP009273.1) with bowtie2. The resulting assembly was used as a reference to assemble the EKO-35 mutant reads. Differences between the wild-type BW25113 and EKO-35 strains were identified by searching for single nucleotide polymorphisms (SNPs) and deletions using the following thresholds: minimum variant frequency of 0.75, maximum variant P-value of 10−6, and minimum variant P-value of 10−5. 11 mutations were identified, including a mutation in hdfR (T806C, L269P). CRISPR-Cas9-mediated counter selection was utilized to repair the mutation in hdfR, which introduced two intentional silent mutations (hdfR C722G and A838G) to remove the adjacent PAM site and AseI-guided screening purposes as described above. For the EKO-35-Pore strain, genomic DNA extraction, sequencing, analysis, genome assembly, and mutation identification was performed as described above. Whole genome sequencing was deposited in the GenBank database (BioProject ID PRJNA838981).


Construction of the pINT2 Efflux Gene Library


Inventors first attempted to generate marker less integrations of efflux-encoding genes into araC using the pINT1 plasmid (Cox, G. et al., 2022), under the constitutive control of the strong PBIa promoter. However, inventors observed numerous deleterious mutations following ligation into this vector and genomic integration, indicating high expression levels were not feasible. Consequently, the pINT2 plasmid was selected for the expression of efflux pump encoding genes from the same constitutive PLacI promoter. This plasmid enables single-copy genomic integration of a selected gene through integration into the nonessential araC gene within the arabinose operon (Cox, G. et al., 2022). All E. coli genes were amplified from E. coli BW25113 genomic DNA, and mexCD was amplified from P. aeruginosa PAO1, using a high-fidelity polymerase, followed by ligation into pINT2. Successful clones were verified using PCR (Primers: pLac-Fwd/pINT-Rev, Table 4) and confirmed via Sanger sequencing at The Centre for Applied Genomics (TCAG) (The Hospital for Sick Children) and the AAC (University of Guelph). For the interplay studies, this process was repeated using the pGDP2 plasmid (Cox, G. et al., 2022).


Construction of the Efflux Platform

For genomic integration, genes of interest and the adjacent kanamycin resistance cassette were amplified from pINT2 using a high-fidelity polymerase and the F1B-Fwd/F4B-Rev or F1C-Fwd/F4C-Rev primers (Table 4). For the integration of efflux pump-encoding genes, electrocompetent EKO-35 cells were transformed with ng of pKD46. Electrocompetent recombinase-induced cells were transformed with 500 ng of each amplicon (BioRad MicroPulser, Ec1 setting, 1 mm electroporation cuvette (Fisher). Genomic integrations were verified via PCR (Primers: PolB-Fwd/pINT-Rev, Table 4). Successful integrations were transformed with pCP20 to remove the kanamycin resistance cassette. Prior to phenotypic profiling, all integrated genes, including their promoters, were verified using Sanger sequencing (TCAG, The Hospital for Sick Children).


For genomic integration of the pore, the fhuA ΔC/Δ4L gene and the adjacent gentamicin resistance cassette were amplified using a high-fidelity polymerase and the fhuA_40_Up/gImS_3680_Low primers (Table 4). Integration of the pore gene was performed as described above. The pore gene was introduced into the intergenic region between the glmS and pstS genes, with gene expression under the control of a constitutive promoter (Kearse, M. et al., 2012). Genomic integrations were verified using PCR (Primers: pstS_520_Up/glmS_3680_Low, Table 4). Successful integrations were transformed with pCP20 to remove the gentamicin resistance cassette as previously described. Activity of the pore was confirmed through susceptibility testing with the large antibiotic vancomycin prior to phenotypic profiling and further susceptibility testing.


Assessing the Utility of the EKO-35 Efflux Platform

To enable comparison between efflux production in different genetic backgrounds, each efflux pump-encoding gene was also integrated into the genome of the wild-type BW25113 strain, the single gene deletion mutant from the Keio Collection, and EKO-35. Strains of interest were propagated on LB agar at 37° C. Cell inoculum was prepared using the colony resuspension method and applied to a 96-well well plate (VWR) in technical duplicate, and the minimum inhibitory concentrations were determined according to Clinical & Laboratory Standards Institute (CLSI) protocols in MHB II (Patel J. B. et al, 2015). The plates were incubated for 18 h (Multitron Shaker, Infors HT) at 37° C. with aeration at 900 rpm. The plates were equilibrated to room temperature before the OD600 nm was measured using a BioTek Synergy H1 microplate reader. For interplay profiling, blank subtracted OD600 nm values >0.1 were considered to represent growth.


Phenotypic Profiling of EKO-35

For growth profiling in nutrient-rich conditions, strains were propagated on LB agar for 18 h at 37° C. Single colonies were inoculated into LB and grown at 37° C. until the mid-exponential phase (OD600 nm˜0.6) was reached. All strains were assessed with at least three biological replicates. The cultures were standardized to an OD600 nm˜0.1 in sterile 0.85% saline (w/v). Standardized cultures were diluted 1/200 into LB and 100 μL of the resulting dilution were applied to round-bottom 96-well microtiter plates (VWR). To prevent evaporation, the microtiter plates were sealed (labeling tape, Fisher Scientific). The OD600 nm was measured every 15 minutes over the course of 24 h using a BioTek Synergy H1 microplate reader. Growth was assessed at both 37° C. and 25° C.


For growth profiling in nutrient-limited conditions, strains were propagated in biological triplicate on LB agar at 37° C. Multiple single colonies were suspended, using three separately prepared inoculums per strain, in sterile 0.85% saline (w/v) to an OD600 nm˜0.1. Standardized cultures were diluted 1/200 in fresh M9 and 100 μL of the resulting dilution was applied to round-bottom 96-well microtiter plates (VWR). The plate was sealed (labeling tape, Fisher Scientific) to prevent evaporation. Growth was assessed as described above, at both 37° C. and 25° C., for 48 h.


For physiological profiling in low-oxygen conditions, strains were prepared in LB or M9 as described above. To a round-bottom 96-well microtiter plate (VWR, tissue culture treated), 100 μL of the diluted cultures were applied in triplicate. Prior to incubation, the sample plate was placed into an anaerobic jar (Oxoid™ AnaeroJar, Thermo Fisher Scientific) with an anaerobic gas generator (AnaeroPack™ Thermo Fisher Scientific) for 30 min. The plates were incubated in a BioTek Synergy H1 plate reader, equipped with an 02 gas controller. Using nitrogen gas, the oxygen levels in the plate reader were maintained at 1% (LB) and 5% (M9). Growth was assessed as described above.


To assess fitness of EKO-35 expressing wild-type copies of the genes identified to harbor nonsynonymous mutations, Inventors obtained clones from the E. coli ASKA library (Kitagawa, M. et al., 2005) with the rspA, tufA, pitA, wcaC, gyrB, and yjfC genes carried on plasmids, with gene expression under the control of an IPTG-inducible promoter. The ASKA plasmids were verified using Sanger sequencing and gene expression was induced with 0.1 mM IPTG. In the wild-type E. coli K-12 strain, the plasmids were maintained with 25 μg/mL chloramphenicol. Due to the changes in susceptibility of the efflux-deficient strains, in EKO-35 the plasmids were maintained with 4 μg/mL and 1 μg/mL chloramphenicol in Lysogeny broth and M9 minimal glucose medium, respectively.


Assessing Biofilm Formation

Overnight cultures were propagated in LB at 37° C. for 18 h. Saturated cultures were diluted 1/100 into LB or M9. To a flat-bottom 96-well microtiter plate (CoStar, untreated polystyrene), 150 uL of diluted culture was applied in triplicate. The plates were sealed to reduce evaporation and incubated statically at 37° C. for 24 h (nutrient-rich media) or 48 h (nutrient-limited media). To assess the effect of the nonsynonymous mutations on biofilm formation, this procedure was repeated with the addition of 0.1 mM IPTG for plasmid induction and chloramphenicol for plasmid maintenance at the concentrations specified above.


Following incubation, the optical density (OD600 nm) of the samples were measured using a BioTek Synergy H1 microplate reader. The cultures were aspirated, and the plates were washed in triplicate with 300 uL of deionized water using a BioTek ELx405 microtiter plate washer. Each well was stained with 175 uL of (w/v) crystal violet (CV), followed by static incubation at room temperature for 20 min. The CV was removed, and the plates were washed with deionized water until no excess stain was present. The plates were allowed to air dry before 175 uL of 0.7% acetic acid was applied to each well, followed by incubation at room temperature for min to solubilize the CV. The absorbance of each sample was measured at 595 nm using a BioTek Synergy H1 microplate reader.


Susceptibility Profiling of the EKO-35 Platform to Determine Physicochemical Substrate Profiles

EKO-35 strains containing the chromosomally integrated genes of interest were propagated on LB agar at 37° C. for 18 h. Single colonies were used to inoculate 3 mL of LB followed by incubation at 37° C. for 18 h with aeration at 220 rpm. The bacterial cells were harvested by centrifugation and resuspended in phosphate buffered saline (PBS) ([pH 7.4], 137 mM NaCl (Bioshop), 2.7 mM KCl (Bioshop), 10 mM Na2PO4 (Bioshop) and 1.8 mM K2PO4) to an OD600 nm˜1.0, followed by 1/2000 dilution into MHB II.


To a 384-well microtiter plate (Corning, untreated polystyrene), 500 nL of compound was dispensed, in duplicate, and serially titrated 2-fold using an Echo 550 acoustic liquid dispenser (Labcyte Inc.). For compounds dissolved in DMSO, the concentration of DMSO did not exceed 1% of the final well volume. As a solvent control, 500 nL of DMSO was applied to wells that contained no compound. Using a multichannel pipette, 50 μL of the prepared bacterial inoculum was applied to each well. To enable background correction post-incubation, the OD600 nm was measured (Biotek Synergy Neo2 microplate reader) prior to incubation. The plates were incubated at 37° C. with aeration at 900 rpm for 18 h. The plates were equilibrated to room temperature and the OD600 nm measured using a BioTek Synergy Neo2 microplate reader. Data was analyzed in both Prism (GraphPad, Version 9.2.0) and Microsoft Excel (Version 16.53). Raw data were input into Microsoft Excel and the pre-incubation OD600 nm measurements were subtracted from the post-incubation OD600 nm measurements. These corrected measurements were input into Prism 9 as a grouped analysis. MIC values for each compound and the corresponding strain were normalized using Prism 9, where the highest MIC value per compound represented 100%. All other MIC values were adjusted accordingly and visualized using the single-color scale grouped heat map function. Identification of compound chemical properties was achieved using DataWarrior (Version 5.5.0). Using PubChem, the SMILES chemical notation for each compound was obtained and compiled in Microsoft Excel. The resulting spreadsheet was input into DataWarrior and properties were calculated from the compound chemical structures.


Measuring PAβN and NMP Antibiotic Synergy Using the EKO-35 Efflux Platform

Synergy measurement using checkerboard analysis was performed in 96-well microtiter plates using the microdilution broth method, according to CLSI guidelines (Patel J. B., 2015). The cell inocula were prepared using the colony resuspension method. The minimum inhibitory concentrations (MICs) were defined as the lowest concentration that provided no growth, as determined by measurement of the OD600nm using a Synergy H1 microplate reader (BioTek). Susceptibility testing was performed in MHB II with a final volume of 100 μL. PAI3N (Bachem Americas) was solubilized in MHB II. When assessing PAI3N synergy, linezolid, oxacillin, fusidic acid, and erythromycin were solubilized in 100% DMSO. Ciprofloxacin and novobiocin were solubilized in distilled water. NMP, linezolid, oxacillin, fusidic acid were solubilized in 50% DMSO (v/v), and erythromycin in 50% ethanol (v/v). Ethidium bromide and ciprofloxacin were solubilized in distilled water. Solvent controls were included in each plate.


The Fractional Inhibitory Concentration Index (FICI) was used to assess the synergy of PAI3N in combination with different antibiotics. The FICI represents the ΣFIC of each drug. The FICI for each drug was calculated using the following formula: FICI=FICA+FICB=(CA/MICA)+(CB/MICB). Where MICA and MICB are the MICs of drugs A (PAI3N/NMP) and B (antibiotic) alone, and CA and CB are the MICs of the drugs in combination. The effects of PAβN or NMP in combination with antibiotics were classified as: synergistic (FICI<0.5), additive (FICI>0.5-1.0), indifferent (FICI>1.0-2.0), and antagonistic (FICI>2.0). Fold increases in resistance provided by efflux pumps were calculated by dividing the MIC values of strains expressing efflux pumps by the MIC value of EKO-35.


AcrB Western Blot Analysis

Overnight cultures of EKO-35, EKO-35 araC::acrB, and EKO-35 araC::acrBD408A were subcultured (1:100) into 200 mL LB and incubated at 37° C. with 220 rpm shaking until an optical density (OD600 nm) of 0.6 was reached. The cells were harvested by centrifugation (5,000×g) and resuspended in 100 mM Tris HCl [pH 7.0] with 150 mM NaCl. The cells were lysed by sonication and the sonicate was cleared at 4,000×g for 10 min, followed by removal of occlusion bodies at 20,000×g for 20 min. Crude membranes were isolated by ultracentrifugation at 100,000×g for 1 h. Membrane fractions were resuspended in 100 mM Tris HCl [pH 7.0] with 150 mM NaCl and 2% sodium dodecyl sulphate (SDS). Fractions were quantified using a BCA assay (Thermo Fisher). 10 μg of each sample was resolved by SDS-PAGE and transferred to Amersham™ Protran™ 0.45 μM nitrocellulose membrane (GE) for Western blot analysis using a polyclonal rabbit anti-AcrB (Hazel, A. J. et al., 2019) and an anti-Rabbit IgG(H+L) horseradish peroxidase (HRP) conjugated secondary antibody (Invitrogen). Visualization was performed using the Luminata Crescendo Western chemiluminescent HRP substrate (Millipore) and a Bio-Rad ChemiDocXRS+ system. Total protein normalization was achieved using Bio-Rad stain-free gel imaging and ImageLab (version 6.1).


Sample Preparation for Proteomic Analysis

Saturated LB overnight cultures of the wild-type and EKO-35 strains were inoculated (1/100 dilution) into 50 mL of LB until the mid-exponential phase of growth was reached (OD600 nm=0.5). 3×10 9 cells were harvested by centrifugation (4000×g), washed twice in phosphate-buffered saline (PBS), and the cell pellet was flash frozen in liquid nitrogen. Whole-cell proteome samples were generated using a modified total proteome extraction protocol (Rappsilber, J. et al., 2007). The cell pellets were stored at −80° C. until the experiment was performed. Briefly, the cell pellet was resuspended in ice cold 100 mM Tris-HCl [pH 8.5]. The cells were lysed using a probe sonicator (three cycles of 30 sec on/off, 30% amplitude) and the samples were treated with 2% SDS and 10 mM dithiothreitol (DTT). To enrich membrane proteins, bacterial membranes were isolated as escribed above. To minimize contamination with cytoplasmic proteins, the membrane pellet was washed in ice cold 100 mM Tris-HCl [pH 8.5], followed by ultracentrifugation. The membrane pellet was resuspended in 100 mM Tris-HCl [pH 8.5] with 2% SDS and 10 mM dithiothreitol (DTT). Both the whole-cell and membrane samples were heated to 95° C. prior to treatment with 55 mM iodoacetamide (IAA). The samples were then incubated with 100% acetone overnight at −20° C. Precipitated protein from both the whole-cell and membrane fractions were combined by centrifugation at 10,000×g at 4° C. and washed twice with 80% acetone. The protein pellets were then solubilized in 40 mM HEPES [pH 5.0] with 8 M urea and quantified using a bovine serum albumin (BSA) tryptophan assay. The samples were digested overnight at room temperature with LysC and trypsin proteases (Promega, protein/enzyme ratio 50:1). 10% v/v trifluoroacetic acid (TFA) was then added and 50 μm acidified peptides were purified and desalted using a STop And Go Extraction (STAGE) tip with 3 layers of C18 resin using the described protocol (Rappsilber, J. et al., 2007).


Mass Spectrometry and Bioinformatic Analysis

Dried peptides were suspended in Buffer A (2% (v/v) acetonitrile, 0.1% (v/v) trifluoroacetic acid, 0.5% (v/v) acetic acid) and 25 ng of peptides were analyzed on a Q Exactive™ HF-X hybrid quadrupole-orbitrap mass spectrometer (ThermoFisher Scientific) coupled to an EasynLC™ 1200 High-Performance Liquid Chromatography (ThermoFisher Scientific). The samples were loaded onto an in-line 75 μm×50 cm PepMap RSLC EASY-Spray column filled with 2 μm C18 reverse-phase silica beads (ThermoFisher Scientific). Peptides were separated and directly electrosprayed into the mass spectrometer using a linear gradient from 3 to 20% Buffer B (80% (v/v) acetonitrile, 0.5% (v/v) acetic acid) over 18 min, from 20 to 35% Buffer B over 31 mins, followed by a steep 2 min ramp to 100% Buffer B for 9 min in 0.1% formic acid at a constant flow of 250 nL/min. The mass spectrometer was operated in data-dependent mode, switching automatically between one fill scan and subsequent MS/MS scans of 30 most abundant peaks, with full-scans (m/z 400-1600) acquired in the Orbitrap analyzer with a resolution of 60,000 at 400 m/z.


Raw mass spectrometry files were analyzed using MaxQuant (ver. 1.6.14.0 (Cox, J. & Mann, M., 2008). The spectra were searched using the Andromeda search engine with the E. coli K-12 proteome as reference (Accession No. P000000625, accessed June 2021 with 4391 sequences). A minimum of two distinct peptides were required for protein identification and the FDR was set to 1%. The ‘match between runs’ feature of MaxQuant was enabled. Quantification was performed by label-free quantification (LFQ) using the MaxLFQ algorithm (Cox, J. et al., 2014). The mass spectrometry proteomics data have been deposited to the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PXD033975. All mass spectrometry experiments were performed in biological quadruplicate.


In nutrient-rich conditions, a total of 1,979 proteins were identified from whole cell extracts of the wild-type strain, which represented 45% of the predicted proteome. Principal component analysis (PCA) separated EKO-35 from the wild-type strain (Component 1, 40.6%), with slight variation observed between the biological replicates (Component 2, 17.2%) (FIG. 1F). In nutrient-rich conditions, biological replicate reproducibility was 96.9% and 96.6% between wild-type and EKO-35 replicates, respectively. In nutrient-limited conditions, Inventors identified a total of 2,019 proteins from whole cell extracts of the wild-type strain, which represented 46% of the predicted proteome. PCA defined significant separation between EKO-35 and the wild-type strain (Component 1, 53.2%), and biological variation (Component 2, 14%) (FIG. 2F). In nutrient-limited conditions, biological replicate reproducibility was 94.8% and 96.6% between wild-type and EKO-35 replicates, respectively. Comparative analysis was performed with proteins identified in at least three biological replicates (1,880 proteins in nutrient-rich, and 1,819 proteins in nutrient-limited).


Statistical analysis and data visualization was performed using Perseus (version 1.6.2.2) (Cox, J. & Mann, M. 2012). Further analysis was only performed on proteins present in at least three out of four biological replicates within each strain. Upon filtering, missing values were imputed from a normal distribution. Significant changes in abundance of proteins between the two proteomes were defined with a false discovery rate (FDR)-correct Student's t-test (p-value 0.05) and Benjamini-Hochberg multiple hypothesis correction testing (FDR=0.05) was applied. 1D-annotation enrichment analysis of UniProt keywords enabled global assessment of changes in protein abundance (Tyanova, S. et al., 2016) using two-sample t-tests with P-value 0.05, FDR=0.05 and score <−0.5, <0.5. Data visualization was performed using GraphPad (version 8).


Results

Generation of EKO-35: Inactivation of E. coli Drug Efflux Pumps


Inventors' first goal was to generate a simplified genetic background to overcome the challenges associated with the complexities of intact drug efflux networks. Using a combination of λ-Red recombineering and CRISPR Cas9-mediated counter selection. Inventors sequentially inactivated 36 genes encoding IM pumps from the genome of E. coli K-12 strain BW25113. Inventors started with an ΔacrB mutant from the Keio Collection, and then removed a further 12 pumps using the λ-Red system. One limitation of this approach is the possibility of unintended genomic deletions due to the introduction of adjacent Flp recognition target sites following the removal of numerous genes. Thus, the remaining genes were inactivated using CRISPR Cas9-mediated counter selection, and the introduction of three tandem stop codons into the beginning of each gene (Table 3).


The efflux genes were inactivated in the following order: ΔacrB; acrD; acrF; mdtF; macB; emrB; mdtL; mdtK; bcr; ydeA; mdtM; yddA; yebQ; emrE; mdtD; sugE; ynfM; emrD; ydeF; mdtJ; ydiM; mdtB, mdlA; emrY; mdfA; fsr; mdtG; mdtH; yieO; mdlB, mdtO, yojH, yojI, yajR, ydhC; cusA. While generating the strain, inventors identified a missense mutation (L269P) within the gene encoding the Hns-dependent flhDC regulator (HdfR), which inventors deduced was present in the acrB mutant used as the starting background of EKO-35. To ascertain whether the hdfR mutation occurred in response to loss of acrB, inventors removed acrB from the genome of the wild-type E. coli BW25113 strain using the λ-Red system. Sequencing of the hdfR gene revealed the mutation was not present (data not shown). Since HdfR is a transcriptional regulator of important physiological processes, and the mutation did not appear to be induced by loss of acrB, inventors repaired this mutation using CRISPR Cas9-mediated counter selection.


Since many of the efflux pump-encoding genes have predicted start codons and are poorly characterized, it is possible that alternative start codons located downstream from the inserted tandem stop codons (Table 3) could be utilized for a subset of the CRISPR-inactivated pumps. To investigate, inventors profiled the genome of the efflux-deficient strain, which included the inserted stop codons, using the Prodigal prokaryotic gene recognition and translation initiation site identifier. Overall, the program did not predict production of any potentially functional efflux pumps, which supports the notion that the tandem stop codons were sufficient to prematurely terminate translation, and that alternate start codons would not be utilized (Tables 26A and 26B). Indeed, Prodigal analysis of the wild-type strain's genome predicted production of all pumps (Tables 26A and 26B).


In addition, inventors also took advantage of new developments in protein structure predictions, and carefully analyzed AlphaFold-generated models of each efflux pump to ascertain whether the predicted start codons were correct based on the structural features of the proteins. Such an analysis indicated the inserted stop codons were sufficient to inactivate the different genes; however, the modeled structure of a predicted ABC efflux pump (YojH) indicated that the yojH gene does not encode an efflux pump. While yojH is located adjacent to another ABC efflux pump, YojI, which does structurally resemble an ABC transporter, the predicted YojH structure lacks the structural features of an ABC-type efflux pump, including transmembrane helices. Investigating further, inventors observed that YojH is described as malate:quinone oxidoreductase, a membrane-associated enzyme involved in the citric acid cycle/glyoxylate cycle. However, the function of this protein in E. coli is poorly described and the enzyme has not been shown to catalyze oxidation of malate in E. coli. Since the gene does not encode an efflux pump, inventors repaired the inactivated yojH gene by removing the inserted stop codons using CRISPR Cas9-mediated counter selection. This strain was subsequently designated Efflux KnockOut-35 (EKO-35), and was used for phenotypic characterization and construction of an efflux platform, as described below. The EKO-35 genome sequence confirmed successful disruption of the 35 efflux-encoding genes, including successful repair of hdfR and yojH, and also revealed ten additional secondary mutations (FIG. 6), six of which encoded missense mutations and four silent substitutions. Inventors mapped the occurrence of these missense mutations to the disruption of specific genes (Table 5 and Table 6).


Characterizing EKO-35: Phenotypic Analysis

With the intent of using EKO-35 as a simplified genetic background to study the functions of drug efflux pumps, inventors' second goal was to fully characterize EKO-35 prior to further investigations. Other efflux-deficient backgrounds (e.g., tolC mutants) display pleiotropic phenotypes, including severe growth defects in minimal M9 medium with glucose supplied as the carbon source. Indeed, tolC inactivation causes periplasmic accumulation of enterobactin in this low-iron growth medium, which underlies this conditionally essential phenotype. In addition, tolC mutants exhibit membrane stress and depletion of essential metabolites, resulting in ‘metabolic shutdown’ in minimal glucose medium. Thus, inventors were curious to ascertain whether loss of 35 IM efflux pumps also affected the fitness of E. coli.


First, inventors generated a control strain that was used as a comparator during phenotypic profiling of EKO-35. RND efflux pumps, such as AcrB, are trimeric complexes spanning the IM up to 36 times. It has been suggested that caution should be taken when interpreting phenotypes of gene deletion mutants since such phenotypes could be due to loss of integral membrane proteins, rather than loss of efflux function. Based on previous studies, inventors introduced a D408A substitution into AcrB to enable the production of an efflux inactive variant in EKO-35. Using the pINT2 plasmid, the mutated acrB gene was integrated into the arabinose operon of EKO-35 (EKO-35 araC::acrBD408A), with gene expression under the control of the constitutive PLacI promoter. Inventors confirmed the AcrBD408A protein was inactive and present at comparable levels to the wild-type protein within the membrane of EKO-35 (FIGS. 1A and 7).


Next, while the successful generation of EKO-35 showed the E. coli drug efflux system is dispensable for growth, inventors measured the growth kinetics and assessed the cellular morphology of EKO-35 under commonly used laboratory conditions: nutrient-rich (Lysogeny broth) and nutrient-limited (M9 defined minimal medium with glucose) medium at 37° C. (FIGS. 1B and 2A, Table 1). Compared to the wild-type strain, EKO-35 exhibited a 1 h extended lag phase in the nutrient-rich medium (FIG. 1B and Table 1), and phenotypic analysis revealed no significant changes in morphology (FIGS. 1C and 1E). Under nutrient-limitation at 37° C., EKO-35 entered the exponential stage of growth ˜5 h later than the parental strain, and exhibited longer cell length (FIG. 2B and Table 1). As a comparison, inventors also profiled a ΔtolC mutant from the Keio Collection, which revealed there were distinct differences between the strains under nutrient-limited conditions (FIGS. 1B and 2A). As mentioned above, loss of TolC results in severe growth defects in nutrient-limited conditions due to compounding pleiotropic effects, including the accumulation of enterobactin due to iron limitation. However, inventors reveal deletion of all IM efflux pumps, including those that form complexes with TolC, does not elicit the same fitness cost (FIG. 2A). Inventors also measured the growth kinetics of EKO-35 in a defined MOPS medium, which included supplemental iron, revealing that the ˜5 h delay in the EKO-35 lag phase was not restored (FIG. 2E).


Next, to explore whether the nonsynonymous EKO-35 mutations (Table 5 and Table 6) were compensatory, and to ascertain if they impacted any of the observed phenotypes detailed in this disclosure, inventors obtained clones from the E. coli ASKA library harboring the rspA, tufA, pitA, wcaC, gyrB, and yjfC genes on plasmids with gene expression under the control of an IPTG-inducible promoter. Growth profiling revealed pitA overexpression conferred a lethal phenotype, and the overexpression of the remaining genes induced a fitness cost in EKO-35 under nutrient-rich optimal growth conditions, indicating that the mutations could be compensatory in nature (FIG. 8A (right)). A lethal phenotype was also observed for pitA in the wild-type strain, and tufA and rspA also decreased fitness (FIGS. 8A (right), 8C (right), and 8D (right)). Under nutrient-limited conditions, pitA and rspA overexpression induced a lethal phenotype and wcaC reduced the fitness of both strains (FIGS. 8E (left), 8A (left), and 8D (left)). Finally, gyrB and yjfC marginally increased the fitness of both strains in nutrient-limited conditions (FIG. 8F (left), FIG. 8B (left)). Overall, findings of this disclosure show the nonsynonymous mutations could alleviate fitness costs induced by loss-of-efflux in EKO-35.


Characterizing EKO-35: Phenotypic Analysis

With the intent of using EKO-35 as a simplified genetic background to study the functions of drug efflux pumps, inventors' second goal was to fully characterize EKO-35 prior to further investigations. Other efflux-deficient backgrounds (e.g., tolC mutants) display pleiotropic phenotypes, including severe growth defects in minimal M9 medium with glucose supplied as the carbon source. Indeed, tolC inactivation causes periplasmic accumulation of enterobactin in this low-iron growth medium, which underlies this conditionally essential phenotype. In addition, tolC mutants exhibit membrane stress and depletion of essential metabolites, resulting in ‘metabolic shutdown’ in minimal glucose medium. Thus, inventors were curious to ascertain whether loss of 35 IM efflux pumps also affected the fitness of E. coli.


First, inventors generated a control strain that was used as a comparator during phenotypic profiling of EKO-35. RND efflux pumps, such as AcrB, are trimeric complexes spanning the IM up to 36 times. It has been suggested that caution should be taken when interpreting phenotypes of gene deletion mutants since such phenotypes could be due to loss of integral membrane proteins, rather than loss of efflux function. Based on previous studies, inventors introduced a D408A substitution into AcrB to enable the production of an efflux inactive variant in EKO-35. Using the pINT2 plasmid, the mutated acrB gene was integrated into the arabinose operon of EKO-35 (EKO-35 araC::acrBD408A), with gene expression under the control of the constitutive PLacI promoter. Inventors confirmed the AcrBD408A protein was inactive and present at comparable levels to the wild-type protein within the membrane of EKO-35 (FIGS. 1A and 7).


Next, while the successful generation of EKO-35 shows the E. coli drug efflux system is dispensable for growth, inventors measured the growth kinetics and assessed the cellular morphology of EKO-35 under commonly used laboratory conditions: nutrient-rich (Lysogeny broth) and nutrient-limited (M9 defined minimal medium with glucose) medium at 37° C. (FIGS. 1B and 2A, Table 1). Compared to the wild-type strain, EKO-35 exhibited a 1 h extended lag phase in the nutrient-rich medium (FIG. 1B and Table 1), and phenotypic analysis revealed no significant changes in morphology (FIG. 1C). Under nutrient-limitation at 37° C., EKO-35 entered the exponential stage of growth ˜5 h later than the parental strain, and exhibited longer cell length (FIG. 2B and Table 1). As a comparison, inventors also profiled a ΔtolC mutant from the Keio Collection, which revealed there were distinct differences between the strains under nutrient-limited conditions (FIGS. 1B and 2A). As mentioned above, loss of TolC results in severe growth defects in nutrient-limited conditions due to compounding pleiotropic effects, including the accumulation of enterobactin due to iron limitation. However, inventors reveal deletion of all IM efflux pumps, including those that form complexes with TolC, does not elicit the same fitness cost (FIG. 2A). Inventors also measured the growth kinetics of EKO-35 in a defined MOPS medium, which included supplemental iron, revealing that the ˜5 h delay in the EKO-35 lag phase was not restored (FIG. 2E).


Next, to explore whether the nonsynonymous EKO-35 mutations (Table and Table 6) were compensatory, and to ascertain if they impacted any of the observed phenotypes detailed in this disclosure, inventors obtained clones from the E. coli ASKA library harboring the rspA, tufA, pitA, wcaC, gyrB, and yjfC genes on plasmids with gene expression under the control of an IPTG-inducible promoter. Growth profiling revealed pitA overexpression conferred a lethal phenotype, and the overexpression of the remaining genes induced a fitness cost in EKO-35 under nutrient-rich optimal growth conditions, indicating the mutations could be compensatory in nature (FIG. 8A (left)). A lethal phenotype was also observed for pitA in the wild-type strain, and tufA and rspA also decreased fitness (FIGS. 8A (left), 8C (left), and 8E (left)). Under nutrient-limited conditions, pitA and rspA overexpression induced a lethal phenotype and wcaC reduced the fitness of both strains (FIGS. 8A (right), 8D (right), 8E (right)). Finally, gyrB and yjfC marginally increased the fitness of both strains in nutrient-limited conditions (FIGS. 8F (right) and 8B (right)). Overall, findings from this disclosure show that the nonsynonymous mutations could alleviate fitness costs induced by loss-of-efflux in EKO-35.


Characterizing EKO-35: Quantitative Proteomic Profiling

To further characterize EKO-35, and to gain fundamental insight into how E. coli responds to loss-of-efflux, inventors assessed fluctuations in the membrane-enriched cellular proteome of cells sampled at the mid-exponential phase of growth (FIGS. 1F and 2D). In nutrient-rich conditions, a total of 1,979 proteins were identified from whole cell extracts of the wild-type strain, which represented 45% of the predicted proteome. Principal component analysis (PCA) separated EKO-35 from the wild-type strain (Component 1, 40.6%), with slight variation observed between the biological replicates (Component 2, 17.2%) (FIG. 1F).


Comparative proteomics showed significant changes in the abundance of 111 proteins in response to loss of the E. coli efflux system: 38 proteins were significantly increased in the wild-type proteome, and 73 proteins were significantly increased in the proteome of EKO-35 (FIG. 1G). The most significant differences in protein abundance were identified for two distantly related Fus homologs, YddB and PqqL (Table 7), which were >7-fold more abundant in EKO-35. YddB is an OM protein with structural homology to the OM ferredoxin transporter FusA. PqqL is a periplasmic metalloprotease analogous to the ferrodoxin processing protease FusC. Along with YddA, these proteins are proposed to function as a poorly characterized iron-uptake system. YddA is a member of the ABC efflux pump superfamily, which was disrupted during the generation of EKO-35. YddA phylogenetically clusters with other putative drug efflux pumps—YojI, MdlA, and MdlB. Other proteins highly abundant in EKO-35 included components of the flagellar apparatus (FliC), chemotaxis-associated proteins (Tsr), periplasmic chaperones (Spy), and metabolism-associated proteins, SrlA and SrlB (Table 7). In the wild-type strain, the most differentially abundant proteins (>3-fold) included components of the ferric citrate transport system40 (FecA, FecB, and FecE), heat-shock molecular chaperone proteins (IbpA, IbpB), and the peptidase component of the HslVU protease (HslV) (Table 7).


Using a false discovery rate (FDR) of 2%, annotation enrichment 42 of the EKO-35 cellular proteome revealed few differences compared to the wild-type proteome. Increasing the FDR to 5% identified three categories enriched in the wild-type strain, including iron transport. These categories correlated to the reduced abundance of proteins with annotated functions associated with iron-transport in EKO-Drug efflux pumps are well-characterized for their role in siderophore extrusion. Therefore, EKO-35 can downregulate iron acquisition systems to alleviate the fitness cost associated with accumulation of these molecules. However, it is important to note that these experiments were performed in relatively nutrient-rich conditions. In addition, five categories were enriched in EKO-35, including bacterial flagellum, phosphate transport, nitrate assimilation, chemotaxis, and electron transport (FIG. 1H).


Next, comparative proteomics was applied to assess fluctuations in the proteome of EKO-35 in nutrient-limited conditions. Inventors identified a total of 2,019 proteins from whole cell extracts of the wild-type strain, which represented 46% of the predicted proteome. PCA defined significant separation between EKO-35 and the wild-type strain (Component 1, 53.2%), and biological variation (Component 2, 14%) (FIG. 2F). Compared to nutrient-rich conditions, a greater number of significant changes in protein abundances were identified: 188 proteins were significantly increased in the wild-type proteome, and 190 proteins were significantly increased in the EKO-35 proteome (FIGS. 2G and 2H). Similar to nutrient-rich conditions, EKO-35 displayed increased abundance of YddB and PqqL (>7-fold). However, inventors also observed increased abundance of nickel ABC transport component NikD, metabolic proteins (SdaA, GarL, DmlA), periplasmic chaperones (Spy and CpxP), and the efflux pump membrane fusion protein MdtA (Table 8). The abundance of Spy, CpxP, and MdtA is tightly controlled at the transcriptional level by the Cpx envelope stress response regulon, which is induced by extracellular stress or the disruption of periplasmic homeostasis. This shows that loss-of-efflux disrupted periplasmic homeostasis under nutrient-limitation. In the wild-type strain, AcrB was observed under both nutrient-limited and nutrient-rich conditions, reinforcing that AcrB is constitutively produced under standard laboratory conditions (Tables 7 and 8).


Similar to nutrient-rich conditions, annotation enrichment revealed few differences between the wild-type and EKO-35 proteomes using an FDR of 2%. When the FDR was increased to 5%, the wild-type proteome was enriched with categories including acetylation, tricarboxylic acid cycle, sugar transport, ubiquinone, and quinones (FIG. 2H). In the EKO-35 proteome, proteins with annotated subcellular localization in the cell inner membrane were enriched (FIG. 2H), further indicating membrane stress in EKO-35, which can be compensated by increased abundance of membrane-associated proteins to alleviate changes in membrane fluidity due to lack of efflux pumps, or the accumulation of endogenously produced physiological substrates. In addition, the increased abundance of proteins with annotated functions associated with metabolism in the wild-type strain shows the metabolism of EKO-35 was impacted due to loss-of-efflux under these conditions.


Finally, two proteins associated with the EKO-35 nonsynonymous mutations were detected in the proteomes of wild-type E. coli and EKO-35; PitA was significantly increased in the wild-type strain, supporting the notion that PitA can negatively impact EKO-35 fitness. Additionally, inventors also detected a higher abundance of RspB in the wild-type proteome, which is encoded in an operon with rspA, further supporting that the nonsynonymous mutation in rspA may mitigate an associated fitness cost. Indeed, EKO-35 can have both reduced protein abundance and mutated the corresponding genes to alleviate the fitness cost associated with loss-of-efflux.


Characterizing EKO-35: Investigating Conditional Essentiality


E. coli is a versatile organism withstanding diverse and challenging environments. It is suggested the majority of efflux pumps are not constitutively produced under optimal growth conditions, which can underpin the observed dispensability of the drug efflux system (FIGS. 1B and 2A). Indeed, in nutrient-rich conditions inventors identified AcrB, YojI, and MdtK in the proteome of the wild-type strain, and AcrB, YojI, MdtK, and CusA in nutrient-limited conditions (Table 9). A significant number of efflux pumps were not identified in these conditions, indicating they can be differentially expressed, or that they are produced at levels that inventors were unable to detect.


To ascertain whether the E. coli efflux system becomes conditionally essential, inventors profiled EKO-35 growth under a range of different conditions. First, inventors confirmed the essentiality of drug efflux pumps for survival under extreme acid and alkaline conditions (FIG. 3A), Efflux pumps are frequently associated with pH homeostasis; for example, moderate acidic conditions increase the expression of mdtEF, mdtG, mdtlJ, and mdtL efflux genes, and the loss of MdtB and EmrB drug efflux pumps impacts fitness at extreme acidic pH. In addition, ΔtolC mutants show decreased fitness during extreme acid exposure. Efflux pumps (e.g., MdfA and MdtM) also contribute to alkalitolerance via Na+/(K+)/H+ antiport-based mechanisms, decreasing the cytoplasmic pH. As such, here inventors show that at pH values ≤5.5 and >8, the E coil efflux system is essential for growth (FIG. 3A). In addition, due to the abovementioned contribution of single component IM pumps to alkaline tolerance, EKO-35 shows pH dispensability patterns that differ from the ΔtolC mutant (FIG. 3A). To ensure the increased pH sensitivity was not associated with the nonsynonymous EKO-35 genomic mutations, growth of EKO-35 harboring the different ASKA clones—rspA, tufA, pitA, wcaC, gyrB, and yjfC—was assessed, revealing these genes were unable to restore the fitness of EKO-35 under acidic and alkaline conditions (FIGS. 9A-9D).


Since efflux pumps have also been associated with biofilm formation, inventors next explored whether loss-of-efflux impacted biofilm formation in E. coli. EKO-35 was propagated statically under both nutrient-rich and nutrient-limited conditions (FIGS. 3B and 3C), revealing loss-of-efflux enhanced biofilm formation compared to the wild-type strain in both conditions. In addition, the ΔtolC mutant exhibited biofilm phenotypes distinct to EKO-35. To investigate whether the phenotype was associated with the nonsynonymous mutations in EKO-35, the biofilms of EKO- and wild-type E, coil expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC were characterized in nutrient-rich conditions. Expression of rspA significantly increased biofilm formation in both EKO-35 and the wild-type strain, whilst the remaining genes significantly lowered biofilm formation in both strains (FIGS. 10A and 10B) Overall, findings of this disclosure highlight that rspA, tufA, pitA, wcaC, gyrB, and yjfC are associated with biofilm formation in E. coli. Future studies should investigate whether the increase in EKO-35 biofilm formation is directly induced by loss-of-efflux, or is indirectly associated with efflux due to these apparently compensatory nonsynonymous mutations.


Next, inventors measured the growth kinetics of EKO-35 at 25° C., and under reduced oxygen concentrations, in both nutrient-rich and -limited conditions (Table 1). The lag-phase was significantly extended in nutrient-rich medium; however, no significant differences were identified in nutrient-limited medium (FIGS. 3D and 3E, and Table 1). Under low oxygen conditions, inventors observed the fitness of EKO-35 was impaired in the nutrient-rich medium (1% 02) at 37° C. (FIG. 3F and Table 1). Growth profiling of EKO-35 harboring the ASKA plasmids did not restore the observed phenotype (FIGS. 9A-9D). The addition of KNOB, which emulates the presence of nitrosative indole derivatives, further impacted EKO-35 fitness (FIG. 3G and Table 1). The MdtEF tripartite efflux assembly has been reported to contribute to fitness under anaerobic conditions, through the removal of toxic by-products produced during anaerobic respiration. However, an MdtF mutant (ΔmdtF) from the Keio Collection did not show any differences in growth (FIG. 3H). In contrast, expression of mdtEF in EKO-35 (EKO-35 araC::mdtEF strain) partially restored the growth of EKO-35 (Table 1), which supports the contribution of MdtEF to E. coli fitness under these conditions, and also shows that additional efflux genes can contribute to the observed phenotype.


Most notably, inventors observed that the E. coli drug efflux system is essential for growth in a nutrient-limited low-oxygen environment (5% O2) (FIG. 3H). Measurement of EKO-35 growth kinetics (Table 1) revealed the strain remained in the lag phase for ˜18 h longer than the wild-type strain and was unable to enter the stationary phase during the duration of the experiment. This phenotype was not restored through the expression of genes harboring nonsynonymous mutations in EKO-35; in fact, the overexpression of pitA, tufA, and rspA decreased fitness further (FIGS. 9A-9D). Expression of mdtEF partially restored fitness (FIG. 3H). In addition, inventors also observed significant differences between the growth of EKO-35 and ΔtolC (FIG. 3H).


In summary, by profiling diverse growth conditions, inventors reveal instances where the fitness of EKO-35 is impacted due to loss-of-efflux. EKO-35 also exhibited phenotypes distinct to the ΔtolC mutant, which provides important biological insight into the physiological functions of drug efflux pumps. Indeed, EKO-35 is an important tool to further characterize the role of drug efflux pumps in physiological processes. The present findings highlight potentially compensatory nonsynonymous mutations that require further investigation.


EKO-35 Displays Differing Susceptibility Levels to a ΔtolC Mutant


Due to the observed phenotypic differences observed between EKO-35 and the ΔtolC mutant, inventors explored whether the strains also exhibited differences in susceptibility to growth inhibitors. Since inventors disrupted all drug efflux pumps known to form complexes with TolC, in addition to single component IM pumps, inventors posited it was likely EKO-35 would exhibit comparable—if not increased susceptibility—to antimicrobial agents.


Inventors curated and profiled a collection of compounds (n=52) with diverse physicochemical properties, including molecular weight (138.059 g/mol to 1449.27 g/mol), lipophilicity (log P −7.8597 to 5.823), aqueous solubility (log S −9.422 to and total polar surface area (PSA) (0 to 530.49 A2) (Table 10). This collection included well-described antibiotics, dyes, detergents, antiseptics, bile acids, and a subset of poorly characterized synthetic compounds (FIG. 12; compounds 1-19) recently identified as efflux substrates in E. coli. Inventors also included vancomycin as a permeability control, which is ordinarily unable to cross the OM, and is not a substrate for efflux 22.


Overall, EKO-35 and the ΔtolC mutant had similar susceptibility profiles for ˜65% (n=34) of the compounds, which were largely well-characterized antibiotics. However, the ΔtolC mutant was more susceptible to 31% of the profiled compounds, and a majority of these were the synthetic and poorly-characterized compounds (Table 10). These compounds also included novobiocin (4-fold difference) (Table 10), which inventors predicted could be due to the EKO-35 nonsynonymous mutation in gyrB (Table 5 and Table 6). Finally, EKO-35 was more susceptible to two compounds (acriflavine and ethidium bromide), which display relatively lower log P values (−1.9857 and −0.102, respectively) and a narrow molecular weight range (˜390 to 460 g/mol) (FIG. 4A and Table 10).


To investigate whether the differences in susceptibility between EKO-35 and ΔtolC were associated with the six missense mutations identified within the EKO-genome (FIGS. 13A-13D), inventors assessed the susceptibility of EKO-35 harboring the ASKA plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC. It was not possible to assess the contribution of pitA to susceptibility since overexpression induced a lethal phenotype. Overall, the remaining genes did not impact the susceptibility of EKO-35 to these compounds, with the exception of gyrB overexpression, which increased novobiocin resistance due to target over production 57 (Tables 11A and 11B). Indeed, this phenotype was also observed in the ΔtolC strain (FIGS. 13A-13D). In addition, while profiling the ASKA EKO-35 strains, inventors only observed a 2-fold difference in novobiocin susceptibility between EKO-35 and ΔtolC, which is within the acceptable error range for these assays.


Finally, inventors also generated an EKO-35 porinated strain (EKO-35-Pore), through introduction of an open variant of the OM siderophore transporter FhuA, which herein will be denoted as a ‘pore’. The FhuA transporter is rendered non-selective through removal of a terminal plug domain and four large external loops, which enables production of a ‘pore’ with an internal diameter of ˜2.4 nm. This non-selective pore increases the influx of both hydrophilic and hydrophobic compounds, without affecting efflux. As described previously, inventors introduced the pore into the intergenic region between the glmS and pstS genes in the genome of EKO-35 and the wild-type strain, with gene expression under the control of a constitutive promoter. Growth of the EKO-35-Pore strain was comparable to EKO-35 under optimal conditions (FIG. 15B), and the genome sequence of this strain did not highlight any secondary mutations induced upon introduction of the pore. The pore was also introduced into the wild-type and ΔtolC strains. Inventors confirmed activity of the pore through susceptibility testing with the large antibiotic vancomycin (FIG. 15A).


Next, inventors profiled the wild-type, EKO-35 and ΔtolC porinated strains against the same curated collection of physicochemically diverse compounds (n=52), to gain insight into the physicochemical properties of compounds retarded by the OM and/or those that are susceptible to efflux (FIG. 4 and Tables 13A, 13B, 14A, and 14B). In regard to OM permeability, compared to the wild-type strain, the porinated wild-type strain displayed increased susceptibility to ˜23% of the compounds; the physicochemical properties of these compounds were quite diverse, including compounds with larger molecular weights (˜286 to 1449 g/mol), lower hydrophobicity (−6.751 to 5.823), and larger PSAs (71.11 to 530.49 Å2) (FIGS. 4A-4F and 15A-15G). The pore did not sensitize E. coli to a large number of compounds, showing that efflux plays a more significant role in intrinsic resistance. Indeed, EKO-35 was susceptible to 50% of the compounds, and the ΔtolC strain to ˜80%, demonstrating that active efflux contributes more significantly than OM retardation for the majority of the compounds (FIGS. 4A and 15A). These compounds were relatively smaller (˜204 to 823 g/mol), more hydrophobic (−3.15 to 5.823), exhibiting a narrower range of relatively lower PSAs (0 to 220 Å2) (FIGS. 15B-15G). Compromising the OM of EKO-35 (EKO-rendered the strain susceptible to 65% of the compounds, and the ΔtolC (ΔtolC-Pore) strain to ˜88% (FIGS. 4A and 15A). This observation supports the well-known synergistic relationship between OM diffusion and efflux, which significantly expanded the physicochemical properties of compounds exhibiting activity against E. coli (FIGS. 4C and 15C).


In summary, the porinated strains provide an additional tool kit to study the transport of compounds across the E. coli cell envelope, enabling dissociation between permeation across the OM and active efflux. Indeed, with an intact OM, the physicochemical properties of compounds that could be assessed using the presently disclosed platform would be limited to those that can permeate the OM; for example, the exclusion limit for porins is considered to be ˜600 g/mol. The pore overcomes the selectivity barrier of the OM, widening the physicochemical properties that could be profiled in this disclosure. In addition, the differing susceptibility levels of EKO-35 and the ΔtolC mutant emphasizes that while both strains can be considered efflux-deficient, inactivation of IM efflux pumps impacts susceptibility differently than inactivation of an OM channel. Therefore, functions distinct from these IM efflux pumps could be attributed to the TolC-associated resistance phenotypes. This observation highlights the utility of EKO-35 for the study of drug efflux across the cell envelope.


Construction of an Efflux Pump Expression Platform

To demonstrate the use of EKO-35 as a tool to investigate the physicochemical substrate specificities of efflux pumps, inventors constructed an efflux platform consisting of strains individually expressing efflux pump-encoding genes. Inventors selected genes encoding pumps that form tripartite complexes with TolC (AcrB, AcrD, AcrEF, MdtEF, MdtBC, EmrAB, EmrKY, and MacAB). In addition, inventors included mexCD from P. aeruginosa—which can function with TolC62—to show that EKO-35 can be used as a broad-spectrum tool to study efflux pumps from other bacterial species. Overall, the intent is for expansion of the platform to include additional efflux pumps of interest as needed.


First, inventors attempted to integrate each gene into the genome of EKO-35 using the pINT1 plasmid, which enables markerless integration of genes into araC, with gene expression under the control of the strong and constitutive PBla promoter. Inventors reasoned that integrated genes with constitutive expression would provide increased stability and circumvent the need for selective markers and inducers. However, inventors observed numerous deleterious mutations in a subset of the genes following ligation into this vector, and also following integration into the genome (data not shown). Consequently, inventors posited that the expression level could be too high and inventors instead integrated each gene using the pINT2 plasmid, which utilizes the relatively weaker and constitutive PLacI promoter. Following genomic integration into araC and removal of the resistance cassette, each gene integration was confirmed using Sanger sequencing. The EKO-35 integrated strains will herein be referred to as EKO-35 araC::X, where X represents the gene of interest. As a proof of principle, comparison of AcrB levels between the wild-type, EKO-35, and EKO-35 araC::acrB strains confirmed the complementation system was functional and the protein was produced at higher levels than when the gene is expressed at the basal level (FIG. 1A).


To highlight the utility of EKO-35 for the investigation of efflux pump substrate profiles, the efflux genes mentioned above were also integrated into the genome of the wild-type E. coli BW25113 strain, and single deletion mutants corresponding to the pumps of interest. These strains, and the EKO-35 integrated strains, were profiled against known substrates for each respective efflux pump (Table 12). Since the wild-type strain harbors an intact drug efflux network, there were no differences in susceptibility when the efflux pump-encoding genes were expressed (FIGS. 14A and 14D-14H). Similarly, only one single efflux deletion strain—ΔacrB—displayed susceptibility profiles that differed from the parental strain (FIG. 14C). Indeed, the single efflux deletion mutants still harbor a relatively intact efflux network, which can mask the effects of other efflux pumps, emphasizing the need for a strain such as EKO-35. With the exception of EmrKY, for which inventors were unable to identify a known substrate, all of the integrated genes increased the resistance levels of EKO-35, confirming that each pump was functional (FIGS. 14A-14H).


In summary, due to the well-described differences in efflux pump basal expression levels, the developed efflux platform enables the study of efflux pumps in isogenic background(s) free of the masking effects of promiscuous pumps, with gene expression under the control of the same constitutive promoter. As such, this platform allows for the comparison of efflux pump substrate profiles, profiling of efflux pump inhibitors (EPIs), efflux pump interplay, and delineation of the molecular properties governing efflux, as described below.


Defining the Physicochemical Substrate Profiles of Drug Efflux Pumps

To investigate the tripartite efflux pump substrate profiles, inventors determined the minimum inhibitory concentrations (MICs) of each compound in the curated collection against each strain within the efflux platform, for both the EKO-35 and EKO-35-Pore strains producing efflux pumps (FIGS. 4A, 4B and Tables 13A, 13B, 14A, and 14B). As described, this compound collection covered a diverse physicochemical space that enabled us to summarize the molecular properties that contribute to efflux in each pump (FIGS. 4C-4E and Tables 13A, 13B, 14A, 14B, 15A, 16A, 16B, and 17).


As anticipated, AcrB was associated with resistance to a significant subset (˜85%) of the compounds (FIG. 4B), supporting the described promiscuous nature of this tripartite pump. The introduction of the pore increased AcrB-mediated resistance to rifampicin, which is a large antibiotic significantly hindered by the OM22 (Tables 14A and 14B). The tripartite complexes AcrEF and MdtEF also conferred broad-spectrum resistance (70% and 52% of the compounds, respectively) (FIG. 4B). Expression of the pore in combination with all three of these pumps (AcrB, AcrEF, and MdtEF) increased resistance to sodium taurodeoxycholate and a poorly-characterized synthetic compound (compound 10), which are both hydrophobic molecules (log P values of 2.091 and 3.638, respectively) (FIG. 4B and Tables 14A and 14B). These changes did not alter the overall physicochemical properties of AcrB and MdtEF (FIGS. 4C-4E and Table 17). In addition, OM porination impacted the ability of AcrEF to confer resistance to nalidixic acid, trimethoprim, and benzalkonium chloride, which are relatively small molecules (FIG. 4B and Tables 14A, 14B and 17). Overall, these three pumps were polyspecific, demonstrating little preference for molecular weight or lipophilicity when compared to the other pumps profiled (FIG. 4C-4E and Tables 13A, 13B, 14A, 14B, and 17).


In contrast, AcrD and EmrAB decreased the susceptibility of EKO-35 to a smaller subset of compounds (30% and 33%, respectively) (Table 17). AcrD was associated with resistance to compounds with a narrower molecular weight range and PSA (FIGS. 4C and 4F), including non-polar compounds with positive log P values, contrary to previous reports that AcrD does not extrude hydrophobic molecules. Several known substrates for AcrD were confirmed (e.g., oxacillin, novobiocin, SDS, and deoxycholate); however, resistance to the aminoglycosides was not observed (FIG. 4B and Tables 13A and 13B). Indeed, despite previous studies showing increased susceptibility of E. coli to various aminoglycosides upon inactivation of acrD, inventors did not observe changes in susceptibility when acrD was inactivated (ΔacrD) in the wild-type K-12 strain, or when acrD was expressed in the ΔacrD or wild-type K-12 strains (FIGS. 16A-16D). Since aminoglycoside susceptibility can be affected by the growth medium, susceptibility testing was performed in both cation-adjusted Mueller Hinton II Broth (MHB II) and LB, showing similar results. These results are in agreement with a previous study reporting that AcrD in Salmonella enterica Serovar Typhimurium does not confer resistance to aminoglycosides. Finally, compromising the OM expanded the substrate profile of AcrD, however, the overall physicochemical profile was unaffected, and aminoglycoside resistance was not observed (FIGS. 4C-4E and Tables 13A, 13B, and 17).


In contrast to the broad substrate profiles of the RND efflux pumps, the remaining pumps were associated with resistance to a much smaller range of compounds. For example, EmrAB primarily conferred resistance to non-polar compounds spanning a small range of lipophilicity, including the uncoupler CCCP, which is consistent with previous studies. EmrAB no longer provided resistance to CCCP in the porinated strain, and was instead associated with resistance to fusidic acid and synthetic compound 10 (FIG. 4B, Tables 14A, 14B, and 17). MacAB and MdtBC conferred resistance to only 6% of the compounds (FIG. 4B and Tables 13A and 13B); consistent with previous reports, MacAB was specific for macrolides (erythromycin and azithromycin). However, MacAB with a porinated OM reduced the MIC of azithromycin to only 2-fold greater than EKO-35, which is within the acceptable error range for these assays (FIG. 4B and Tables 14A and 14B). MdtBC conferred resistance to novobiocin and deoxycholate, as previously reported (FIG. 4B, Tables 13A and 13B). Introduction of the pore additionally associated MdtBC with resistance to sodium taurodeoxycholate (FIG. 4B, Tables 14A and 14B), supporting a role in bile salt tolerance. Production of MdtBC in combination with the pore was also associated with resistance to daunorubicin and doxorubicin, substantially expanding the lipophilicity range of this pump (FIG. 4D and Table 17). EmrKY did not increase EKO-35 resistance to any of the compounds profiled, even when the OM was compromised (FIG. 4B and Tables 13A, 13B, 14A, and 14B).


Finally, inventors also profiled the MexCD pump from P. aeruginosa to demonstrate the use of EKO-35 as a tool for the study of bacterial efflux pumps from other bacterial species. MexCD conferred resistance to ˜55% of compounds profiled, many of which were known substrates, in addition to six of the poorly-characterized compounds (FIG. 4B and Tables 13A and 13B). These compounds were chemically unrelated, which was consistent with the polyspecific substrate profiles of the other multidrug-resistant RND pumps profiled (AcrB, AcrEF, and MdtEF) (FIG. 4B). Furthermore, compromising the OM no longer associated MexCD with resistance to puromycin, azithromycin, deoxycholate, and synthetic compound 13, and instead increased resistance to norfloxacin, sodium taurodeoxycholate, and synthetic compound 10 (FIG. 4B). However, these changes did not affect the overall physicochemical substrate profile, and therefore the polyspecificity of MexCD (FIGS. 4C-4E).


Overall, porinating the OM of the EKO-35 efflux-integrated strains did not substantially affect the activity of the efflux pumps, including their overall physicochemical substrate profiles. However, inventors did identify additional substrates when the OM was compromised, revealing that efflux pumps have expanded substrate profiles in environments that increase OM permeation. In the few instances (e.g., AcrEF, MacAB, and MexCD) where inventors observed decreased efflux-mediated resistance following introduction of the pore, it is possible that increased permeation overwhelmed the pump. However, the findings of the present disclosure indicate that efflux pumps can function robustly even when the OM is compromised.


EKO-35 and the Efflux Platform can be Used to Evaluate the Specificity of Efflux Pump Inhibitors

Due to their role in antibiotic resistance, efflux pumps are attractive antibacterial targets. Indeed, an inhibitor of a polyspecific efflux pump, such as AcrAB, could simultaneously enhance the activity of numerous antibiotics against resistant strains. Phenylalanine-Arginine 8-Naphthylamide (PAβN) is one of the best-studied efflux pump inhibitors (EPIs), which inhibits AcrAB and its homologues, including numerous P. aeruginosa pumps (e.g., MexAB-OprM, MexCD-OprJ, MexXY-OprM, and MexEF-OprN). In addition, several arylpiperazines have been associated with E. coli efflux inhibition, including 1-(1-naphthylmethyl)-piperazine (NMP). Here, using PAβN and NMP as a proof of concept, inventors show EKO-35 and the developed efflux platform can be used to assess the specificity of EPIs.


First, inventors assessed PAM and NMP synergy with various antibiotics by checkerboard analysis against the efflux-deficient strains, EKO-35, EKO-35 acrBD408A, and ΔtolC, in addition to the wild-type strain (FIGS. 5A-5J and Tables 18A, 18B, 19A, and 19B). Both EPIs synergized with several antibiotics in the wild-type strain (FIG. 5). PAM is an efflux substrate, albeit a poor substrate that reduces the extrusion of other substrates. The compound also exhibits antibacterial activity, which is enhanced upon efflux inactivation (Tables 18A and 18B). In contrast, the susceptibility of the efflux-deficient strains was comparable to the wild-type strain for NMP, indicating the compound inhibits efflux in a different way, or does not exhibit antibacterial properties (Tables 19A and 19B). Consistent with the observation that PAM permeabilizes membranes in a concentration-dependent manner, the EPI synergized with various antibiotics in the efflux-deficient strains, including oxacillin, novobiocin, fusidic acid, and erythromycin (FIGS. 5A-5C and Tables 18A and 18B). However, PAM was not synergistic in these strains in combination with linezolid, which can more readily penetrate the OM (FIG. 5C and Table 18A and 18B). NMP did not exhibit synergy with the majority of the antibiotics against EKO-35 and EKO-35 acrBD408A (FIG. 5D-5F and Tables 19A and 19B). However, inventors did observe low-level synergy with erythromycin, and also synergy with ethidium bromide against ΔtolC (FIGS. 5D and 5F and Tables 19A and 19B). Overall, the findings show NMP does not exhibit the same OM permeability permeabilizing properties as PaβN, consistent with previous findings indicating NMP only destabilizes membranes at concentrations exceeding 250 μg/mL (Tables 19A and 19B).


Acknowledging that distinguishing EPI permeabilizing properties from efflux inhibition is a challenge, inventors next utilized the porinated strains to assess synergy, predicting that synergy would be lost in the porinated strains. Indeed, inventors observed that PaβN was no longer synergistic in combination with erythromycin, novobiocin, and oxacillin against the porinated efflux-deficient strains (FIGS. 5A, 5D and 5F, and Table 18A and 18B). However, synergy was maintained for fusidic acid (FIG. 5B and Tables 18A and 18B). Similarly, NMP was no longer synergistic in combination with erythromycin, indicating the compound exhibits weak OM permeabilizing properties (Tables 19A and 19B). Overall, the results demonstrate that profiling EPIs against efflux-deficient strains like EKO-35 and the EKO-35-Pore derivative is an important step during the characterization of such compounds.


Next, inventors investigated EPI specificity against both EKO-35 and the EKO-35-Pore strain producing different efflux pumps, by assessing synergy with identified antibiotic substrates for each pump (FIGS. 5G-5J, Tables 18A, 18B and Tables 19A and 19B). Use of the porinated strains enabled isolation of efflux pump inhibition from OM permeabilizing properties, and inventors observed distinct phenotypes for different efflux pumps and antibiotic combinations (FIGS. 5A-5F, Tables 18A, 18B, 19A, and 19B). For example, PAM was synergistic in combination with all of the antibiotics profiled against the EKO-35 porinated strain expressing acrB and acrF, and no synergy was observed for the functionally inactive AcrB variant (FIG. and Tables 18A and 18B). In contrast, when acrD was expressed in the porinated strain, synergy was lost for novobiocin, yet was still observed for oxacillin and erythromycin. Similarly, synergy was lost for ciprofloxacin in EKO-35-Pore expressing the P. aeruginosa pump mexCD. Overall, the findings show that PAM exhibits different levels of inhibition and specificity against the various efflux pumps and their antibiotic substrates (Tables 18A and 18B).


Overall, NMP is not as potent as PAβN, providing relatively higher fractional inhibitory concentration index values (FICIs) (FIGS. 5A-5F). Additionally, inventors demonstrate that, with the exception of potentiating ethidium bromide against the strain producing AcrEF, NMP is specific for AcrB, enhancing the activity of ethidium bromide, fusidic acid, linezolid and oxacillin in the porinated strain producing AcrB (FIGS. 5A-5F and Tables 19A and 19B).


In summary, EKO-35 and the efflux platform are important tools for the assessment of candidate EPIs, enabling differentiation between compounds that permeabilize membranes, which increases the influx of antibiotics, and those that solely act as EPIs. In addition, there are major limitations associated with investigating EPI specificity in strains harboring intact drug efflux networks. EKO-35 and the efflux platform overcome these limitations, enabling users to systematically assess inhibition of each efflux pump within the platform.


Investigating Efflux Pump Functional Interplay Using EKO-35 as a Simplified Genetic Background

Previous studies revealed the combination of structurally distinct efflux pumps—single component inner membrane efflux pumps and tripartite systems, which span the cell envelope—can confer multiplicative effects on resistance. Specifically, the combination of these two pump types confers a fold increase—or multiplicative effect—on resistance that is equal to or greater than the product of the fold increases conferred by the individual efflux pumps alone. An additive effect is observed when the fold increase in resistance equates to the sum of the individual efflux pumps alone. Interplay is considered to be the result of single component inner membrane pumps effluxing compounds to the periplasm, where tripartite systems can then access these compounds, extruding to the outside of the cell. Indeed, AcrB was shown to only provide robust resistance to ethidium bromide and acriflavine when single component pumps are present, since AcrB is considered to only access substrates from the outer leaflet of the inner membrane and the periplasm. Therefore, for compounds with cytoplasmic targets, such as acriflavine and ethidium bromide, it is possible that tripartite efflux systems rely on single component inner membrane pumps to first efflux substrates to the periplasm. However, inventors observed that with the exception of ethidium bromide and acriflavine, the overexpression of acrB alone restored the sensitivity of EKO-35 to levels comparable, if not greater, than those observed in the wild-type strain for the majority of compounds profiled in this disclosure (Tables 13A and 13B). Thus, AcrB provides robust efflux independent of single component inner membrane pumps for a wide range of compounds with diverse physicochemical properties. Indeed, findings of this disclosure show that permeation across the cell envelope is sufficiently rate limiting, since the tripartite pumps can access the drugs from the periplasm and the inner-membrane outer leaflet as they are diffusing.


To demonstrate the use of EKO-35 to study efflux pump interplay, the inner membrane efflux pump EmrE was introduced into EKO-35 strains with integrated RND tripartite efflux pumps (AcrB, AcrEF, AcrD, and MdtEF) using the pGDP2 plasmid (pGDP2:emrE), which features the constitutive PLacI promoter. Inventors then assessed resistance to ethidium bromide and acriflavine, since AcrB alone did not restore resistance to wild-type levels. Overall, inventors observed that the combination of EmrE with all three tripartite systems conferred multiplicative effects for both ethidium bromide and acriflavine (FIG. 5G-5J and Table 20). AcrB and AcrEF conferred a higher-level of resistance alone to these compounds; as such, the multiplicative effects of these pumps with EmrE was substantially greater than AcrD and MdtEF. Inventors also included novobiocin and minocycline as negative controls that were not extruded by EmrE, and inventors did not observe synergy (FIGS. 17A-17D and Table 20).


Next, inventors predicted that interplay can be more apparent when the OM is compromised, causing a greater influx of the compounds into the cell. To investigate, the EKO-35-Pore strains were profiled using the same approach. Overall, the multiplicative effects were maintained for the majority of the pump combinations, with the exception of AcrD with acriflavine, where the multiplicative effect was lost, and AcrD did not increase resistance to acriflavine when produced alone or in combination with EmrE (FIGS. 5G-5J and Table 20).


Discussion

Bacterial drug efflux networks are expansive and poorly characterized, extending beyond archetypal pumps (e.g., AcrB) that are well-studied due to their polyspecific transporting capabilities. However, the substrate specificity and functions of many efflux pumps remain poorly understood, which can be attributed to the complexities of these systems, including differential gene expression and a high degree of functional redundancy. Here, inventors describe the generation of EKO-35, a simplified genetic background to address the described limitations of the efflux field. This strain can be used to study the functions and physicochemical substrate specificities of individually introduced efflux pumps, to assess the mechanism of action and efficacy of EPIs, and to study efflux pump interplay.


Inventors' ability to inactivate such a significant number of efflux pumps within the E. coli genome has provided important biological insight. Despite the high degree of functional redundancy, at least in terms of antibiotic detoxification, the E. coli drug efflux system is highly conserved. Conservation shows these proteins could contribute to physiologically essential roles, in addition to their well-described ability to extrude clinically important antibiotics. Indeed, numerous physiological functions have been associated with drug efflux pumps. For example, the TolC OM channel is broadly implicated in enterobacterial physiology. Inactivation causes pleiotropic phenotypes, including severe growth defects in nutrient-limited conditions. As described, MdtEF-TolC has been associated with the detoxification of nitrosative derivatives produced during anaerobic respiration. In addition, many E. coli efflux pumps have been associated with the extrusion of enterobactin, MdtJI exports the polyamine spermidine, and SugE is a guanidinium ion efflux pump.


Despite the contribution of these proteins to the maintenance of cellular homeostasis, here inventors show the E. coli drug efflux system is dispensable under optimal growth conditions (FIG. 1B), including during nutrient-limitation (FIG. 2A). Membrane-enriched comparative proteomics revealed only minor changes to the proteome of EKO-35 in nutrient-rich medium; however, numerous adaptations were observed in nutrient-limited medium (FIGS. 1A and 2B). While it was possible to inactivate such a significant number of IM efflux pumps, inventors did identify six nonsynonymous mutations during the generation of EKO-35 (FIG. 6). The overexpression of wild-type unmutagenized copies of these genes, using plasmids isolated from ASKA clones harboring the rspA, tufA, pitA, wcaC, gyrB, and yjfC genes, revealed a significant reduction in EKO-35 fitness under nutrient-rich optimal growth conditions for all of these genes. The fitness of the wild-type strain was also reduced by the overexpression of pitA, tufA and rspA. In addition, pitA and rspA overexpression was lethal, and wcaC negatively impacted fitness, in both EKO-35 and the wild-type strain in nutrient-limited conditions (FIGS. 8A (left) and 8C-8E (left)). EKO-35 was generated in a nutrient-rich medium, and the observation that the nonsynonymous mutations occurred in genes that are associated with EKO-35 fitness show they could be compensatory in nature (FIGS. 8A-8F (left)). Indeed, the findings show that the mutations could have been induced in response to loss-of-efflux, to enhance EKO-35 fitness, which could explain why the strain only exhibits minor changes in growth kinetics in nutrient-rich and nutrient-limited conditions (FIGS. 1B and 2A).


In support of efflux-associated physiological functions, inventors show the E. coli efflux network is conditionally essential. Indeed, the introduction of wild-type copies of the above mentioned genes did not restore the conditionally essential phenotypes described in this disclosure, showing these phenotypes correlate with loss-of-efflux pumps directly. The fitness of EKO-35 was significantly impacted under acid and alkali stress (FIG. 3A), in accordance with previous studies associating efflux pumps with pH homeostasis. Most striking was the observation that efflux is essential for growth in a nutrient-limited low oxygen environment (FIG. 3F), and findings of this disclosure highlight that other pumps can be associated with this phenotype, in addition to MdtEF-mediated extrusion of toxic by-products during anaerobic respiration. Finally, during the phenotypic characterization of EKO-35, inventors were surprised to observe differing growth phenotypes in comparison to the ΔtolC mutant. Indeed, while it is clear efflux pumps contribute to physiological processes, TolC inactivation induces a different and apparently pleiotropic cellular response that is not observed in EKO-35. Overall, these findings open the way for future studies to investigate the efflux pumps and underlying mechanisms associated with the identified conditionally essential phenotypes; the described efflux platform is ideal for such studies. In addition, by performing an in-depth assessment of EKO-35, inventors provide a well-characterized strain for the study of efflux pump functions and physicochemical substrate profiles.


To the best of inventors' knowledge, EKO-35 is the most efflux-deficient mutant to be reported. As such, this strain is highly susceptible to numerous antimicrobial agents (Tables 13A and 13B). Similar to the observed phenotypic differences, EKO-35 exhibited differing susceptibility levels to the ΔtolC mutant. Importantly, most of the well-characterized antibiotics inhibited the growth of both strains comparably, indicating tripartite efflux pumps are primarily responsible for extruding these compounds, and are the major contributors to resistance in the efflux network. However, numerous compounds exhibited increased activity against the ΔtolC mutant, despite the lack of tripartite efflux pumps in EKO-35. Most of these were the poorly characterized synthetic compounds (Tables 10A and 10B, compounds 1-19). Inventors have shown these differences were not associated with the nonsynonymous mutations, since the introduction of wild-type copies of these genes did not increase the susceptibility of EKO-35 (FIGS. 13A-F). Porination of the OM only increased the susceptibility of EKO-35 to two of the synthetic compounds that were originally inactive against EKO-35 (FIGS. 15A and 15B and Table 10), indicating that the OM of ΔtolC could be more permeable than EKO-35 in these instances. Indeed, the inactivation of tolC leads to membrane stress, which has been suggested to contribute significantly to its increased susceptibility to multiple antibiotics. However, the remaining synthetic compounds did not impact the susceptibility of the EKO-35-Pore strain, showing that permeability did not underlie the differences observed between ΔtolC and EKO-35. Clearly, loss of IM efflux pumps impacts susceptibility differently than deletion of an OM channel, which shows that TolC is associated with other functions related to these resistance phenotypes. As such, this should be taken into account when using ΔtolC mutants to study drug efflux. Indeed, EKO-35 is an important addition to the arsenal of tools to explore the movement of compounds across the cell envelope.


With an intact OM, the physicochemical properties that can be assessed using EKO-35 and the efflux integration platform would be limited to those that can penetrate the OM, which would restrict the molecular weight range to compounds <600 g/mol. To overcome this limitation, a pore was introduced into the wild-type, ΔtolC, EKO-35, and EKO-35 efflux pump-integrated strains, which enabled uncoupling of the contributions of influx and efflux. Inventors show that efflux contributed more significantly than OM permeability to the intrinsic resistance of E. coli, and compromising both the OM and efflux increased susceptibility to a wide range of compounds (FIGS. 4A, 4B, and 15A). Overall, compromising the OM of EKO-35 significantly broadened the physicochemical properties that could be profiled with the efflux platform, while maintaining efflux pump activity.


Previously, different approaches have been taken to investigate the E. coli drug efflux system. Sulavik et al., individually inactivated 16 efflux pumps and profiled these strains against a panel of 20 toxic molecules. Due to efflux pump functional redundancies, and differential expression levels, there are limitations associated with this approach. Nishino & Yamaguchi individually expressed 37 efflux pump-encoding genes in an AcrAB-devoid host, and subsequently profiled 26 toxic molecules. Both studies substantiated AcrAB-TolC as the major contributor to intrinsic resistance. A subset of additional efflux pumps were associated with resistance to a proportion of the compounds, but a large number did not provide resistance phenotypes. Additional studies have also investigated E. coli efflux using tolC inactivated mutants, to ascertain molecular features of compounds amenable to efflux. Since TolC is the predominant gate keeper for extrusion across the OM in E. coli, the study of tolC mutants represents loss of efflux as a whole, and provides important information relating to the properties of compounds that are susceptible to efflux by tripartite systems. However, little insight is provided into the physicochemical substrate specificities of the IM pump components. In addition, as described above, tolC inactivation causes pleiotropic effects that appear to be distinct from loss of drug efflux pump functions. Therefore, there are limitations associated with the use of tolC mutants to study drug efflux, which are overcome by EKO-35.


Construction of the developed efflux platform enabled us to assess the physicochemical substrate profiles of E. coli efflux pumps forming tripartite complexes with TolC. Inventors also included MexCD from P. aeruginosa, showing that the platform can be used to study pumps from other organisms. The efflux platform was built upon an isogenic and highly susceptible background (EKO-35), with gene expression under the control of the same constitutive promoter. Such an approach enabled direct comparisons to be made between strains and inventors were able to summarize molecular properties that contribute to efflux in each pump (FIGS. 4C-4F). Inventors revealed that AcrB, AcrEF, MdtEF, and MexCD exhibited polyspecific redundant substrate profiles, with little specificity for molecular weight, aqueous solubility or polar surface area (FIG. 4C-4F). AcrB and AcrEF mediated resistance to a wide array of hydrophilic and lipophilic compounds, and MdtEF was associated with resistance to more lipophilic substrates. AcrD provided resistance to a smaller subset of compounds that were mostly lipophilic and fell within a narrower molecular weight range (˜285 to 613 g/mol). EmrAB also exhibited resistance to a smaller fraction of the compounds, which displayed more specific criteria, including lipophilicity and a molecular weight ranging from 205-613 g/mol. MacAB was specific for macrolides, MdtBC for bile salts, and inventors were unable to identify any substrates of EmrKY. While EmrKY is a homologue of EmrAB, the pump has only been associated with resistance to deoxycholate, which inventors could not substantiate. Overall, despite a subset of the pumps appearing to have evolved to extrude specific substrates (e.g., MacAB and MdtBC), a significant number of the pumps were polyspecific and thus functionally redundant. When examined phylogenetically, these RND pumps (AcrB, AcrF, and MdtF) cluster together, which can be indicative of their multidrug-resistant functions. The clustering of AcrF and MdtF can explain the similarities observed in the physicochemical substrate profiles of these homologous proteins (Teelucksingh & Thompson et al., 2020) (FIGS. 4C-4F). In addition, the P. aeruginosa MexCD pump exhibited comparable resistance profiles to these two pumps. In the case of AcrB, this polyspecific phenotype appears to be an ancient and conserved trait. It is unclear why all three polyspecific pumps have been conserved across the E. coli species. Combined, the redundant polyspecific nature of these efflux pumps highlight the challenges of designing new antibacterial agents that overcome efflux.


Previous studies indicate that molecular weight and hydrophobicity are key factors impacting compound susceptibility to efflux; specifically, compounds exhibiting molecular weights between 300 and 700 g/mol are more susceptible to efflux. Findings from this disclosure were consistent with these observations, yet inventors observed a slightly larger molecular weight range through EKO-35 susceptibility testing, identifying compounds ranging from −227 to 750 g/mol as being susceptible to efflux (FIG. 15C). Indeed, numerous efflux pumps (AcrB, AcrEF, MdtEF, and MacAB) were associated with resistance to compounds >700 g/mol (FIG. 4C, Table 17). In addition, when the OM was compromised, AcrB provided resistance to rifampicin (MW=822.95 g/mol). Hydrophobic molecules have also been reported to be more susceptible to efflux than hydrophilic molecules. In this disclosure, efflux activity was only observed for compounds with log P≥−1.986; however, ˜33% of compounds active against EKO-35 were hydrophilic (Tables 10 and 17). Additionally, several hydrophobic compounds were inactive against EKO-35 (Table 10). Inventors also identified a subset of compounds that meet these molecular weight and hydrophobicity criteria, but were inactive against EKO-35 (Table 10). Altogether, findings of this disclosure show that molecular weight and hydrophobicity are not a prerequisite for efflux; the charge, globularity, flexibility, and stability of compounds are also important physicochemical properties governing the influx and efflux of compounds.


It is possible that efflux pump interplay could impact the substrate profiles of tripartite efflux pumps; as described, interplay refers to synergistic relationships between tripartite systems and single component IM pumps. However, inventors show the production of AcrB alone can restore the susceptibility of EKO-35 to wild-type levels for most compounds profiled. Indeed, acriflavine and ethidium bromide were the only compounds that tripartite pumps appeared to rely on contributions from single component inner membrane pumps to provide robust resistance (FIGS. 5G-5J). Inventors show the efflux platform is ideal for studying efflux pump interplay, which would otherwise be complicated by the complexities of the E. coli drug efflux network. Future studies could harness EKO-35 and the platform to investigate further instances of efflux pump interplay.


In addition to investigating efflux pump physicochemical substrate profiles, the efflux platform can also be used to evaluate EPIs. As a proof of principle, inventors assessed synergy of the EPIs PAβN and NMP with various antibiotics (Table 12 and FIGS. 5A-5F). Since decreased permeability and active efflux synergistically contribute to intrinsic resistance, it is difficult to ascertain the mechanism of action of antibiotic adjuvants such as EPIs. Uncoupling influx from efflux inhibition, through the use of the EKO-35-Pore strain and the integrated efflux pump library, can provide important insight into EPI mechanism(s) of action. Indeed, inventors propose that candidate EPIs are routinely profiled against the efflux-deficient strains, EKO-35 and EKO-35-Pore, providing insight into whether an EPI confers pleiotropic effects, including membrane destabilization, as exemplified by PAβN. In addition, profiling EPIs against the EKO-35-Pore strain producing individual efflux pumps provides insight into the pump specificity of EPIs. Indeed, findings of this disclosure highlight that both PAβN and NMP exhibit efflux pump inhibition; however, each inhibitor exhibits differing efflux pump specificities, including potentiation of different antibiotic substrates. There is precedent underlying this observation in the literature; PAβN is predicted to bind both the binding pocket groove and cave regions of AcrB, which enables the EPI to potentiate a diverse range of compounds with affinity for either binding site (e.g., novobiocin and oxacillin) (FIGS. 5A-5C). In addition, PAβN has been shown to inhibit AcrB primarily through perturbation of drug-binding structural dynamics, rather than competitive binding, which could underlie the compound's ability to potentiate such a wide range of antibiotics. In addition, inventors show that PAβN is a broad-spectrum inhibitor both in terms of antibiotic potentiation and efflux pump specificity (FIG. 5A-5C). In contrast, NMP is predicted to bind solely to the binding pocket cave and, as such, NMP largely potentiates cave binding compounds (e.g., ethidium bromide) (FIGS. 5D-5F). Finally, inventors show that for the most part NMP exhibits specificity for AcrB (FIGS. 5D-5F). In summary, the efflux platform provides an essential tool to deconvolute EPI mechanism(s) of action.


In conclusion, efflux pumps are a major contributor to the intrinsic antibiotic resistome of Gram-negative pathogenic bacteria. Understanding the molecular properties that influence efflux is key for overcoming these resistance mechanisms. It is important that all efflux pumps are considered since inventors have a poor understanding of the fitness advantage conferred by each pump during the bacterial lifecycle. The efflux platform represents an innovative tool kit to fully dissect the movement of compounds across the cell envelope, providing a unique opportunity for users to introduce desired combinations of efflux pumps, and to also probe the relationship and balance between permeation and active efflux. Overall, EKO-35 and the developed platform will be an important resource to the efflux field, which can be used to profile efflux pumps of interest, to assess physiological functions and substrate specificities, and ultimately assist the design of new antibacterial agents and EPIs.









TABLE 5







EKO-35 genomic mutations. Single nucleotide polymorphisms


were identified relative to the parent E. coli BW25113


K-12 (Grenier et al. 2014) genome (List #1).















Efflux






gene



Base


associated



pair


with the


Gene
mutation
Mutation
Gene Function
mutation





gntU
G489A
Silent
Gluconate transporter
mdtF


pitA
T1433A
V478E
Metal phosphate:H+ sympoter
mdtF


yjfC
A470G
E157G
Putative acid-amine ligase
mdtF


tufA
C677T
T2261
Elongation factor Tu
ydeA


tig
C225T
Silent
Chaperone protein known as
mdtB





Trigger Factor F. Specifically





interacts with nascent proteins
















TABLE 6







EKO-35 genomic mutations. Single nucleotide polymorphisms


were identified relative to the parent E. coli BW25113


K-12 (Grenier et al. 2014) genome (List #2).












Base


Efflux gene



pair


associated



muta-
Muta-

with the


Gene
tion
tion
Gene Function
mutation





rpsA
T795A
D265E
30S ribosomal subunit protein
mdtB





S. The largest of the ribosomal





proteins


wcaC
A355C
K119Q
Galactosyltransferase
mdtB





predicted to be involved in





colonic acid biosynthesis


ybdK
G834A
Silent
Carboxylate-amine ligase
mdlB


gyrB
G373T
A125S
Type II topoisomerase that
cusA





negatively supercoils circular





double stranded DNA


yebS
G639A
Silent
Inner membrane protein
cusA





predicted to contribute to





membrane integrity
















TABLE 7







Quantitative comparative proteomic analysis revealed statistically


significant differentially abundant proteins between EKO-35 and


the wild-type E. coli K-12 strain in nutrient-rich conditions.


Comparative analysis was performed with proteins identified


in at least three biological replicates (1,979 proteins), statistical


analysis was performed using a Student's t-test (P-value ≤0.05,


FDR = 0.05, SO = 1).














Fold






Protein
differ-


Strain
IDs
ence
P-value
Gene
Protein















EKO-
P31828
8.63
2.09E−07
pqqL
Putative TonB-


35




dependent







receptor YddB


EKO-
P31827
7.92
1.39E−06
yddB
Periplasmic


35




metalloprotease PqqL


EKO-
P76520
7.87
7.75E−08
yfdX
Uncharacterized


35




protein YfdX


EKO-
P04949
4.96
1.84E−03
fliC
Flagellin filament


35




protein FliC


EKO-
P02942
4.31
4.40E−03
tsr
Methyl-accepting


35




chemotaxis protein I


EKO-
P77754
4.09
2.69E−03
spy
Periplasmic chaperone


35




Spy


EKO-
P05706
3.88
2.06E−03
srlB
Sorbitol-specific


35




phosphotransferase







enzyme IIA component







SrlB


EKO-
P56579
3.87
9.81E−04
srlA
Sorbitol permease


35




phosphotransferase







enzyme IIC2 component







SrlA


EKO-
P00634
3.69
5.03E−04
phoA
Alkaline phosphatase


35




PhoA


EKO-
P28861
3.66
1.49E−04
fpr
Ferredoxin--NADP+


35




reductase Fpr


K-12
P13036
−2.64
2.59E−02
fecA
Ferric citrate outer







membrane transporter







FecA


K-12
POAAEO
−2.66
6.34E−03
cycA
D-serine/D-







alanine/glycine/:H+







symporter CycA


K-12
P15028
−2.74
1.76E−03
fecB
Ferric citrate ABC







transporter periplasmic







binding protein FecB


K-12
P33941
−3.04
9.63E−04
yojl
ABC efflux pump Yojl


K-12
P38105
−3.25
1.30E−03
rspB
Putative zinc-binding







dehydrogenase RspB


K-12
POC058
−3.48
1.57E−03
ibpB
Small heat shock protein







IbpB


K-12
POA7B8
−3.69
3,18E−04
hsIV
ATP-dependent protease







subunit HsIV


K-12
POC054
−3.90
2.31E−03
ibpA
Small heat shock protein







lbpA


K-12
P15031
−4.76
1.49E−02
fecE
Ferric citrate ABC







transporter ATP binding







subunit FecE


K-12
P31224
−5.69*
1.31E−04
acrB
Multidrug efflux pump







subunit AcrB





*AcrB fold difference was calculated through imputation using a normal distribution.













TABLE 8







Quantitative comparative proteomic analysis revealed statistically


significant differentially abundant proteins between EKO-35 and


the wild-type E. coli K-12 strain in nutrient-limited conditions.


Comparative analysis was performed with proteins identified


in at least three biological replicates (2,019 proteins), statistical


analysis was performed using a Student's t-test (P-value ≤0.05,


FDR = 0.05, SO = 1).














Fold






Protein
differ-


Strain
IDs
ence
P-value
Gene
Protein















EKO-
P31827
8.70
1.05E−05
yddB
Putative TonB-


35




dependent receptor







YddB


EKO-
P77754
7.56
1.47E−05
spy
Periplasmic chaperone


35




Spy


EKO-
P31828
7.04
5.63E−06
pqqL
Periplasmic


35




metalloprotease PqqL


EKO-
P33593
6.07
1.73E−05
nikD
Nickel ABC transporter


35




ATP binding subunit







NikD


EKO-
P76397
5.66
1.52E−06
mdtA
Multidrug efflux pump


35




membrane fusion







protein MdtA


EKO-
P21865
5.50
1.10E−05
kdpD
Sensor histidine kinase


35




KdpD


EKO-
POAE85
5.09
4.59E−06
cpxP
Periplasmic protein


35




CpxP


EKO-
P16095
4.98
5.29E−05
sdaA
L-serine dehydratase 1


35




SdaA


EKO-
P23522
4.96
8.72E−05
garL
5-keto-4-deoxy-D-


35




glucarate aldolase GarL


EKO-
P76251
2.28
2.28E−02
dmlA
D-malate


35




dehydrogenase DmlA


K-12
P13036
−4.15
2.07E−03
agp
Glucose-1-phosphatase







Agp


K-12
POAAEO
−4.16
1.89E−05
pitA
Low-affinity inorganic







phosphate transporter 1







PitA


K-12
P15028
−4.22
1.17E−07
cusA
Copper/silver RND







permease CusA


K-12
P33941
−4.25
5.67E−05
ggt
Gamma-







glutamyltranspeptidase







Ggt


K-12
P38105
−4.82
1.90E−03
otsB
Trehalose-6-phosphate







phosphatase OtsB


K-12
POC058
−4.89*
7.41E−04
acrB
Multidrug RND







permease AcrB


K-12
POA7B8
−4.91
5.11E−05
gcd
Quinoprotein glucose







dehydrogenase Qcd


K-12
POC054
−5.16
8.20E−04
lamB
Maltose outer







membrane channel







LamB


K-12
P15031
−5.40
6.01E−04
tnaA
Tryptophanase TnaA


K-12
P31224
−5.93
2.21E−05
puuE
4-aminobutyrate







aminotransferase PuuE





*AcrB fold difference was calculated through imputation using a normal distribution













TABLE 9







Efflux peptides detected in LC-MS/MS comparative proteomics from


cultures grown in Lysogeny broth and minimal M9 medium with a glucose


carbon source, in the absence of antibiotic selection. Peptides were


considered significant if they were identified in at least three biological


replicates. Additionally, a minimum of two peptides detected for each


efflux pump was required.








Efflux



Pump
Peptides Observed in K-12





AcrB
AADGQMVPFSAFSSSR (SEQ ID NO: 256),



AQALGVSINDINTTLGAAWGGSYVNDFIDR (SEQ ID NO: 257),



AQNAQVAAGQLGGTPPVK (SEQ ID NO: 258), DWADRPGEENKVEAITMR



(SEQ ID NO: 259), FQLTPVDVITAIK (SEQ ID NO: 260),



GFFGWENR (SEQ ID NO: 261), GLIEATLDAVR (SEQ ID NO:



262), GQNTGIAFVSLK (SEQ ID NO: 263),



HPDMLTSVRPNGLEDTPQFK (SEQ ID NO: 264), IVYPYDTTPFVK



(SEQ ID NO: 265), IWMNPNELNK (SEQ ID NO: 266),



LATGANALDTAAAIR (SEQ ID NO: 267), LPTGVGYDWTGMSYQER



(SEQ ID NO: 268), LQLAMPLLPQEVQQQGVSVEK (SEQ ID NO:



269), MEPFFPSGLK (SEQ ID NO: 270), MLPDDIGDWYVR (SEQ ID



NO: 271), NAILIVEFAK (SEQ ID NO: 272),



NNVESVFAVNGFGFAGR (SEQ ID NO: 273), STGEAMELMEQLASK



(SEQ ID NO: 274), TSGVGDVQLFGSQYAMR (SEQ ID NO: 275),



VEAITMR (SEQ ID NO: 276), VLNEVTHYYLTK (SEQ ID NO:



277), VMAEEGLPPK (SEQ ID NO: 278), VYVMSEAK (SEQ ID NO:



279), WEYGSPR (SEQ ID NO: 280), YNGLPSMEILGQAAPGK (SEQ



ID NO: 281)





CusA
ASGYLQTLDDENHIVLK (SEQ ID NO: 282), DRDMVSVVHDLQK (SEQ



ID NO: 283), HDLADLR (SEQ ID NO: 284), IIEELDNTVR (SEQ



ID NO: 285), LAQYGISLAEVK (SEQ ID NO: 286),



LDEALYHGAVLR (SEQ ID NO: 287), LFGPLAFTK (SEQ ID NO:



288), LPGLANLWVPPIR (SEQ ID NO: 289), QLPILTPMK (SEQ ID



NO: 290), QQITLADVADIK (SEQ ID NO: 291), SLQDWELK (SEQ



ID NO: 292), TIPDVAEVASVGGVVK (SEQ ID NO: 293),



TVPGVASALAER (SEQ ID NO: 294), VLEYLNQVQGK (SEQ ID NO:



295)





MdtK
GTAKPDPAVMK (SEQ ID NO: 296), LPSAIILQR (SEQ ID NO:



297)





Yojl
AEFPRPQAFPNWQTLELR (SEQ ID NO: 298),



EFYQVLLPLMQEMGK (SEQ ID NO: 299), ILDTHVER (SEQ ID NO:



300), LFSAVFTDVWLFDQLLGPEGKPANPQLVEK (SEQ ID NO: 301)
















TABLE 10







Susceptibility of ΔtolC and EKO-35 +/− the pore to a diverse


panel of antimicrobial agents. Strains were assessed in technical duplicate


and instances where the MIC value differed (4-fold or greater) between


EKO-35 and ΔtolC are bolded. Values with a 4-fold or greater change


in MIC are in bold font to indicate increased susceptibility in EKO-35


compared to ΔtolC. STDC: Sodium taurodeoxycholate.









Minimum inhibitory concentration (MIC) (μg/mL)









Pore













Compound
K-12
ΔtolC
EKO-35
K-12
ΔtolC
EKO-35
















Rifampicin
12.5
6.25
6.25
0.781
0.391
0.391


Vancomycin
200
200
200
3.125
6.25
6.25


Fosfomycin
6.25
6.25
3.125
3.125
3.125

0.781



Ampicillin
100
25
25
12.5
1.563
1.563


Oxacillin
160
0.625
0.625
40
0.313
0.313


Chloramphenicol
6.5
1.563
0.781
3.125
0.781
0.781


Puromycin
50
3.125
1.563
50
1.563
0.781


Azithromycin
6.25
0.781
0.781
0.391
0.049
0.049


Erythromycin
100
3.125
3.125
6.25
0.195
0.195


Spectinomycin
25
6.25

25

12.5
6.25
12.5


Tetracycline
1.563
0.391
0.195
0.781
0.391
0.195


Linezolid
500
7.813
7.813
125
3.906
3.906


Kanamycin
3.125
1.563
3.125
3.125
1.563
1.563


Streptomycin
6.25
3.125
3.125
12.5
1.563
3.125


Minocycline
0.781
0.098
0.049
0.781
0.098
0.049


Fusidic acid
400
3.125
3.125
100
0.391
0.391


Ciprofloxacin
0.010
0.005
0.005
0.005
0.002
0.002


Norfloxacin
0.078
0.020
0.020
0.078
0.010
0.010


Nalidixic acid
10
1.25
1.25
5
1.25
1.25


Novobiocin
200
0.781

3.125

12.5
0.391
0.781


Trimethoprim
0.391
0.098
0.195
0.391
0.049

0.195



Doxorubicin
200
1.563
1.563
50
0.781
0.781


Daunorubicin
200
1.563
3.125
100
0.781
0.781


Ethidium
100
3.125

0.195

100
3.125

0.098



bromide


Bicyclomycin
200
200
200
200
200
200


Sulfathiazole
5
5
10
5
2.5
5


Acriflavine
50
3.125

0.098

50
3.125

0.098



SDS
1000
15.625
31.25
1000
15.625
31.25


Benzalkonium
12.5
0.391
0.391
6.25
0.391
0.391


chloride


Deoxycholate
1500
187.5
375
1500
46.875

187.5



STDC
1000
250
500
1000
250
250


Chlorhexidine
0.781
0.391
0.391
0.781
0.391
0.391


CCCP
25
0.781

12.5

12.5
0.391

6.25



Spermine
2000
2000
2000
2000
2000
2000


Compound 1
320
5

320

320
10

320



Compound 2
320
1.25

320

320
1.25

320



Compound 3
320
2.5

320

320
1.25

320



Compound 4
320
10
20
320
1.25
2.5


Compound 5
320
10
20
320
2.5

20



Compound 6
320
0.625

320

320
0.625

320



Compound 7
320
0.313

320

320
0.313

320



Compound 8
640
1.25

320

160
1.25

80



Compound 10
160
10

160

160
5
10


Compound 11
320
0.156
0.078
80
0.156
0.078


Compound 12
320
1.25

320

320
0.625

160



Compound 13
320
1.25

40

320
1.25

5



Compound 14
320
2.5

320

320
1.25

320



Compound 15
320
1.25

320

320
0.625

320



Compound 16
320
10
10
160
5
5


Compound 17
320
1.25

320

320
0.313

320



Compound 18
320
5
5
320
1.25
1.25


Compound 19
320
2.5

320

320
0.625

320

















TABLE 11A







Assessing the susceptibility of EKO-35 harboring ASKA


plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC.


Strains were assessed in technical duplicate and instances


where the MIC value differed >2-fold between EKO-35 and


EKO-35 harboring ASKA plasmids are bolded. Gene expression


was induced with 0.1 mM IPTG. Control strains harbored


empty pCA24N. ND: not determined. NV: not viable.


Susceptibility testing was performed both in the presence


and absence of plasmid selection (25 μg/mL and 4 μg/mL


chloramphenicol for the wild-type E. coli


and EKO-35 strains, respectively).









Strain (pCA24N)











Benzalkonium
Novobiocin
Trimethoprim



chloride (μg/mL)
(μg/mL)
(μg/mL)













Chlor

+

+

+
















K-12
25
25
400
200
0.781
0.781


K-12 gyrB
ND
ND
400
100
ND
ND


K-12
ND
ND
ND
ND
1.56
0.195


wcaC


ΔtolC
1.56
0.781
3.13
1.56
0.195
1.56


ΔtolC
ND
ND

12.5


12.5

ND
ND


gyrB


ΔtolC
ND
ND
ND
ND
0.195
0.195


wcaC


EKO-35
0.781
0.781
3.13
3.13
0.391
0.391


EKO-35
0.781
0.781

12.5


25

0.391
0.391


gyrB


EKO-35
0.781
0.391
1.56
1.56
0.781
0.781


wcaC


EKO-35
0.781
0.781
3.13
1.56
0.391
0.391


rspA


EKO-35
0.781
NV
1.56
NV
0.391
NV


pitA


EKO-35
0.781
0.781
1.56
3.13
0.391
0.391


tufA


EKO-35
0.781
0.781
3.13
3.13
0.391
0.391


yjfC
















TABLE 11B







Assessing the susceptibility of EKO-35 harboring ASKA


plasmids expressing rspA, tufA, pitA, wcaC, gyrB, and yjfC.


Strains were assessed in technical duplicate and instances


where the MIC value differed >2-fold between EKO-35 and


EKO-35 harboring ASKA plasmids are bolded. Gene expression


was induced with 0.1 mM IPTG. Control strains harbored


empty pCA24N. ND: not determined. NV: not viable.


Susceptibility testing was performed both in the presence


and absence of plasmid selection (25 μg/mL and 4 μg/mL


chloramphenicol for the wild-type E. coli


and EKO-35 strains, respectively).










Strain (pCA24N)















Synthetic 2

Synthetic 14

Synthetic 19




(μg/mL)

(μg/mL)

(μg/mL)















Chlor

+

+

+



















K-12
>5
>5
>5
>5
>5
>5



K-12
ND
ND
ND
ND
ND
ND



gyrB



K-12
ND
ND
ND
ND
ND
ND



wcaC



ΔtolC
1.25
1.25
1.25
1.25
2.5
2.5



ΔtolC
ND
ND
ND
ND
ND
ND



gyrB



ΔtolC
ND
ND
ND
ND
ND
ND



wcaC



EKO-35
>5
>5
>5
>5
>5
>5



EKO-35
>5
>5
>5
>5
>5
>5



gyrB



EKO-35
>5
>5
>5
>5
>5
>5



wcaC



EKO-35
>5
>5
>5
>5
>5
>5



rspA



EKO-35
>5
NV
>5
NV
>5
NV



pitA



EKO-35
>5
>5
>5
>5
>5
>5



tufA



EKO-35
>5
>5
>5
>5
>5
>5



yjfC

















TABLE 12







Efflux genes and reported substrates.








Gene
Known Substrates





acrB
Ampicillin, oxacillin, meropenem, chloramphenicol, puromycin,



erythromycin, ciprofloxacin, norfloxacin, nalidixic acid, linezolid, fusidic



acid, tetracycline, novobiocin, trimethoprim, acriflavine, ethidium



bromide, SDS, deoxycholate, sodium cholate, rifampin


acrD
Kanamycin, amikacin, gentamicin, tobramycin, neomycin, novobiocin,



SDS, deoxycholate, oxacillin, carbenicillin puromycin


acrF
Chloramphenicol, erythromycin, nalidixic acid, tetracycline, acriflavine,



trimethoprim, doxorubicin, novobiocin, norfloxacin, SDS, deoxycholate,



benzalkonium chloride, oxacillin


emrB
CCCP, SDS, deoxycholate, TSA, nalidixate


emrY
Deoxycholate


mdtF
Erythromycin, telithromycin, azithromycin, ethidium bromide,



doxorubicin, crystal violet, TTP, SDS, novobiocin, ciprofloxacin,



deoxycholate, cholate, taurocholate, oxacillin


mdtBC
Norfloxacin, nalidixic acid, novobiocin, SDS, deoxycholate, fosfomycin,



benzalkonium chloride


macB
Erythromycin, azithromycin, additional macrolides


emrE
Erythromycin, acriflavine, ethidium bromide, benzalkonium chloride,



tetracycline, TTP, crystal violet, streptomycin, tobramycin (and additional



aminoglycosides), sulfadiazine


mdtK
Chloramphenicol, ciprofloxacin, norfloxacin, trimethoprim, acriflavine,



ethidium bromide, doxorubicin, benzalkonium chloride, fosfomycin,



novobiocin,


mexCD
Tetracycline, chloramphenicol, novobiocin, macrolides, quinolones,



meropenem, acriflavine, ethidium bromide
















TABLE 13A







Minimum inhibitory concentrations (MICs) of various compounds against the wild-type K-12,


ΔtolC, EKO-35, and the efflux-integrated EKO-35 strains, which were used to calculate


fold-change. Strains were assessed in technical duplicate and values that showed a 4-fold


or greater increase from the EKO-35 MIC are bolded. STDC: Sodium taurodeoxycholate.









Minimum Inhibitory Concentration (ug/mL)



EKO-35 araC::gene














Compound
K-12
ΔtolC
EKO-35
acrB
acrD
acrEF
mdtEF

















Rifampicin
12.5
6.25
6.25
6.25
6.25
6.25
6.25


Vancomycin
200
200
200
200
200
200
200


Fosfomycin
6.25
6.25
3.125
1.563
1.563
1.563
1.563


Ampicillin
100
25
25
100
100
50
25


Oxacillin
160
0.625
0.625
160
160
160
20


Chloramphenicol
6.25
1.563
0.781
6.25
1.563
1.563
0.781


Puromycin
50
3.125
1.563
100
1.563
6.25
1.563


Azithromycin
6.25
0.781
0.781
12.5
0.781
6.25
6.25


Erythromycin
100
3.125
3.125
100
3.125
50
50


Spectinomycin
25
6.25
25
25
25
25
25


Tetracycline
1.563
0.391
0.195
0.781
0.195
0.195
0.195


Linezolid
500
7.813
7.813
250
7.813
15.625
3.906


Kanamycin
3.125
1.563
3.125
3.125
3.125
3.125
3.125


Streptomycin
6.25
3.125
3.125
6.25
6.25
3.125
6.25


Minocycline
0.781
0.098
0.049
0.391
0.098
0.098
0.049


Fusidic acid
400
3.125
3.125
400
100
50
50


Ciprofloxacin
0.010
0.005
0.005
0.020
0.005
0.020
0.005


Norfloxacin
0.078
0.020
0.020
0.078
0.020
0.078
0.020


Nalidixic acid
10
1.25
1.25
10
2.5
5
1.25


Novobiocin
200
0.781
3.125
400
200
400
50


Trimethoprim
0.391
0.098
0.195
1.563
0.391
0.781
0.391


Doxorubicin
200
1.563
1.563
200
3.125
100
100


Daunorubicin
200
1.563
3.125
200
6.25
200
200


Ethidium bromide
100
3.125
0.195
12.5
0.391
3.125
1.563


Bicyclomycin
200
200
200
200
200
200
200


Sulfathiazole
5
5
10
10
10
10
10


Acriflavine
50
3.125
0.098
3.125
0.195
0.781
0.195


SDS
1000
15.625
31.25
1000
1000
1000
1000


Benzalkonium
12.5
0.391
0.391
12.5
0.391
1.563
1.563


chloride


Deoxycholate
1500
187.5
375
1500
1500
1500
1500


STDC
1000
250
500
1000
1000
1000
1000


Chlorhexidine
0.781
0.391
0.391
0.391
0.391
0.391
0.391


CCCP
25
0.781
12.5
12.5
6.25
12.5
12.5


Spermine
2000
2000
2000
2000
2000
2000
2000


Compound 1
320
5
320
320
320
320
320


Compound 2
320
1.25
320
320
320
320
320


Compound 3
320
2.5
320
320
320
320
320


Compound 4
320
10
20
320
320
320
320


Compound 5
320
10
20
320
40
320
320


Compound 6
320
0.625
320
320
320
320
320


Compound 7
320
0.313
320
320
320
320
320


Compound 8
640
1.25
320
640
160
320
320


Compound 10
160
10
160
160
160
160
160


Compound 11
320
0.156
0.078
320
0.625
320
10


Compound 12
320
1.25
320
320
320
320
320


Compound 13
320
1.25
40
320
320
320
320


Compound 14
320
2.5
320
320
320
320
320


Compound 15
320
1.25
320
320
320
320
320


Compound 16
320
10
10
320
10
320
160


Compound 17
320
1.25
320
320
320
320
320


Compound 18
320
5
5
320
320
320
320


Compound 19
320
2.5
320
320
320
320
320
















TABLE 13B







Minimum inhibitory concentrations (MICs) of various compounds against


the wild-type K-12, ΔtolC, EKO-35, and the efflux-integrated EKO-35


strains, which were used to calculate fold-change. Strains were assessed


in technical duplicate and values that showed a 4-fold or greater increase


from the EKO-35 MIC are bolded. STDC: Sodium taurodeoxycholate.









Minimum Inhibitory Concentration (ug/mL)



EKO-35 araC::gene













Compound
mdtBC
macAB
emrKY
emrAB
mexCD
acrBD408A
















Rifampicin
6.25
6.25
6.25
6.25
3.125
3.125


Vancomycin
200
200
200
200
200
200


Fosfomycin
1.563
3.125
1.563
3.125
1.563
3.125


Ampicillin
25
12.5
25
25
25
25


Oxacillin
0.625
0.625
0.625
1.25

20

1.25


Chloramphenicol
0.781
0.781
0.391
0.781
0.781
0.781


Puromycin
1.563
1.563
1.563
1.563

6.25

1.563


Azithromycin
0.781

3.125

0.391
0.781

3.125

0.781


Erythromycin
3.125

12.5

3.125
3.125

25

3.125


Spectinomycin
25
25
25
25
25
25


Tetracycline
0.195
0.195
0.195
0.195
0.195
0.195


Linezolid
3.906
3.906
3.906
3.906
15.625
7.813


Kanamycin
3.125
3.125
1.563
3.125
1.563
1.563


Streptomycin
6.25
3.125
3.125
3.125
3.125
3.125


Minocycline
0.049
0.049
0.049
0.049
0.049
0.049


Fusidic acid
6.25
3.125
3.125
6.25

12.5

3.125


Ciprofloxacin
0.005
0.005
0.005
0.005
0.010
0.005


Norfloxacin
0.020
0.020
0.010
0.020
0.039
0.020


Nalidixic acid
1.25
1.25
1.25

10

2.5
1.25


Novobiocin

12.5

1.563
3.125

25


25

3.125


Trimethoprim
0.195
0.195
0.195
0.195
0.391
0.098


Doxorubicin
1.563
1.563
1.563
1.563

25

1.563


Daunorubicin
1.563
6.25
3.125
3.125

100

3.125


Ethidium
0.195
0.195
0.195
0.195

1.563

0.391


bromide


Bicyclomycin
200
200
200
200
200
200


Sulfathiazole
10
5
10
10
10
10


Acriflavine
0.098
0.098
0.098
0.098

0.781

0.098


SDS
62.5
31.25
62.5

125


1000

62.5


Benzalkonium
0.391
0.391
0.391
0.391
0.781
0.391


chloride


Deoxycholate

1500

187.5
375

1500


1500

375


STDC
1000
250
500
1000
1000
1000


Chlorhexidine
0.391
0.391
0.391
0.391
0.391
0.391


CCCP
12.5
12.5
12.5

50

12.5
12.5


Spermine
2000
2000
2000
2000
2000
2000


Compound 1
320
320
320
320
320
320


Compound 2
320
320
320
320
320
320


Compound 3
320
320
320
320
320
320


Compound 4
20
20
20

320


320

20


Compound 5
10
20
20

320


320

20


Compound 6
320
320
320
320
320
320


Compound 7
320
320
320
320
320
320


Compound 8
320
320
320
320
320
320


Compound 10
160
160
160
160
160
160


Compound 11
0.078
0.078
0.078

40


1.25

0.078


Compound 12
320
320
320
320
320
320


Compound 13
40
40
40

320


320

40


Compound 14
320
320
320
320
320
320


Compound 15
320
320
320
320
320
320


Compound 16
5
10
5

160


160

10


Compound 17
320
320
320
320
320
320


Compound 18
10
2.5
2.5

320


320

5


Compound 19
320
320
320
320
320
320
















TABLE 14A







Minimum inhibitory concentrations (MICs) of various compounds against the wild-type (WT)-Pore,


ΔtolC-Pore, EKO-35-Pore, and the efflux-integrated EKO-35-Pore strains, which were used


to calculate fold-change. Strains were assessed in technical duplicate and values that showed


a 4-fold or greater increase from the EKO-35 MIC are bolded. STDC: Sodium taurodeoxycholate.









Minimum inhibitory concentration (μg/mL)



EKO-35 araC::gene Pore














Compound
K-12
ΔtolC
EKO-35
acrB
acrD
acrEF
mdtEF

















Rifampicin
0.781
0.391
0.391
1.563
0.391
0.391
0.391


Vancomycin
3.125
6.25
6.25
3.125
3.125
3.125
6.25


Fosfomycin
3.125
3.125
0.781
0.781
0.781
1.563
0.781


Ampicillin

1.563
1.563
12.5
25
3.125
1.563


Oxacillin
40
0.313
0.313
20
20
5
1.25


Chloramphenicol
3.125
0.781
0.781
3.125
0.781
0.781
0.781


Puromycin
50
1.563
0.781
50
0.781
3.125
1.563


Azithromycin
0.391
0.049
0.049
0.195
0.024
0.195
0.195


Erythromycin
6.25
0.195
0.195
6.25
0.195
1.563
1.563


Spectinomycin
12.5
6.25
12.5
25
25
12.5
12.5


Tetracycline
0.781
0.391
0.195
0.391
0.195
0.195
0.195


Linezolid
125
3.906
3.906
62.5
7.813
7.813
7.813


Kanamycin
3.125
1.563
1.563
3.125
1.563
1.563
1.563


Streptomycin
12.5
1.563
3.125
6.25
3.125
3.125
3.125


Minocycline
0.781
0.098
0.049
0.391
0.098
0.098
0.098


Fusidic acid
100
0.391
0.391
100
12.5
12.5
3.125


Ciprofloxacin
0.005
0.002
0.002
0.009
0.002
0.010
0.002


Norfloxacin
0.078
0.010
0.010
0.078
0.020
0.039
0.020


Nalidixic acid
5
1.25
1.25
10
1.25
2.5
1.25


Novobiocin
12.5
0.391
0.781
400
25
25
12.5


Trimethoprim
0.391
0.049
0.195
0.781
0.195
0.195
0.391


Doxorubicin
50
0.781
0.781
50
0.781
12.5
25


Daunorubicin
100
0.781
0.781
100
1.563
25
50


Ethidium bromide
100
3.125
0.098
6.25
0.195
1.563
0.781


Bicyclomycin
200
200
200
200
200
200
200


Sulfathiazole
5
2.5
5
10
5
5
10


Acriflavine
50
3.125
0.098
1.563
0.195
0.781
0.195


SDS
1000
15.625
31.25
1000
1000
1000
1000


Benzalkonium
6.25
0.391
0.391
3.125
0.391
0.781
1.563


chloride


Deoxycholate
1500
46.875
187.5
1500
1500
1500
1500


STDC
1000
250
250
1000
1000
1000
1000


Chlorhexidine
0.781
0.391
0.391
0.391
0.391
0.391
0.391


CCCP
12.5
0.391
6.25
6.25
6.25
3.125
6.25


Spermine
2000
2000
2000
2000
2000
2000
2000


Compound 1
320
10
320
320
320
320
320


Compound 2
320
1.25
320
320
320
320
320


Compound 3
320
1.25
320
320
320
320
320


Compound 4
320
1.25
2.5
320
10
320
320


Compound 5
320
2.5
20
320
10
320
320


Compound 6
320
0.625
320
320
320
320
320


Compound 7
320
0.313
320
320
320
320
320


Compound 8
160
1.25
80
160
40
40
80


Compound 10
160
5
10
160
160
160
160


Compound 11
80
0.156
0.078
80
0.313
80
5


Compound 12
320
0.625
160
320
160
320
320


Compound 13
320
1.25
5
320
10
20
40


Compound 14
320
1.25
320
320
320
320
320


Compound 15
320
0.625
320
320
320
320
320


Compound 16
160
5
5
160
5
80
80


Compound 17
320
0.313
320
320
320
320
320


Compound 18
320
1.25
1.25
320
10
320
320


Compound 19
320
0.625
320
320
320
320
320
















TABLE 14B







Minimum inhibitory concentrations (MICs) of various compounds against the


wild-type (WT)-Pore, ΔtolC-Pore, EKO-35-Pore, and the efflux-integrated


EKO-35-Pore strains, which were used to calculate fold-change. Strains were


assessed in technical duplicate and values that showed a 4-fold or greater


increase from the EKO-35 MIC are bolded. STDC: Sodium taurodeoxycholate.









Minimum inhibitory concentration (μg/mL)



EKO-35 araC::gene Pore













Compound
mdtBC
macAB
emrKY
emrAB
mexCD
acrBD408A
















Rifampicin
0.781
0.391
0.391
0.195
0.391
0.195


Vancomycin
1.563
6.25
3.125
3.125
6.25
6.25


Fosfomycin
0.781
0.781
0.781
1.563
1.563
0.781


Ampicillin
0.781
1.563
3.125
0.781
1.563
0.781


Oxacillin
0.313
0.313
0.313
0.313

2.5

0.156


Chloramphenicol
0.781
0.781
0.391
0.781
0.781
0.781


Puromycin
0.781
0.781
1.563
0.781

1.563

0.781


Azithromycin
0.049
0.098
0.024
0.049
0.098
0.098


Erythromycin
0.195

0.781

0.195
0.195
1.563
0.098


Spectinomycin
12.5
12.5
12.5
12.5
12.5
12.5


Tetracycline
0.195
0.195
0.195
0.195
0.195
0.195


Linezolid
3.906
3.906
3.906
7.813
7.813
3.906


Kanamycin
1.563
3.125
1.563
1.563
1.563
0.781


Streptomycin
3.125
3.125
3.125
3.125
3.125
1.563


Minocycline
0.049
0.049
0.049
0.049
0.049
0.049


Fusidic acid
0.391
0.391
0.391

1.563


1.563

0.391


Ciprofloxacin
0.002
0.002
0.002
0.005
0.005
0.002


Norfloxacin
0.020
0.020
0.010
0.020

0.039

0.020


Nalidixic acid
1.25
1.25
1.25

10

2.5
1.25


Novobiocin

3.125

0.781
0.781

6.25


3.125

0.391


Trimethoprim
0.195
0.195
0.391
0.391
0.195
0.195


Doxorubicin

3.125

0.781
0.781
0.781

3.125

0.781


Daunorubicin

3.125

1.563
0.781
1.563

12.5

0.781


Ethidium bromide
0.098
0.098
0.098
0.098

0.781

0.098


Bicyclomycin
200
200
200
200
200
200


Sulfathiazole
5
10
5
10
5
1.25


Acriflavine
0.098
0.195
0.098
0.195

0.391

0.098


SDS
31.25
31.25
31.25

125


125

31.25


Benzalkonium
0.195
0.391
0.195
0.391
0.391
0.391


chloride


Deoxycholate

750

187.5
187.5

750

375
93.75


STDC

1000

250
250
500

1000

250


Chlorhexidine
0.391
0.391
0.391
0.391
0.391
0.391


CCCP
12.5
6.25
6.25
12.5
6.25
6.25


Spermine
2000
2000
2000
2000
2000
500


Compound 1
320
320
320
320
320
320


Compound 2
320
320
320
320
320
320


Compound 3
320
320
320
320
320
320


Compound 4
2.5
5
1.25

20


40

2.5


Compound 5
10
10
10

320


320

20


Compound 6
320
320
320
320
320
320


Compound 7
320
320
320
320
320
320


Compound 8
80
80
80
40
80
80


Compound 10
10
10
10

160


160

10


Compound 11
0.078
0.078
0.078

1.25


0.625

0.078


Compound 12
320
320
320
320
320
320


Compound 13
5
5
2.5
10
5
5


Compound 14
320
320
320
320
320
320


Compound 15
320
320
320
320
320
320


Compound 16
5
5
2.5

80


80

5


Compound 17
320
320
320
320
320
320


Compound 18
1.25
1.25
1.25

320


20

1.25


Compound 19
320
320
320
320
320
320
















TABLE 15A







Fold change in the MIC of profiled compounds against EKO-35


efflux pump-integrated strains compared to EKO-35. Strains


were assessed in technical duplicate and values that showed


a 4-fold or greater increase in resistance compared to


EKO-35 are bolded. Related to FIGS. 4A-4F.









Fold change of MICs



EKO-35 araC::gene













Compound
EKO-35
acrB
acrD
acrEF
mdtEF
mdtBC
















Rifampicin
1
1
1
1
1
1


Vancomycin
1
1
1
1
1
1


Fosfomycin
1
1
1
1
1
1


Ampicillin
1

4


4

2
1
1


Oxacillin
1

256


256


256


32

1


Chloramphenicol
1

8

2
2
1
1


Puromycin
1

64

1

4

1
1


Azithromycin
1

16

1

8


8

1


Erythromycin
1

32

1

16


16

1


Spectinomycin
1
1
1
1
1
1


Tetracycline
1

4

1
1
1
1


Linezolid
1

32

1
2
1
1


Kanamycin
1
1
1
1
1
1


Streptomycin
1
2
2
1
2
2


Minocycline
1

8

2
2
1
1


Fusidic acid
1

128


32


16


16

2


Ciprofloxacin
1

4

1

4

1
1


Norfloxacin
1

4

1

4

1
1


Nalidixic acid
1

8

2

4

1
1


Novobiocin
1

128


64


128


16


4



Trimethoprim
1

8

2

4

2
1


Doxorubicin
1

128

2

64


64

1


Daunorubicin
1

64

2

64


64

1


Ethidium bromide
1

64

2

16


8

1


Bicyclomycin
1
1
1
1
1
1


Sulfathiazole
1
1
1
1
1
1


Acriflavine
1

32

2

8

2
1


SDS
1

32


32


32


32

2


Benzalkonium
1

32

1

4


4

1


chloride


Deoxycholate
1

4


4


4


4


4



Sodium
1
2
2
2
2
2


taurodeoxycholate


Chlorhexidine
1
1
1
1
1
1


CCCP
1
1
1
1
1
1


Spermine
1
1
1
1
1
1


Compound 1
1
1
1
1
1
1


Compound 2
1
1
1
1
1
1


Compound 3
1
1
1
1
1
1


Compound 4
1

16


16


16


16

1


Compound 5
1

16

2

16


16

1


Compound 6
1
1
1
1
1
1


Compound 7
1
1
1
1
1
1


Compound 8
1
2
1
1
1
1


Compound 10
1
1
1
1
1
1


Compound 11
1

4096


8


4096


128

1


Compound 12
1
1
1
1
1
1


Compound 13
1

8


8


8


8

1


Compound 14
1
1
1
1
1
1


Compound 15
1
1
1
1
1
1


Compound 16
1

32

1

32


16

1


Compound 17
1
1
1
1
1
1


Compound 18
1

64


64


64


64

2


Compound 19
1
1
1
1
1
1
















TABLE 15B







Fold change in the MIC of profiled compounds against EKO-35


efflux pump-integrated strains compared to EKO-35. Strains


were assessed in technical duplicate and values that showed


a 4-fold or greater increase in resistance compared to


EKO-35 are bolded. Related to FIGS. 4A-4F.









Fold change of MICs



EKO-35 araC::gene












Compound
macAB
emrKY
emrAB
mexCD
acrBD408A















Rifampicin
1
1
1
1
1


Vancomycin
1
1
1
1
1


Fosfomycin
1
1
1
1
1


Ampicillin
1
1
1
1
1


Oxacillin
1
1
2

32

2


Chloramphenicol
1
1
1
1
1


Puromycin
1
1
1

4

1


Azithromycin

4

1
1

4

1


Erythromycin

4

1
1

8

1


Spectinomycin
1
1
1
1
1


Tetracycline
1
1
1
1
1


Linezolid
1
1
1
2
1


Kanamycin
1
1
1
1
1


Streptomycin
1
1
1
1
1


Minocycline
1
1
1
1
1


Fusidic acid
1
1
2

4

1


Ciprofloxacin
1
1
1
2
1


Norfloxacin
1
0
1
2
1


Nalidixic acid
1
1

8

2
1


Novobiocin
1
1

8


8

1


Trimethoprim
1
1
1
2
0


Doxorubicin
1
1
1

16

1


Daunorubicin
2
1
1

32

1


Ethidium bromide
1
1
1

8

2


Bicyclomycin
1
1
1
1
1


Sulfathiazole
1
1
1
1
1


Acriflavine
1
1
1

8

1


SDS
1
2

4


32

2


Benzalkonium
1
1
1
2
1


chloride


Deoxycholate
1
1

4


4

1


Sodium
1
1
2
2
2


taurodeoxycholate


Chlorhexidine
1
1
1
1
1


CCCP
1
1

4

1
1


Spermine
1
1
1
1
1


Compound 1
1
1
1
1
1


Compound 2
1
1
1
1
1


Compound 3
1
1
1
1
1


Compound 4
1
1

16


16

1


Compound 5
1
1

16


16

1


Compound 6
1
1
1
1
1


Compound 7
1
1
1
1
1


Compound 8
1
1
1
1
1


Compound 10
1
1
1
1
1


Compound 11
1
1

512


16

1


Compound 12
1
1
1
1
1


Compound 13
1
1

8


8

1


Compound 14
1
1
1
1
1


Compound 15
1
1
1
1
1


Compound 16
1
1

16


16

1


Compound 17
1
1
1
1
1


Compound 18
1
1

64


64

1


Compound 19
1
1
1
1
1
















TABLE 16A







Fold change in the MIC of profiled compounds against EKO-35


efflux pump-integrated pore strains compared to EKO-35-Pore.


Strains were assessed in technical duplicate and values


that showed a 4-fold or greater increase in resistance compared


to EKO-35 are bolded. Related to FIGS. 4A-4F.









Fold changes of MICs



EKO-35 araC::gene Pore












Compound
EKO-35
acr-B
acrD
acrEF
mdtEF















Rifampicin
1
4
1
1
1


Vancomycin
1
1
1
1
1


Fosfomycin
1
1
1
2
1


Ampicillin
1
8
16
2
1


Oxacillin
1
64
64
16
4


Chloramphenicol
1
4
1
1
1


Puromycin
1
64
1
4
2


Azithromycin
1
4
1
4
4


Erythromycin
1
32
1
8
8


Spectinomycin
1
2
2
1
1


Tetracycline
1
2
1
1
1


Linezolid
1
16
2
2
2


Kanamycin
1
2
1
1
1


Streptomycin
1
2
1
1
1


Minocycline
1
8
2
2
2


Fusidic acid
1
256
32
32
8


Ciprofloxacin
1
4
1
4
1


Norfloxacin
1
8
2
4
2


Nalidixic acid
1
8
1
2
1


Novobiocin
1
512
32
32
16


Trimethoprim
1
4
1
1
2


Doxorubicin
1
64
1
16
32


Daunorubicin
1
128
2
32
64


Ethidium bromide
1
64
2
16
8


Bicyclomycin
1
1
1
1
1


Sulfathiazole
1
2
1
1
2


Acriflavine
1
16
2
8
2


SDS
1
32
32
32
32


Benzalkonium
1
8
1
2
4


chloride


Deoxycholate
1
8
8
8
8


Sodium
1
4
4
4
4


taurodeoxycholate


Chlorhexidine
1
1
1
1
1


CCCP
1
1
1
1
1


Spermine
1
1
1
1
1


Compound 1
1
1
1
1
1


Compound 2
1
1
1
1
1


Compound 3
1
1
1
1
1


Compound 4
1
128
4
128
128


Compound 5
1
16
1
16
16


Compound 6
1
1
1
1
1


Compound 7
1
1
1
1
1


Compound 8
1
2
1
1
1


Compound 10
1
16
16
16
16


Compound 11
1
1024
4
1024
64


Compound 12
1
2
1
2
2


Compound 13
1
64
2
4
8


Compound 14
1
1
1
1
1


Compound 15
1
1
1
1
1


Compound 16
1
32
1
16
16


Compound 17
1
1
1
1
1


Compound 18
1
256
8
256
256


Compound 19
1
1
1
1
1
















TABLE 16B







Fold change in the MIC of profiled compounds against EKO-35 efflux pump-


integrated pore strains compared to EKO-35-Pore. Strains were assessed in


technical duplicate and values that showed a 4-fold or greater increase


in resistance compared to EKO-35 are bolded. Related to FIGS. 4A-4F.









Fold changes of MICs



EKO-35 araC::gene Pore













Compound
mdtBC
macAB
emrKY
emrAB
mexCD
acrBD408A
















Rifampicin
2
1
1
1
1
1


Vancomycin
0
1
1
1
1
1


Fosfomycin
1
1
1
2
2
1


Ampicillin
1
1
2
1
1
1


Oxacillin
1
1
1
1

8

1


Chloramphenicol
1
1
1
1
1
1


Puromycin
1
1
2
1
2
1


Azithromycin
1
2
1
1
2
2


Erythromycin
1

4

1
1

8

0


Spectinomycin
1
1
1
1
1
1


Tetracycline
1
1
1
1
1
1


Linezolid
1
1
1
2
2
1


Kanamycin
1
2
1
1
1
1


Streptomycin
1
1
1
1
1
1


Minocycline
1
1
1
1
1
1


Fusidic acid
1
1
1

4


4

1


Ciprofloxacin
1
1
1
2
2
1


Norfloxacin
2
2
1
2

4

2


Nalidixic acid
1
1
1

8

2
1


Novobiocin

4

1
1

8


4

1


Trimethoprim
1
1
2
2
1
1


Doxorubicin

4

1
1
1

4

1


Daunorubicin

4

2
1
2

16

1


Ethidium bromide
1
1
1
1

8

1


Bicyclomycin
1
1
1
1
1
1


Sulfathiazole
1
2
1
2
1
0


Acriflavine
1
2
1
2

4

1


SDS
1
1
1

4


4

1


Benzalkonium
1
1
1
1
1
1


chloride


Deoxycholate

4

1
1

4

2
1


Sodium

4

1
1
2

4

1


taurodeoxycholate


Chlorhexidine
1
1
1
1
1
1


CCCP
2
1
1
2
1
1


Spermine
1
1
1
1
1
0


Compound 1
1
1
1
1
1
1


Compound 2
1
1
1
1
1
1


Compound 3
1
1
1
1
1
1


Compound 4
1
2
1

8


16

1


Compound 5
1
1
1

16


16

1


Compound 6
1
1
1
1
1
1


Compound 7
1
1
1
1
1
1


Compound 8
1
1
1
1
1
1


Compound 10
1
1
1

16


16

1


Compound 11
1
1
1

16


8

1


Compound 12
2
2
2
2
2
2


Compound 13
1
1
1
2
1
1


Compound 14
1
1
1
1
1
1


Compound 15
1
1
1
1
1
1


Compound 16
1
1
1

16


16

1


Compound 17
1
1
1
1
1
1


Compound 18
1
1
1

256


16

1


Compound 19
1
1
1
1
1
















TABLE 17







The physicochemical substrate parameters of drug efflux pumps assessed using EKO-35


and EKO-35-Pore strains. Molecular properties were summarized using the SMILES


chemical notation for each compound and DataWarrior (Version 5.5.0). Median values


are indicated in parentheses. (Related to FIG. 4A-4F and Table 7).
















Molecular


Polar




Compounds
Weight


Surface


Gene
Pore
Effluxed
(g/mol)
logP
logS
Area





AcrB

28/33
227.778 to
−1.986 to
−7.266 to
0 to





748.992
5.823
−1.265
206.070





(393.447)
(1.081)
(−3.641)
(104.785)



+
30/33
227.778 to
−1.986 to
−7.266 to
0 to 220.15





822.95
5.823
−1.435
(107.66)





(393.447)
(1.664)
(−4.027)


AcrEF

23/33
227.778 to
−1.986 to
−7.266 to
0 to





748.992
5.823
−1.705
206.070





(394.315)
(1.672)
(−4.507)
(90.240)



+
22/33
285.215 to
−1.986 to
−7.266 to
54.79 to





748.992
5.823
−2.031
206.070





(414.846)
(2.095)
(−4.807)
(106.935)


MdtEF

17/33
227.778 to
−0.340 to
−7.266 to
0 to





748.992
5.823
−1.705
206.070





(401.442)
(2.129)
(−4.879)
(104.060)



+
19/33
227.778 to
−0.340 to
−7.266 to
0 to





748.992
5.823
−1.705
206.070





(401.442)
(2.129)
(−4.879)
(109.810)


AcrD

10/33
285.215 to
−1.653 to
−7.266 to
65.200 to





612.63
5.823
−1.565
196.100





(397.010)
(3.125)
(−5.076)
(114.145)



+
11/33
285.215 to
−1.653 to
−7.266 to
71.98 to





612.63
5.823
−1.565
196.100





(401.442)
(2.980)
(−5.272)
(124.230)


EmrAB

11/33
204.620 to
0.536 to
−7.266 to
54.790 to





612.63
4.077
−2.031
196.100





(341.676)
(3.270)
(−4.879)
(77.76)



+
11/33
232.238 to
0.536 to
−7.266 to
54.790 to





612.63
5.823
−2.031
196.100





(341.676)
(3.369)
(−5.363)
(90.240)


MacAB

 2/33
733.933 to
1.657 to
−3.645 to
180.080 to





748.992
1.672
−3.094
193.910





(741.463)
(1.664)
(−3.370)
(186.995)



+
 1/33
733.933
1.672
−3.645
193.91


MdtBC

 2/33
392.578 to
3.27 to
−5.272 to
77.760 to





612.63
4.032
−4.879
196.100





(502.604)
(3.651)
(−5.076)
(136.930)



+
 5/33
392.578 to
0.167 to
−5.272 to
77.76 to





612.63
4.032
−4.395
206.70





(527.524)
(2.091)
(−4.879)
(185.84)


EmrKY

 0/33







+
 0/33






MexCD

18/33
285.215 to
−1.986 to
−7.266 to
54.790 to





748.992
5.823
−2.031
206.070





(443.887)
(2.113)
(−4.871)
(114.145)



+
17/33
285.215 to
−1.986 to
−7.266 to
54.790 to





733.933
5.823
−2.031
206.070





(428.25)
(2.098)
(−5.014)
(109.810)
















TABLE 18A







Defining the Fractional Inhibitory Concentration Index (FICI)


for PABN in combination with different antibiotics using


EKO-35 and the efflux platform. The FICI represents


the ΣFIC of each drug. The FIC for each drug was


determined by dividing the MIC of each drug in combination


by the MIC of each drug alone. ΣFIC = FICA + FICB =


(CA/MICA) + (CB/MICB). MICA and MICB are the MICs of drugs


A (PAβN) and B (antibiotic) alone, respectively. CA and CB


are the MICs of the drugs in combination. Synergy (FICI ≤0.5),


indifferent (FICI >1.0;), and additive (FICI >0.5-1.0).


Related to FIGS. 5A-5J.














PABN
PABN






MICa
MICa




Alone
Combined


Strain
Compound
(μg/mL)
(μg/mL)
FICI
Effect















K-12
Ciprofloxacin
256
64
1.250



ΔtolC
Ciprofloxacin
64
32
1.000



EKO-35
Ciprofloxacin
64
4
0.563
Additive


EKO-35
Ciprofloxacin
64
8
0.625
Additive


acrBD408A


EKO-35
Ciprofloxacin
32
16
1.000



acrEF


EKO-35
Ciprofloxacin
64
8
0.375
Synergistic


mexCD


K-12
Ciprofloxacin
256
256
2.000



Pore


ΔtolC
Ciprofloxacin
128
64
0.551
Additive


Pore


EKO-35
Ciprofloxacin
64
2
0.531
Additive


Pore


EKO-35
Ciprofloxacin
32
8
0.750
Additive


acrBD408A


Pore


EKO-35
Ciprofloxacin
64
16
0.750
Additive


acrEF


Pore


EKO-35
Ciprofloxacin
64
16
0.506
Additive


mexCD


Pore


K-12
Erythromycin
256
16
0.094
Synergistic


ΔtolC
Erythromycin
64
8
0.188
Synergistic


EKO-35
Erythromycin
128
8
0.093
Synergistic


EKO-35
Erythromycin
64
8
0.190
Synergistic


acrBD408A


EKO-35
Erythromycin
256
16
0.078
Synergistic


acrB


EKO-35
Erythromycin
128
16
0.188
Synergistic


acrEF


EKO-35
Erythromycin
256
16
0.094
Synergistic


mdtEF


EKO-35
Erythromycin
64
8
0.188
Synergistic


mexCD


K-12
Erythromycin
256
64
0.313
Synergistic


Pore


ΔtolC
Erythromycin
128
16
0.188
Synergistic


Pore


EKO-35
Erythromycin
64
8
0.610
Additive


Pore


EKO-35
Erythromycin
64
16
0.735
Additive


acrBD408A


Pore


EKO-35
Erythromycin
256
16
0.078
Synergistic


acrB Pore


EKO-35
Erythromycin
128
16
0.385
Synergistic


acrEF


Pore


EKO-35
Erythromycin
256
32
0.185
Synergistic


mdtEF


Pore


EKO-35
Erythromycin
64
8
0.385
Synergistic


mexCD


Pore


K-12
Fusidic Acid
256
32
0.156
Synergistic


ΔtolC
Fusidic Acid
64
16
0.375
Synergistic


EKO-35
Fusidic Acid
128
16
0.158
Synergistic


EKO-35
Fusidic Acid
64
8
0.250
Synergistic


acrBD408A


EKO-35
Fusidic Acid
256
32
0.129
Synergistic


acrB


EKO-35
Fusidic Acid
64
8
0.141
Synergistic


acrD


EKO-35
Fusidic Acid
64
8
0.375
Synergistic


acrEF


EKO-35
Fusidic Acid
64
8
0.250
Synergistic


mdtEF


K-12
Fusidic Acid
256
32
0.188
Synergistic


Pore


ΔtolC
Fusidic Acid
128
32
0.375
Synergistic


Pore


EKO-35
Fusidic Acid
64
16
0.310
Synergistic


Pore


EKO-35
Fusidic Acid
64
8
0.255
Synergistic


acrBD408A


Pore


EKO-35
Fusidic Acid
256
32
0.129
Synergistic


acrB Pore


EKO-35
Fusidic Acid
64
8
0.250
Synergistic


acrD


Pore


EKO-35
Fusidic Acid
128
8
0.313
Synergistic


acrEF


Pore


EKO-35
Fusidic Acid
64
8
0.250
Synergistic


mdtEF Pore


K-12
Linezolid
256
16
0.125
Synergistic


ΔtolC
Linezolid
128
64
0.750
Additive


EKO-35
Linezolid
64
32
0.750
Additive


EKO-35
Linezolid
64
32
0.750
Additive


acrBD408A


EKO35
Linezolid
256
16
0.125
Synergistic


araC::acrB


K-12
Linezolid
256
32
0.250
Synergistic


Pore


ΔtolC
Linezolid
128
64
0.563
Additive


Pore


EKO-35
Linezolid
64
32
1.000



Pore


EKO-35
Linezolid
64
32
1.000



acrBD408A


Pore


EKO-35
Linezolid
256
16
0.125
Synergistic


acrB Pore


K-12
Novobiocin
256
32
0.188
Synergistic


ΔtolC
Novobiocin
64
16
0.500
Synergistic


EKO-35
Novobiocin
64
8
0.375
Synergistic


EKO-35
Novobiocin
64
8
0.375
Synergistic


acrBD408A


EKO-35
Novobiocin
256
32
0.156
Synergistic


acrB


EKO-35
Novobiocin
64
16
0.313
Synergistic


acrD


K-12
Novobiocin
256
2
0.508
Additive


Pore


ΔtolC
Novobiocin
64
32
0.740
Additive


Pore


EKO-35
Novobiocin
32
16
0.630
Additive


Pore


EKO-35
Novobiocin
16
8
0.750
Additive


acrBD408A


Pore


EKO-35
Novobiocin
256
16
0.094
Synergistic


acrB Pore


EKO-35
Novobiocin
32
16
0.563
Additive


acrD Pore


K-12
Oxacillin
256
32
0.188
Synergistic


ΔtolC
Oxacillin
128
8
0.313
Synergistic


EKO-35
Oxacillin
64
4
0.323
Synergistic


EKO-35
Oxacillin
128
16
0.185
Synergistic


acrBD408A


EKO-35
Oxacillin
256
16
0.125
Synergistic


acrB


EKO-35
Oxacillin
128
4
0.156
Synergistic


acrD


EKO-35
Oxacillin
128
16
0.133
Synergistic


acrEF


K-12
Oxacillin
256
64
0.750
Additive


Pore


ΔtolC
Oxacillin
128
64
0.740
Additive


Pore


EKO-35
Oxacillin
64
32
1.020



Pore


EKO-35
Oxacillin
64
32
1.020



acrBD408A


Pore


EKO-35
Oxacillin
256
16
0.188
Synergistic


acrB Pore


EKO-35
Oxacillin
64
16
0.500
Synergistic


acrD Pore


EKO-35
Oxacillin
128
32
0.500
Synergistic


acrEF Pore
















TABLE 18B







The FICI represents the ΣFIC of each drug. The FIC for each drug


was determined by dividing the MIC of each drug in combination by the MIC of each


drug alone. ΣFIC = FICA + FICB = (CA/MICA) + (CB/MICB).


MICA and MICB are the MICs of drugs A (PAβN) and B (antibiotic) alone,


respectively. CA and CB are the MICs of the drugs in combination. Synergy


(FICI ≤0.5), indifferent (FICI >1.0), and additive (FICI >0.5-


1.0). Related to FIG. 5A-5J.














MICb
MICb






Alone
Combined


Strain
Compound
(μg/mL)
(μg/mL)
FICI
Effect















K-12
Ciprofloxacin
0.0156
0.0156
1.250



ΔtolC
Ciprofloxacin
0.0078
0.0039
1.000



EKO-35
Ciprofloxacin
0.0078
0.0039
0.563
Additive


EKO-35
Ciprofloxacin
0.0078
0.0039
0.625
Additive


acrBD408A


EKO-35 acrEF
Ciprofloxacin
0.0156
0.0078
1.000



EKO-35
Ciprofloxacin
0.0156
0.0039
0.375
Synergistic


mexCD


K-12 Pore
Ciprofloxacin
0.0313
0.0313
2.000


ΔtolC Pore
Ciprofloxacin
0.0039
0.0002
0.551
Additive


EKO-35 Pore
Ciprofloxacin
0.0078
0.0039
0.531
Additive


EKO-35
Ciprofloxacin
0.0078
0.0039
0.750
Additive


acrBD408A Pore


EKO-35 acrEF
Ciprofloxacin
0.0078
0.0039
0.750
Additive


Pore


EKO-35
Ciprofloxacin
0.0078
0.002
0.506
Additive


mexCD Pore


K-12
Erythromycin
64
2
0.094
Synergistic


ΔtolC
Erythromycin
4
0.25
0.188
Synergistic


EKO-35
Erythromycin
2
0.06
0.093
Synergistic


EKO-35
Erythromycin
2
0.13
0.190
Synergistic


acrBD408A


EKO-35 acrB
Erythromycin
64
1
0.078
Synergistic


EKO-35 acrEF
Erythromycin
8
0.5
0.188
Synergistic


EKO-35
Erythromycin
16
0.5
0.094
Synergistic


mdtEF


EKO-35
Erythromycin
8
0.5
0.188
Synergistic


mexCD


K-12 Pore
Erythromycin
4
0.25
0.313
Synergistic


δtolC Pore
Erythromycin
1
0.063
0.188
Synergistic


EKO-35 Pore
Erythromycin
0.13
0.063
0.610
Additive


EKO-35
Erythromycin
0.13
0.063
0.735
Additive


acrBD408A Pore


EKO-35 acrB
Erythromycin
32
0.5
0.078
Synergistic


Pore


EKO-35 acrEF
Erythromycin
0.5
0.13
0.385
Synergistic


Pore


EKO-35
Erythromycin
1
0.06
0.185
Synergistic


mdtEF Pore


EKO-35
Erythromycin
0.5
0.13
0.385
Synergistic


mexCD Pore


K-12
Fusidic Acid
1024
32
0.156
Synergistic


ΔtolC
Fusidic Acid
2
0.25
0.375
Synergistic


EKO-35
Fusidic Acid
4
0.13
0.158
Synergistic


EKO-35
Fusidic Acid
4
0.5
0.250
Synergistic


acrBD408A


EKO-35 acrB
Fusidic Acid
1024
4
0.129
Synergistic


EKO-35 acrD
Fusidic Acid
256
4
0.141
Synergistic


EKO-35 acrEF
Fusidic Acid
32
8
0.375
Synergistic


EKO-35
Fusidic Acid
64
8
0.250
Synergistic


mdtEF


K-12 Pore
Fusidic Acid
512
32
0.188
Synergistic


δtolC Pore
Fusidic Acid
2
0.25
0.375
Synergistic


EKO-35 Pore
Fusidic Acid
1
0.06
0.310
Synergistic


EKO-35
Fusidic Acid
1
0.13
0.255
Synergistic


acrBD408A Pore


EKO-35 acrB
Fusidic Acid
512
2
0.129
Synergistic


Pore


EKO-35 acrD
Fusidic Acid
64
8
0.250
Synergistic


Pore


EKO-35 acrEF
Fusidic Acid
4
1
0.313
Synergistic


Pore


EKO-35
Fusidic Acid
16
2
0.250
Synergistic


mdtEF Pore


K-12
Linezolid
256
16
0.125
Synergistic


ΔtolC
Linezolid
8
2
0.750
Additive


EKO-35
Linezolid
16
4
0.750
Additive


EKO-35
Linezolid
16
4
0.750
Additive


acrBD408A


EKO35
Linezolid
256
16
0.125
Synergistic


araC::acrB


K-12 Pore
Linezolid
128
16
0.250
Synergistic


ΔtolC Pore
Linezolid
8
0.5
0.563
Additive


EKO-35 Pore
Linezolid
8
4
1.000



EKO-35
Linezolid
8
4
1.000



acrBD408A Pore


EKO-35 acrB
Linezolid
128
8
0.125
Synergistic


Pore


K-12
Novobiocin
128
8
0.188
Synergistic


ΔtolC
Novobiocin
2
0.5
0.500
Synergistic


EKO-35
Novobiocin
4
1
0.375
Synergistic


EKO-35
Novobiocin
8
2
0.375
Synergistic


acrBD408A


EKO-35 acrB
Novobiocin
1024
32
0.156
Synergistic


EKO-35 acrD
Novobiocin
512
32
0.313
Synergistic


K-12 Pore
Novobiocin
16
8
0.508
Additive


ΔtolC Pore
Novobiocin
0.25
0.06
0.740
Additive


EKO-35 Pore
Novobiocin
1
0.13
0.630
Additive


EKO-35
Novobiocin
1
0.25
0.750
Additive


acrBD408A Pore


EKO-35 acrB
Novobiocin
512
16
0.094
Synergistic


Pore


EKO-35 acrD
Novobiocin
16
1
0.563
Additive


Pore


K-12
Oxacillin
512
32
0.188
Synergistic


ΔtolC
Oxacillin
1
0.25
0.313
Synergistic


EKO-35
Oxacillin
0.5
0.13
0.323
Synergistic


EKO-35
Oxacillin
1
0.06
0.185
Synergistic


acrBD408A


EKO-35 acrB
Oxacillin
1024
64
0.125
Synergistic


EKO-35 acrD
Oxacillin
128
16
0.156
Synergistic


EKO-35 acrEF
Oxacillin
256
2
0.133
Synergistic


K-12 Pore
Oxacillin
32
16
0.750
Additive


ΔtolC Pore
Oxacillin
0.25
0.06
0.740
Additive


EKO-35 Pore
Oxacillin
0.25
0.13
1.020



EKO-35
Oxacillin
0.25
0.13
1.020



acrBD408A Pore


EKO-35 acrB
Oxacillin
128
16
0.188
Synergistic


Pore


EKO-35 acrD
Oxacillin
4
1
0.500
Synergistic


Pore


EKO-35 acrEF
Oxacillin
4
1
0.500
Synergistic


Pore
















TABLE 19A







Defining the Fractional Inhibitory Concentration Index (FICI) for NMP in combination


with different antibiotics using EKO-35 and the efflux platform. The FICI


represents the ΣFIC of each drug. The FIC for each drug was determined by


dividing the MIC of each drug in combination by the MIC of each drug alone. ΣFIC =


FICA + FICB = (CA/MICA) + (CB/MICB). MICA and MICB are the MICs of


drugs A (NMP) and B (antibiotic) alone, respectively. CA and CB are the MICs


of the drugs in combination. Synergy (FICI ≤0.5), indifferent (FICI >1.0),


and additive (FICI >0.5-1.0). Related to FIGS. 5A-5J.














NMP
NMP






MICa
MICa




Alone
Combined


Strain
Compound
(μg/mL)
(μg/mL)
FICI
Effect















K-12
Ciprofloxacin
512
128
0.748
Additive


ΔtolC
Ciprofloxacin
512
512
2.000



EKO-35
Ciprofloxacin
512
512
2.000



EKO-35
Ciprofloxacin
512
64
0.625
Additive


acrBD408A


EKO-35 acrEF
Ciprofloxacin
256
64
0.748
Additive


EKO-35
Ciprofloxacin
512
128
0.750
Additive


mexCD


K-12 Pore
Ciprofloxacin
512
512
2.000



δtolC Pore
Ciprofloxacin
512
256
0.750
Additive


EKO-35 Pore
Ciprofloxacin
512
512
2.000



EKO-35
Ciprofloxacin
512
4
0.508
Additive


acrBD408A Pore


EKO-35 acrEF
Ciprofloxacin
512
256
0.526
Additive


Pore


EKO-35
Ciprofloxacin
512
256
1.000



mexCD Pore


K-12
Erythromycin
256
128
0.625
Additive


ΔtolC
Erythromycin
256
128
1.000



EKO-35
Erythromycin
1024
256
0.375
Synergistic


EKO-35
Erythromycin
1024
256
0.500
Synergistic


acrBD408A


EKO-35 acrB
Erythromycin
256
8
0.531
Additive


EKO-35 acrEF
Erythromycin
256
256
2.000



EKO-35 mdtEF
Erythromycin
512
64
0.250
Synergistic


EKO-35
Erythromycin
64
16
0.375
Synergistic


mexCD


K-12 Pore
Erythromycin
512
256
1.000



ΔtolC Pore
Erythromycin
512
256
0.625
Synergistic


EKO-35 Pore
Erythromycin
512
128
0.770
Additive


EKO-35
Erythromycin
512
128
0.735
Additive


acrBD408A Pore


EKO-35 acrB
Erythromycin
512
256
0.563
Additive


Pore


EKO-35 acrEF
Erythromycin
512
128
0.750
Additive


Pore


EKO-35 mdtEF
Erythromycin
256
128
0.625
Additive


Pore


EKO-35
Erythromycin
128
64
0.565
Additive


mexCD Pore


K-12
Ethidium
512
64
0.375
Synergistic



Bromide


ΔtolC
Ethidium
1024
32
0.281
Synergistic



Bromide


EKO-35
Ethidium
512
512
2.000




Bromide


EKO-35
Ethidium
1024
256
0.750
Additive


acrBD408A
Bromide


EKO-35 acrB
Ethidium
1024
128
0.253
Synergistic



Bromide


EKO-35 acrEF
Ethidium
1024
256
0.500
Synergistic



Bromide


K-12 Pore
Ethidium
512
128
0.375
Synergistic



Bromide


ΔtolC Pore
Ethidium
512
128
0.500
Additive



Bromide


EKO-35 Pore
Ethidium
512
4
0.508
Additive



Bromide


EKO-35
Ethidium
512
256
1.000



acrBD408A Pore
Bromide


EKO-35 acrB
Ethidium
512
32
0.191
Synergistic


Pore
Bromide


EKO-35 acrEF
Ethidium
512
128
0.500
Synergistic


Pore
Bromide


K-12
Fusidic Acid
1024
256
0.375
Synergistic


ΔtolC
Fusidic Acid
512
256
0.625
Additive


EKO-35
Fusidic Acid
512
256
0.625
Additive


EKO-35
Fusidic Acid
1024
256
0.500
Synergistic


acrBD408A


EKO-35 acrB
Fusidic Acid
512
128
0.500
Synergistic


EKO-35 acrD
Fusidic Acid
512
256
0.563
Additive


EKO-35 acrEF
Fusidic Acid
512
128
0.750
Additive


EKO-35 mdtEF
Fusidic Acid
512
128
0.375
Synergistic


K-12 Pore
Fusidic Acid
512
128
0.500
Synergistic


δtolC Pore
Fusidic Acid
512
128
0.750
Additive


EKO-35 Pore
Fusidic Acid
512
256
0.620
Additive


EKO-35
Fusidic Acid
512
128
0.750
Additive


acrBD408A Pore


EKO-35 acrB
Fusidic Acid
512
128
0.500
Synergistic


Pore


EKO-35 acrD
Fusidic Acid
256
128
1.000



Pore


EKO-35 acrEF
Fusidic Acid
512
64
0.625
Additive


Pore


EKO-35 mdtEF
Fusidic Acid
256
128
0.750
Additive


Pore


K-12
Linezolid
512
128
0.375
Synergistic


ΔtolC
Linezolid
512
512
2.000



EKO-35
Linezolid
512
16
0.531
Additive


EKO-35
Linezolid
512
8
0.516
Additive


acrBD408A


EKO-35 acrB
Linezolid
256
64
0.281
Synergistic


K-12 Pore
Linezolid
512
64
0.375
Synergistic


ΔtolC Pore
Linezolid
512
256
1.000



EKO-35 Pore
Linezolid
512
512
2.000



EKO-35
Linezolid
512
512
2.000



acrBD408A Pore


EKO-35 acrB
Linezolid
512
64
0.250
Synergistic


Pore


K-12
Oxacillin
512
64
0.375
Synergistic


ΔtolC
Oxacillin
256
8
0.531
Additive


EKO-35
Oxacillin
1024
256
0.510
Additive


EKO-35
Oxacillin
1024
1024
2.000



acrBD408A


EKO-35 acrB
Oxacillin
512
256
0.531
Additive


EKO-35 acrD
Oxacillin
512
256
0.750
Additive


EKO-35 acrEF
Oxacillin
512
64
0.375
Synergistic


K-12 Pore
Oxacillin
512
8
0.266
Synergistic


δtolC Pore
Oxacillin
512
16
0.531
Additive


EKO-35 Pore
Oxacillin
512
128
0.750
Additive


EKO-35
Oxacillin
512
512
2.000



acrBD408A Pore


EKO-35 acrB
Oxacillin
512
128
0.500
Synergistic


Pore


EKO-35 acrD
Oxacillin
512
256
0.750
Additive


Pore


EKO-35 acrEF
Oxacillin
512
256
1.000



Pore
















TABLE 19B







Defining the Fractional Inhibitory Concentration Index (FICI) for NMP in combination


with different antibiotics using EKO-35 and the efflux platform. The FICI


represents the ΣFIC of each drug. The FIC for each drug was determined by


dividing the MIC of each drug in combination by the MIC of each drug alone. ΣFIC =


FICA + FICB = (CA/MICA) + (CB/MICB). MICA and MICB are the MICs of


drugs A (NMP) and B (antibiotic) alone, respectively. CA and CB are the MICs


of the drugs in combination. Synergy (FICI ≤0.5), indifferent (FICI >1.0),


and additive (FICI >0.5-1.0). Related to FIGS. 5A-5J.














MICb
MICb






Alone
Combined


Strain
Compound
(μg/mL)
(μg/mL)
FICI
Effect















K-12
Ciprofloxacin
0.0313
0.0156
0.748
Additive


ΔtolC
Ciprofloxacin
0.0078
0.0078
2.000



EKO-35
Ciprofloxacin
0.0078
0.0078
2.000



EKO-35
Ciprofloxacin
0.0156
0.0078
0.625
Additive


acrBD408A


EKO-35 acrEF
Ciprofloxacin
0.0313
0.0156
0.748
Additive


EKO-35
Ciprofloxacin
0.0156
0.0078
0.750
Additive


mexCD


K-12 Pore
Ciprofloxacin
0.0156
0.0156
2.000



ΔtolC Pore
Ciprofloxacin
0.0156
0.0039
0.750
Additive


EKO-35 Pore
Ciprofloxacin
0.0078
0.0078
2.000



EKO-35
Ciprofloxacin
0.0156
0.0078
0.508
Additive


acrBD408A Pore


EKO-35 acrEF
Ciprofloxacin
0.0078
0.0002
0.526
Additive


Pore


EKO-35
Ciprofloxacin
0.0078
0.0039
1.000



mexCD Pore


K-12
Erythromycin
128
16
0.625
Additive


ΔtolC
Erythromycin
4
2
1.000



EKO-35
Erythromycin
2
0.25
0.375
Synergistic


EKO-35
Erythromycin
2
0.5
0.500
Synergistic


acrBD408A


EKO-35 acrB
Erythromycin
128
64
0.531
Additive


EKO-35 acrEF
Erythromycin
8
8
2.000



EKO-35 mdtEF
Erythromycin
64
8
0.250
Synergistic


EKO-35
Erythromycin
16
2
0.375
Synergistic


mexCD


K-12 Pore
Erythromycin
16
8
1.000



ΔtolC Pore
Erythromycin
4
0.5
0.625
Synergistic


EKO-35 Pore
Erythromycin
0.25
0.13
0.770
Additive


EKO-35
Erythromycin
0.13
0.063
0.735
Additive


acrBD408A Pore


EKO-35 acrB
Erythromycin
8
0.5
0.563
Additive


Pore


EKO-35 acrEF
Erythromycin
1
0.5
0.750
Additive


Pore


EKO-35 mdtEF
Erythromycin
8
1
0.625
Additive


Pore


EKO-35
Erythromycin
2
0.13
0.565
Additive


mexCD Pore


K-12
Ethidium Bromide
500
125
0.375
Synergistic


ΔtolC
Ethidium Bromide
7.81
1.95
0.281
Synergistic


EKO-35
Ethidium Bromide
0.244
0.244
2.000



EKO-35
Ethidium Bromide
0.488
0.244
0.750
Additive


acrBD408A


EKO-35 acrB
Ethidium Bromide
15.6
2
0.253
Synergistic


EKO-35 acrEF
Ethidium Bromide
2
0.5
0.500
Synergistic


K-12 Pore
Ethidium Bromide
250
31.3
0.375
Synergistic


ΔtolC Pore
Ethidium Bromide
1.95
0.488
0.500
Additive


EKO-35 Pore
Ethidium Bromide
0.488
0.244
0.508
Additive


EKO-35
Ethidium Bromide
0.244
0.122
1.000



acrBD408A Pore


EKO-35 acrB
Ethidium Bromide
15.6
2
0.191
Synergistic


Pore


EKO-35 acrEF
Ethidium Bromide
2
0.5
0.500
Synergistic


Pore


K-12
Fusidic Acid
1024
128
0.375
Synergistic


ΔtolC
Fusidic Acid
4
0.5
0.625
Additive


EKO-35
Fusidic Acid
4
0.5
0.625
Additive


EKO-35
Fusidic Acid
4
1
0.500
Synergistic


acrBD408A


EKO-35 acrB
Fusidic Acid
1024
256
0.500
Synergistic


EKO-35 acrD
Fusidic Acid
256
16
0.563
Additive


EKO-35 acrEF
Fusidic Acid
32
16
0.750
Additive


EKO-35 mdtEF
Fusidic Acid
64
8
0.375
Synergistic


K-12 Pore
Fusidic Acid
512
128
0.500
Synergistic


ΔtolC Pore
Fusidic Acid
2
1
0.750
Additive


EKO-35 Pore
Fusidic Acid
0.5
0.06
0.620
Additive


EKO-35
Fusidic Acid
0.5
0.25
0.750
Additive


acrBD408A Pore


EKO-35 acrB
Fusidic Acid
512
128
0.500
Synergistic


Pore


EKO-35 acrD
Fusidic Acid
64
32
1.000



Pore


EKO-35 acrEF
Fusidic Acid
2
1
0.625
Additive


Pore


EKO-35 mdtEF
Fusidic Acid
8
2
0.750
Additive


Pore


K-12
Linezolid
256
32
0.375
Synergistic


ΔtolC
Linezolid
8
8
2.000



EKO-35
Linezolid
16
8
0.531
Additive


EKO-35
Linezolid
16
8
0.516
Additive


acrBD408A


EKO-35 acrB
Linezolid
256
8
0.281
Synergistic


K-12 Pore
Linezolid
128
32
0.375
Synergistic


δtolC Pore
Linezolid
8
4
1.000



EKO-35 Pore
Linezolid
8
8
2.000



EKO-35
Linezolid
8
8
2.000



acrBD408A Pore


EKO-35 acrB
Linezolid
128
16
0.250
Synergistic


Pore


K-12
Oxacillin
512
128
0.375
Synergistic


ΔtolC
Oxacillin
1
0.5
0.531
Additive


EKO-35
Oxacillin
0.5
0.13
0.510
Additive


EKO-35
Oxacillin
0.13
0.13
2.000



acrBD408A


EKO-35 acrB
Oxacillin
512
16
0.531
Additive


EKO-35 acrD
Oxacillin
128
32
0.750
Additive


EKO-35 acrEF
Oxacillin
256
64
0.375
Synergistic


K-12 Pore
Oxacillin
64
16
0.266
Synergistic


ΔtolC Pore
Oxacillin
1
0.5
0.531
Additive


EKO-35 Pore
Oxacillin
0.5
0.25
0.750
Additive


EKO-35
Oxacillin
0.13
0.13
2.000



acrBD408A Pore


EKO-35 acrB
Oxacillin
64
16
0.500
Synergistic


Pore


EKO-35 acrD
Oxacillin
2
0.5
0.750
Additive


Pore


EKO-35 acrEF
Oxacillin
2
1
1.000



Pore
















TABLE 20







Assessing efflux pump interplay using EKO-35 and the efflux platform. MIC values


were calculated by averaging the OD600 nm values of three biological replicates


and identifying the highest concentration of drug for which the OD600 nm value


>0.100. The fold changes between EKO-35 and each efflux pump expressing


strain were calculated by dividing the MIC value of each strain by that of


EKO-35. Fold increases in resistance 4-fold and above are bolded.

















Fold








Change
Interplay


Compound
Strain
Pore
MIC
from EKO-35
effect
P-Value
















Acriflavine
EKO-35

0.098




1.75 × 10−6



EKO-35

0.781

8




pEmrE



EKO-35
+
0.049







EKO-35

0.781

16



7.20 × 10−64




pEmrE



acrB

1.563

16

Multiplicative



acrB

25

256


1.75 × 10−6



pEmrE



acrB
+
0.781

16

Multiplicative



acrB

12.5

256


2.01 × 10−2



pEmrE



acrEF

0.781

8

Multiplicative



acrEF

12.5

128


2.23 × 10−2



pEmrE



acrEF
+
0.781

16

Multiplicative



acrEF

6.25

128



9.79 × 10−64




pEmrE



acrD

0.098
1
Multiplicative



acrD

1.563

16


1.60 × 10−6



pEmrE



acrD
+
0.098
2




acrD

0.781

16



9.79 × 10−64




pEmrE



mdtEF

0.098
1
Multiplicative



mdtEF

1.563

16



7.26 × 10−64




pEmrE



mdtEF
+
0.195

4

Multiplicative



mdtEF

1.563

32


1.60 × 10−6



pEmrE


Ethidium
EKO-35

0.122






Bromide
EKO-35

0.488

4


4.52 × 10−5



pEmrE



EKO-35
+
0.061







EKO-35

0.244

4



2.45 × 10−31




pEmrE



acrB

7.813

64

Multiplicative



acrB

31.25

256


3.14 × 10−2



pEmrE



acrB
+
3.91

64

Multiplicative



acrB

15.6

256


4.52 × 10−5



pEmrE



acrEF

1.953

16

Multiplicative



acrEF

7.813

64


4.52 × 10−5



pEmrE



acrEF
+
0.977

16

Multiplicative



acrEF

3.91

64


1.32 × 10−3



pEmrE



acrD

0.244
2
Multiplicative



acrD

1.953

16


2.86 × 10−2



pEmrE



acrD
+
0.061
1
Multiplicative



acrD

0.488

8


3.69 × 10−5



pEmrE



mdtEF

0.977

8

Multiplicative



mdtEF

3.906

32


3.69 × 10−5



pEmrE



mdtEF
+
0.488

8

Multiplicative



mdtEF

1.95

32


3.14 × 10−2



pEmrE


Novobiocin
EKO-35

0.781





EKO-35

0.781
1

1.00 × 100 



pEmrE



EKO-35
+
0.391





EKO-35

0.391
1

1.00 × 100 



pEmrE



acrB

400

512





acrB

400

512


7.25 × 10−1



pEmrE



acrB
+
100

256




acrB

100

256


1.32 × 10−1



pEmrE



acrEF

100

128





acrEF

50

64


1.16 × 10−1



pEmrE



acrEF
+
12.5

32





acrEF

12.5

32


1.00 × 100 



pEmrE



acrD

100

128





acrD

50

64


5.50 × 10−2



pEmrE



acrD
+
25

64





acrD

6.25

16


5.50 × 10−2



pEmrE



mdtEF

12.5

16





mdtEF

6.25

8


3.74 × 10−1



pEmrE



mdtEF
+
3.13

8





mdtEF

1.56

4


1.48 × 10−1



pEmrE


Minocycline
EKO-35

1.25





EKO-35

1.25
1

1.00 × 100 



pEmrE



EKO-35
+
0.63




EKO-35

0.63
1

3.72 × 10−1



pEmrE



acrB

5

4





acrB

5

4


1.00 × 100 



pEmrE



acrB
+
2.5

4





acrB

2.5

4


3.74 × 10−1



pEmrE



acrEF

2.5
2




acrEF

5.0

4


3.74 × 10−1



pEmrE



acrEF
+
1.25
2




acrEF

1.25
2

1.00 × 100 



pEmrE



acrD

2.5
2




acrD

2.5
2

1.00 × 100 



pEmrE



acrD
+
1.25
2




acrD

1.25
2

3.98 × 10−1



pEmrE



mdtEF

2.5
2




mdtEF

2.5
2

1.00 × 100 



pEmrE



mdtEF
+
1.25
2




mdtEF

1.25
2

1.28 × 10−1



pEmrE









Example 2. Development and Utilization of EKO-35v2
Materials and Methods
Strains, Plasmids, and Growth Conditions

Bacterial strains and plasmids used in this Example are provided in Table 21. E. coli K-12 str. BW25113, the parental strain of the Keio Collection (Baba, T. et al., 2006) was used as the background for generation of EKO-35v2. E. coli TOP10 or E. coli DH5a strains were used as routine cloning hosts. Plasmids for CRISPR-Cas9 mediated counterselection, pCas and pTargetF, were purchased from Addgene (Jiang, Y. et al., 2015). Strains were routinely grown in Lysogeny broth (LB) (Bioshop) at 37° C. or 30° C. For optimal aeration, broth cultures were grown with aeration at 220 rpm. For growth profiling, microtiter plates were incubated at 37° C. with continuous linear shaking at 600 rpm. Ampicillin (100 μg/mL) (Bioshop), kanamycin (50 μg/mL) (Sigma-Aldrich), spectinomycin (50 μg/mL) (Bioshop), and gentamicin (10 μg/mL) (BioBasic) were used at the listed concentrations for selection of resistance markers.









TABLE 21







Strains and plasmids used in this Example.










Genotype or Description
Source











Strains










E. coli K-12 str.

The parental strain of the KEIO collection
Baba, T. et


BW25113

al. (2006)



E. coli TOP10

Cloning host, mcrA deficient for increased
Thermo



efficiency in foreign DNA uptake
Fisher




Scientific



E. coli DH5α

Cloning host, endA deficient for high quality
Thermo



DNA preparations
Fisher




Scientific



E. coli EKO-35v2

BW25113 efflux deficient derivative (AacrB;
This



acrD; acrF; mdtF; macB; emrB; mdtL; mdtK;
disclosure



bcr; ydeA; mdtM; yddA; yebQ; emrE; mdtD;



sugE; ynfM; emrD; ydeF; mdtJ; ydiM; mdtB;



mdIA; emrY; mdfA; fsr; mdtG; mdtH; yieO;



mdlB, mdtO, yojI, yajR, ydhC; cusA)







Plasmids









pCas
Kanr, temperature sensitive permissive (30° C.),
Jiang, Y. et



non-permissive (37° C.), arabinose-induced
al. (2015)



expression of the λ-Red recombinase for



homologous recombination. Constitutive



expression of Cas-9


pTargetF
Specr, modifiable by PCR to contain N20
Jiang, Y. et



sequence recognizable by Cas-9
al. (2015)


pTargetF-mdtD-
Specr, modified by PCR to contain an N20


sugE
sequence recognizable by Cas-9 to target a



PAM site within mdtD and sugE


pTargetF-ynfM-
Specr, modified by PCR to contain an N20


emrD-ydeF
sequence recognizable by Cas-9 to target a



PAM site within ynfM, emrD, and ydeF


pTargetF-mdIA-
Specr, modified by PCR to contain an N20


emrY
sequence recognizable by Cas-9 to target a



PAM site within mdlA and emrY


pTargetF-bcr-mdtK
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within bcr and mdtK


pTargetF-mdIB-
Specr, modified by PCR to contain an N20


mdtH
sequence recognizable by Cas-9 to target a



PAM site within mdlB and mdtH


pTargetF-macB-
Specr, modified by PCR to contain an N20


yddA
sequence recognizable by Cas-9 to target a



PAM site within macB and yddA


pTargetF-emrE
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within emrE


pTargetF-mdtJ
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtIJ


pTargetF-ydiM
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within ydiM


pTargetF-mdtB
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtB


pTargetF-mdfA
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdfA


pTargetF-fsr
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within fsr


pTargetF-mdtG
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtG


pTargetF-yieO
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within yieO


pTargetF-mdtO
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within mdtO


pTargetF-yojI
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within yojI


pTargetF-yajR
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within yajR


pTargetF-ydhC
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within ydhC


pTargetF-cusA
Specr, modified by PCR to contain an N20
This



sequence recognizable by Cas-9 to target a
disclosure



PAM site within cusA


pTargetF-acrB
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within acrB


pTargetF-acrD
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within acrD


pTargetF-acrF
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within acrF


pTargetF-mdtF
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within mdtF


pTargetF-emrB
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within emrB


pTargetF-ydeA
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within ydeA


pTargetF-mdtM
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within mdtM


pTargetF-yddA
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within yddA


pTargetF-yebQ
Specr, modified by PCR to contain an N20



sequence recognizable by Cas-9 to target a



PAM site within yebQ









Generation of an Efflux Deficient Strain

Generation of EKO-35 was achieved using a CRISPR-Cas9 counter-selection (Jiang, Y. et al., 2015). The efflux genes were inactivated in the order denoted in Table 22. All PCR reactions and restriction enzyme digests were prepared according to manufacturers' guidelines. Amplicons were purified using a GeneJET PCR purification kit (Thermo Fisher Scientific) according to manufacturer's guidelines. The 2×GB-AMP™ high-fidelity PaCeR™ polymerase Master Mix (GeneBio Systems Inc) and Taq 2× polymerase Master Mix (FroggaBio) were used according to the manufacturer's suggested guidelines.


For CRISPR-Cas9-mediated counterselection, the methodology described by Jiang et al. was modified for high-throughput screening of mutants (Jiang, Y. et al., 2015). Multiple efflux-encoding genes were targeted simultaneously by multiplexing two or three guide RNAs in the pTargetF vector. CRISPR guide software (Benchling) was employed for selection of appropriate N20 sequences. pTargetF was modified via PCR to introduce an N20 for the gene of interest (Table 23). Amplicon size (2100 bp) was verified via gel electrophoresis, and the remaining PCR product was purified. A second N20 sequence was amplified using PaCeR™ polymerase and inserted into pTargetF-gene1 vector through restriction digest with EcoR1 and XhoI and ligation with T4 ligase. A third N20 sequence was amplified using PaCeR™ polymerase and inserted into pTargetF-gene1-gene2 vector through restriction digest with XbaI and HindIII and ligation with T4 ligase. pTargetF vectors were verified using Sanger Sequencing at the Advanced Analysis Centre (AAC) University of Guelph. To enable rapid screening of positive mutants and to disrupt the target gene, ssDNA repair oligos (˜100 bp in length) were designed to contain an AseI restriction site and three tandem stop codons (Table 23). All ssDNA repair oligos were purchased through Integrated DNA Technologies (IDT). Electrocompetent cells of the mutant strain of interest were transformed with 50 ng of pCas. A broth culture of each strain was grown to the mid exponential phase (OD600 nm˜0.5) in the presence of kanamycin and 10 mM arabinose to induce recombinase expression. To recombinase induced electrocompetent cells, 100 ng of pTargetF that was modified to contain the desired N20 sequence, and 2000 ng of repair ssDNA targeting the gene of interest were electroporated (Bio-Rad MicroPulser, Ec1 setting, 1 mm electroporation cuvette (Fisher)). The cultures were recovered in LB with 1 mM arabinose at 30° C. and propagated on selective agar (LB with kanamycin and spectinomycin) to identify successful gene disruptions. For high-throughput screening of colonies, Taq polymerase was used with primers annealing to the target region of each gene (Table 23). The amplicons were digested with AseI and successfully inactivated genes were identified via gel electrophoresis by digestion relative to a wild-type negative control. Insertion of the three tandem stop codons into the gene of interest was verified using Sanger sequencing at the Advanced Analysis Centre (AAC) (University of Guelph). Genes disrupted using CRISPR-Cas9-mediated counter selection are indicated in Table 22.









TABLE 22







Gene inactivation during the generation of EKO-35v2. For genes


inactivated using CRISPR-Cas9 mediated counter selection,


the location of the inserted stop codons are noted. Genes


are listed in the order in which they were inactivated.











Gene
Gene Size (bp)
Stop Codon Placement (bp)















yajR
1365
47



mdtO
2052
75



ydhC
1212
90



emrE
333
93



yojI
1644
25



mdtD
1416
26



sugE
318
93



ynfM
1254
115 



emrD
1185
206 



ydeF
1188
43



mdlA
1773
69



emrY
1539
41



mdtK
1374
135*



bcr
1191
 48*



mdtG
1227
276 



mdtH
1209
136 



mdlB
1782
72



macB
1947
 51*



yddA
1686
105*



fsr
1221
242 



ydiM
1215
124 



yieO
1428
177 



mdfA
1233
116 



mdtM
1233
 48*



mdtJ
366
98



emrB
1539
108*



mdtB
3123
160 



mdtL
1176
 51*



yebQ
1374
 27*



cusA
3144
400 



mdtF
3114
 72*



ydeA
1191
142*



acrF
3105
 42*



acrD
3114
 45*



acrB
3150
 66*







*indicates genes previously disrupted using λ-Red recombineering in EKO-35 of Example 1 (i.e. EKO-35v1).













TABLE 23







Primers and oligonucleotides used in this Example.











SEQ ID


Primer
Sequence (5′-3′)
NO:












AcrB Seq Up
CTGAAACAAGAGAACGGCAAAGGC
1





AcrB Seq Low
CTTACTGACCTGGACTTGCCCTCTCG
2





AcrB_N20_Fwd
GATCGCCATTATCATCATGTGTTTTAGAGCTAGAAATAGCAAG
302





AcrB_N20_Rvs
ACATGATGATAATGGCGATCACTAGTATTATACCTAGGACTGAG
303





AcrB SSDNA
TTG CGC CAC CGG CAG TTT GAG GAT CGC TTA TTA
304


Repair
TTA ATT TAA CAT GAT GAT AAT GGC GAT CAC CCA




CGC AAA AAT CGG GCG ATC GAT AAA GAA ATT AGG




CAT






AcrD Seq Up
CGCTGACTTTTTCACAACCTTCCG
5





AcrD Seq Low
GTCCCCCGGAGGTAGTCATCGCAGC
6





AcrD_N20_Fwd
CCAGCACCCAGGCAAAAATGGTTTTAGAGCTAGAAATAGCAAG
305





AcrD_N20_Rvs
CATTTTTGCCTGGGTGCTGGACTAGTATTATACCTAGGACTGAG
306





AcrD SSDNA
TTG TTC AAC GGG CAA TGA AAA AAT CGC CAG GGT
307


Repair
ACC TGT CAG TTA TTA TTA ATT CAG CAC CCA GGC




AAA AAT TCG ATC AAT AAA GAA ATT CGC CAT






AcrF Seq Up
GAGGCTGAAGCAATCCGTAGAGC
9





AcrD Seq Low
GATACTGTATCGTTAAAAAGAGCGCG
10





AcrF_N20_Fwd
TCGACGACCGATATTTGCATGTTTTAGAGCTAGAAATAGCAAG
308





AcrF_N20_Rvs
ATGCAAATATCGGTCGTCGAACTAGTATTATACCTAGGACTGAG
309





AcrF SSDNA
CTG AGC GAC GGG CAA TTG TAG GAT CGC CAG TGC
310


Repair
GCC CGC CAT CAT CAG AAT TTA TTA TTA ATT TCA




TGC AAA TAT CGG TCG TCG AAT AAA AAA GTT TGC




CAT






MdtF 200 Up
GATGTCGTGCAGCTACGCGAAAT
13





MdtF 200 Low
ACGAATGGCTGGAGTGGTTTC
14





MdtF_N20_Fwd
ATTATTATGATGCTTGCAGGGTTTTAGAGCTAGAAATAGCAAG
311





MdtF_N20_Rvs
CCTGCAAGCATCATAATAATACTAGTATTATACCTAGGACTGAG
312





MdtF SSDNA
AAT CTG CGG ATA CTG CGC AAC CGG TAA GTT CAT
313


Repair
TTA TTA TTA ATT ACC TGC AAG CAT CAT AAT AAT




GGC AAG TAC CCA GGC AAA AAC CGG GCG ATC AAT




AAA ATA






MacB 200 Up
ATGTGCTGACGATCCCTCTGTC
17





MacB 200 Low
TTCGCTCATTATTCCACCATTCAG
18





MacB_N20_Fwd
ATTCGTCGCAGCTATCCTGCGTTTTAGAGCTAGAAATAGCAAG
314





MacB_N20_Rvs
GCAGGATAGCTGCGACGAATACTAGTATTATACCTAGGACTGAG
315





MacB SSDNA
ACC CGC ATA AAT ATC GAG GCT GAT GCC CTT CAG
316


Repair
CAC CTC AAC TTA TTA TTA ATT GGC AGG ATA GCT




GCG ACG AAT ATC CTT TAA TTC GAG CAA AGG CGT




CAT






EmrB 200 Up
CGTTCAGCGTCTGCCTGTGCG
21





EmrB 200 Low
GCGGCAATGGAAGACGTGCTG
22





EmrB_N20_Fwd
GGACTCCACCATTGCTAACGGTTTTAGAGCTAGAAATAGCAAG
317





EmrB_N20_Rvs
CGTTAGCAATGGTGGAGTCCACTAGTATTATACCTAGGACTGAG
318





EmrB SSDNA
CTG GCT GAG CGA TGA GCC CAG ATT CCC GGC GAT
319


Repair
TTA TTA TTA ATT AAC GTT AGC AAT GGT GGA GTC




CAG CAC CTG CAT GAA TGT CGC CAG TGA CAG CGC




AAT CGT






MdtL 200 Up
CATTCTCTTTGGTATAACCGTG
25





MdtL 200 Low
TTTGCTCCATGCTGACCAT
26





MdtL_N20_Fwd
GGCGGGATAAAGTAAAACCAGTTTTAGAGCTAGAAATAGCAAG
320





MdtL_N20_Rvs
TGGTTTTACTTTATCCCGCCACTAGTATTATACCTAGGACTGAG
321





MdtL SSDNA
ATT GAG ATC GGC GGC GAT GCG CGG TAA ACC AAC
322


Repair
GAG GTA TTA TTA TTA ATT GGC GGG ATA AAG TAA




AAC CAG AAA ACT ACA AAT CAA AAA GCG GGA CAT






MdtK 200 Up
GAAATCAGTTAAGACATTCTGTTC
29





MdtK 200 Low
CATGTGCAACTGAAAGTGAAAC
30





MdtK_N20_Fwd
CTATAGTGCCACCGACATGGGTTTTAGAGCTAGAAATAGCAAG
323





MdtK_N20_Rvs
CCATGTCGGTGGCACTATAGACTAGTATTATACCTAGGACTGAG
324





MdtK SSDNA
ACC AAA GAG GAT CGC CGG AAG CCA GAT AGA AGT
325


Repair
ACC TTA TTA TTA ATT CAT GTC GGT GGC ACT ATA




GCC GCC CGC CAT CAC GGT ATC GAC AAA ACC CAT




CGC






Bcr 200 Up
CCTCTATGGCTCTGATTTAAGTA
33





Bcr 200 Low
GTTATCATCAGGTGAAACGCAT
34





Bcr_N20_Fwd
AATCGACAGCGGCATCAACAGTTTTAGAGCTAGAAATAGCAAG
326





Bcr_N20_Rvs
TGTTGATGCCGCTGTCGATTACTAGTATTATACCTAGGACTGAG
327





Bcr ssDNA Repair
CGG TAG CGC GGG CAG ATA CAT ATC AAT CGA CAG
328



CGG CAT CAA CAT TTA TTA TTA ATT AAG GAT AAA




AAC AAT AGC AAA CGA CGA ATG CTG TCG GGT GGT




CAC






YdeA 150 Fwd
CCGTGATGTTACCGACTCTC
329





YdeA 150 Rvs
GTGGCATTGAAGCGATCTCC
330





YdeA_N20_Fwd
CAACATGATGCCGACCTGAGGTTTTAGAGCTAGAAATAGCAAG
331





YdeA_N20_Rvs
CTCAGGTCGGCATCATGTTGACTAGTATTATACCTAGGACTGAG
332





YdeA SSDNA
CAT TAG CGC TAC TAC CCA TGC GTA AAT GGT CAA
333


Repair
CAT GAT GCC GAC CTG AGC TTA TTA TTA ATT TTG




CAT GTG AAA ACT TTG CGC AAT GTC AGA GAG CAG




GCC AAC AGG GAC






MdtM 250 Up
CAGCGTAACGACAAAGGTAGCAG
41





MdtM 200 Low
ACCACCGCAAACCAGTC
42





MdtM_N20_Fwd
CATCGGGAAAAACAGCGTGGGTTTTAGAGCTAGAAATAGCAAG
334





MdtM_N20_Rvs
CCACGCTGTTTTTCCCGATGACTAGTATTATACCTAGGACTGAG
335





MdtM SSDNA
CTG GAT CAG ATC CGT CGA CAG ATA CGC AGC AAA
336


Repair
GTC ATA TTA TTATTA ATT CAT CGG GAA AAA CAG




CGT GGC ATG GCG GGT AAA AAA ACG TGG CAT






YddA 250 Up
TGTCGGGTGTTTCGTCAT
45





YddA 250 Low
TCGCTGATATTGCCATTC
46





YddA_N20_Fwd
CCACGCCAAGGATCATGGCGGTTTTAGAGCTAGAAATAGCAAG
337





YddA_N20_Rvs
CGCCATGATCCTTGGCGTGGACTAGTATTATACCTAGGACTGAG
338





YddA SSDNA
GTC GTT TAA CCA GAC CTG AAT TTT AAC CAC GCC
339


Repair
AAG GAT CAT GGC GAG TTA TTA TTA ATT TAA CAA




CAC TGA AGT TTT ATT ATT CTT ACG CAG CCA AAA




GGG CTT






YebQ 200 Up
CACGGAAGATACAGAATCAGG
49





YebQ 200 Low
CAGCTATGAACCGCAAGAA
50





YebQ_N20_Fwd
AATATCGCACCGTATCGCTGGTTTTAGAGCTAGAAATAGCAAG
340





YebQ_N20_Rvs
CAGCGATACGGTGCGATATTACTAGTATTATACCTAGGACTGAG
341





YebQ SSDNA
AAT ACC AAT CAC AAT GGT TAA TAT CGC ACC GTA
342


Repair
TCG CTG TTA TTATTA ATT GCC GTC GGC CTG AAC




TTT TGG CAT AGG AAT TTT ATA TCT TTG GTG AAT




AAT






EmrE N20 Up
AGTTTTCAGAAGGTTTTACAGTTTTAGAGCTAGAAATAGCAAG
51





EmrE N20 Low
TGTAAAACCTTCTGAAAACTACTAGTATTATACCTAGGACTGAG
52





EmrE SSDNA
ATA ACA AAT AAT TGT ACC AAC AGA TGG CCA TAA
53


Repair
TTA TTA TTA ATT TGT AAA ACC TTC TGA AAA CTT




CAT TAA GGT TGT ACC AAT GAC CTT TAT TAT TAC




TGC






EmrE 200 Up
CGGTTCGCTACCAGAGAAGAATG
54





EmrE 200 Low
CATGGTGACACCTGCTAACGTATGC
55





MdtD N20 Up
CCACAATCCACAATTGCCAAGTTTTAGAGCTAGAAATAGCAAG
56





MdtD N20 Low
TTGGCAATTGTGGATTGTGGACTAGTATTATACCTAGGACTGAG
57





MdtD SSDNA
TG TCC AGC GAC TGC ATA AAG AAG CCG AAA GCC ACA
58


Repair
ATC CAC AAT TGC CAA TTA TTA TTA ATT GGT GCT




GTC GGG AAG ATC TGT CAT TTA CTC GGT TAC CGT




TTG TTT AGG TT






MdtD 200 Up
CGCCCGATTATGATGACTAC
59





MdtD 200 Low
CTGAAAGACAAAGCGATCATTG
60





SugE N20 Up
CGTCAAACGACTAAAGCCGTGTTTTAGAGCTAGAAATAGCAAG
61





SugE N20 Low
CGTCAAACGACTAAAGCCGTACTAGTATTATACCTAGGACTGAG
62





SugE SSDNA
GAC AAT CAT CGC CGT CAC AGT AAT AAC ACT CGG
63


Repair
CGT CAA ACG ACT AAA GCC GTG TTA TTA TTA ATT




ATA TTT CAG GCC AAC GGC CCA TAC CAC TTC CAG




CAG ACC AGC AAT AAC TAA GAT






SugE 200 Up
CGCAGCAACGAAAGCGCA
64





YnfM N20 Up
TCCGGCAGAGAACAGCGCCAGTTTTAGAGCTAGAAATAGCAAG
65





YnfM N20 Low
TGGCGCTGTTCTCTGCCGGAACTAGTATTATACCTAGGACTGAG
66





YnfM SSDNA
CTG CAC ACA ATA GAG AAG TGC AAA TGT TGC CAG
67


Repair
TCC GGC AGA GAA CAG CGC CAG TTA TTA TTA ATT




GAC GCG CAT AAA TTG CGG CGT ACC GCG TTT AAT




AAA TTG ATT TGG CTG AGA AAT






YnfM 200 Up
GTTGCGAAATATTCAGGC
68





YnfM 200 Low
AAAGCAGTAGAATAACTGC
69





EmrD N20 Up
TCACCGGTCGGCGGCCCACGGTTTTAGAGCTAGAAATAGCAAG
70





EmrD N20 Low
CGTGGGCCGCCGACCGGTGAACTAGTATTATACCTAGGACTGAG
71





EmrD SSDNA
CGT TGC CAG CAT AAA AAT GGA CAT TCC GAC GAG
72


Repair
GAT CAC CGG TCG GCG GCC CAC GCG TTA TTA TTA





ATT GGA AAT CGG GCC ATA AAA CAG CTG TGA GAC





ACC GTA AGT CAG CAG ATA AGC GCC






EmrD 200 Up
CGATGCTGACGCATCTTATCCGCCC
73





EmrD 200 Low
GGTGCGGGCAGATATCAGTCGTATC
74





YdeF N20 Up
GATGGTTAATAACAACGACGGTTTTAGAGCTAGAAATAGCAAG
75





YdeF N20 Low
CGTCGTTGTTATTAACCATCACTAGTATTATACCTAGGACTGAG
76





YdeF SSDNA
AAT GGT CAT AAA TGG CAG CGT AGC GCC GCG TCC
77


Repair
GAT GGT TAA TAA CAA CGA CGA TTA TTA TTA ATT




AAG AAG GGC GCT GGT AGA GCG TCG TAG GGA TAA




GTT CAT






YdeF 250 Up
CTGATGGTTAATCCATACCCCAGC
78





YdeF Check
GATGCTCTGCATTACCAACAGCGTG
79


Internal







MdtJ N20 Up
AGCGTCAGTGAGGGAAATGGGTTTTAGAGCTAGAAATAGCAAG
80





MdtJ N20 Low
CCATTTCCCTCACTGACGCTACTAGTATTATACCTAGGACTGAG
81





MdtJ SSDNA
CGA CAG AGA AAT CAT CAC CAG CAT TAA AAT AAA
82


Repair
TTA TTA TTA ATT GCC ATT TCC CTC ACT GAC GCT




CGC CCA TTT CAT TGA CAG CGT ACC GGT






MdtJ 200 Up
CAATGCATAAGCGACAGACAAGTCG
83





MdtJ 200 Low
CATCCGCGATGACGAGAAGCAACAC
84





YdiM N20 Up
GATAACTATCGAGACACCCGGTTTTAGAGCTAGAAATAGCAAG
85


YdiM N20 Up
CGGGTGTCTCGATAGTTATCACTAGTATTATACCTAGGACTGAG
86





YdiM SSDNA
CAA GAC ACT TAA TCG ACC AAT GCC CAG CGA TGA
87





Repair
GAT AAC TAT CGA GAC ACC CGC TTA TTA TTA ATT




ATT AGT CTG CCA AAG TGT CTC CAG CGA GGC CAT




ATT CAG






YdiM Check Up
CAAGTGTGCCATTCCTGATCGTG
88





YdiM Check Up
GAACCCACGGTGTAGATACTGAG
89





MdtB N20 Up
GTAGAGCGTGACCACCTGAAGTTTTAGAGCTAGAAATAGCAAG
90





MdtB N20 Low
TTCAGGTGGTCACGCTCTACACTAGTATTATACCTAGGACTGAG
91





MdtB SSDNA
AAC GGC AGA GGT CAT GAC ATC CGG GCT GGC ACC
92


Repair
TGG GTA GAG CGT GAC CAC CTG AAT TTA TTA TTA




ATT CGG ATA GTC CAC TTC CGG CAG CGC CGA AAC




GGG CAG






MdtB 200 Up
GTCAGAAAGTGGTGATCCGTGCAG
93





MdtB Check Low
GATCGCTCGGCAACAAGTTGGTCG
94





MdlA N20 Up
CATCGCGATAATGACAAGCAGTTTTAGAGCTAGAAATAGCAAG
95





MdlA N20 Low
GCTTGTCATTATCGCGATGACTAGTATTATACCTAGGACTGAGT
96





MdlA SSDNA
ACC AAC CAC TTT TGG CGG AAC CAG TTG CAG CAT
97


Repair
CGC GAT AAT GAC AAG CAA TTA TTA TTA ATT GAC




AGC CCC GAG ATA GCG ACG CCA TTC CCG ACG GAA




ATA CCA GCT






MdlA 300 Up
GTCACGGTGGTTACCGAAATGCCAG
98





MdlA Check
GCGTTAAACTGCCCTGCACCAC
99


Internal







EmrY N20 Up
ACTCCGGCACCATTAACCGGGTTTTAGAGCTAGAAATAGCAAG
100





EmrY N20 Low
CCGGTTAATGGTGCCGGAGTACTAGTATTATACCTAGGACTGAG
101





EmrY SSDNA
TTG CAT AAA TGT CGC TAA TGA CAA TGC AAT AGT
102


Repair
GAC GCA CCA TAA CGT TTA TTA TTA ATT ACC GGT




TAA TGG TGC CGG AGT TGA TTT AGT GAT TGC CAT






EmrY 200 Up
AGCGCAGAACAACTGCGTAATA
103





EmrY 200 Low
GTACGGGTTGAAGTTTCTCTTG
104





MdfA N20 Up
GGCAACGATATGATTCAACCGTTTTAGAGCTAGAAATAGCAAG
105





MdfA N20 Low
GGTTGAATCATATCGTTGCCACTAGTATTATACCTAGGACTGAG
106





MdfA SSDNA
AAT GCC CGC CTG ATA TTG TTC CAC CAC GGC CAA
107


Repair
CAT TTA TTA TTA ATT GGG TTG AAT CAT ATC GTT




GCC GAT ATA GGT TGA AAA TTC GTA AAG CAC CAG




ACA






MdfA_200_Up
ATCGTCTTATTTCCCTCAAGC
108





MdfA_200_Low
ATGTGCCGAGTGGATACAAAGT
109





Fsr N20 Up
TCGCTACTGCAACCAGTGGTGTTTTAGAGCTAGAAATAGCAAG
110





Fsr N20 Up
ACCACTGGTTGCAGTAGCGAACTAGTATTATACCTAGGACTGAG
111





Fsr ssDNA Repair
CGA CCA TGG CAT CGG ATA TTT ATC GGT CCA GTA
112



TTA TTA TTA ATT GAC CAC TGG TTG CAG TAG CGA




AGA GGC GAG CTG GAA GGT GAG GGT TAT CAT GCC




AAT CTG






Fsr Check Up
GGTTAACAGCGCTAACGCCACG
113





Fsr Check Low
GTGGCGTGATGCATTCCGTCTC
114





MdtG N20 Up
ATGCTATTACGCTCTGCCCTGTTTTAGAGCTAGAAATAGCAAG
115


MdtG N20 Low
AGGGCAGAGCGTAATAGCATACTAGTATTATACCTAGGACTGAG
116








MdtG SSDNA
GAT ATT TTG TGC CAG CCC CAT CAA CAC CAT CAC
117


Repair
GAT GCC CAT TTA TTA TTA ATT GAG GGC AGA GCG




TAA TAG CAT GAG TTT TCG GCC TTT ACG GTC GGC




GAG TCC ACC CCA AAA CGG






MdtG Check Up
GGCATTGAACTGTTGCACATTCGC
118





MdtG Check Low
CATGATGGCACCAGAGCAGTATATG
119





MdtH N20 Up
GAGAGCAATACCGACCATGAGTTTTAGAGCTAGAAATAGCAAG
120





MdtH N20 Low
TCATGGTCGGTATTGCTCTCACTAGTATTATACCTAGGACTGAG
121





MdtH SSDNA
GAA AAT ACC CAG ACC TTG CTG AAT AAA TTG GCG
122


Repair
TAG ACC GAG AGC AAT ACC GAC CAT GAC TTA TTA





TTA ATT GGC CCA GCC CAT TTG ATC AAC GAA GCG





GAT AGA






MdtH Check Up
GCGTCGTCGTTGAGCAGAACATG
123





MdtH Check Low
GTCGGTCTGTGGTTAAGCGCAC
124





YieO N20 Up
CATCAGTTATACGCTGACGGGTTTTAGAGCTAGAAATAGCAAG
125





YieO N20 Low
CCGTCAGCGTATAACTGATGACTAGTATTATACCTAGGACTGAG
126





YieO SSDNA
GCG ATC GGC TAG CCA TCC GCT TAC CGG AAT AAG
127


Repair
CAT TTA TTA TTA ATT CAC CGT CAG CGT ATA ACT




GAT GAT GGC TGA TTG CAT CGC GAG AGG AGA ACG




ATT AAG






YieO Check Up
CGTCAATTACCAGCGACACAGTG
128





YieO Check
CGTGCATGGAGAATATAGAGAAGC
129


Internal







MdlB N20 Up
ATCAGGACCGCAATCCCCAGGTTTTAGAGCTAGAAATAGCAAG
130





MdlB N20 Low
CTGGGGATTGCGGTCCTGATACTAGTATTATACCTAGGACTGAG
131





MdlB SSDNA
ACT GAC TTC TGC CGC CGC CGC AAC CCA CAT CAT
132


Repair
CAG GAC CGC AAT CCC CAG TTA TTA TTA ATT TTT




ACG CCA CGG CGA ACC GTA CGC TAA CAG GCG CTT




GAG AGT






MdlB Check Up
CTTGATGATGCGCTTTCGGCGGTG
133





MdlB Check
CGCCATATAGTGTGAACGACTGGCC
134


Internal







MdtO N20 Up
TTCATGAAGAGTTAAGCGAGGTTTTAGAGCTAGAAATAGCAAG
135





MdtO N20 Low
CTCGCTTAACTCTTCATGAAACTAGTATTATACCTAGGACTGAG
136





MdtO SSDNA
GAG TTG CAC GGT CTG CGG CAC GCG ACC TGG TCG
137


Repair
TTA TTA TTA ATT CTC GCT TAA CTC TTC ATG AAA




GAA CGC CAG CAG CCT GAC CAC CGG TAA TGG CAG




GGA GTT






MdtO Check
CGTAGCGCATATAGTCTGGATTGG
138


Internal







MdtO Check Up
GAGGGTAAAGTGGATTCGATTGGC
139





YojI N20 Up
AACTTCTTGTACTTGTCTGGGTTTTAGAGCTAGAAATAGCAAG
145





YojI N20 Low
GCCAGACAAGTACAAGAAGTTACTAGTATTATACCTAGGACTGAG
146





YojI SSDNA
TAG CGC CAT CAC ACT GAT AAA TGG CCA GCG ATA
147


Repair
CTG TTA TTA TTA ATT CCA GAC AAG TAC AAG AAG




TTC CAT GCA GAA AAC CCG GAC AAT GAA TTA CAG




CCC GCA GTT






YojI Check
GTCGCGGCAACGTTGGTATCAG
148


Internal







YojI Check Up
GCTGCATCAGGATAAAGACGAACCG
149





YajR N20 Up
GGTGAGAGGCGCGCGACCTGGTTTTAGAGCTAGAAATAGCAAG
150





YajR N20 Low
CAGGTCGCGCGCCTCTCACCACTAGTATTATACCTAGGACTGAG
151





YajR SSDNA
GCC CAG CAT GCG CAA CGA GAA TAC GGT CCC TTA
152


Repair
TTA TTA ATT CCA GGT CGC GCG CCT CTC ACC TGG




CGT CAT TTT ATA ATC GTT cat TAC CAC CTC TGT




TTT AAA TTC






YajR Check Up
GTTGCTGATGACAGAATCTGGGCGC
153





YajR Check
CCATTCCGGACTCACGATTAAGTACG
154


Internal







YdhC N20 Up
TTGCAGGTCGGCCTGTATGGGTTTTAGAGCTAGAAATAGCAAG
155





YdhC N20 Low
CCATACAGGCCGACCTGCAAACTAGTATTATACCTAGGACTGAG
156





YdhC SSDNA
AAG GAA CAG ACT AAG GCT GGC ACT GAC AGC AGA
157


Repair
CGC AGG CGT TTG CAG GTC GGC CTG TAT GGC TTA




TTA TTA ATT GAA AGC AGG CAG ATA CAT ATC GGT




TGC CAG AAA






YdhC Check Up
CACATCACGGTGCCGTCGTTCAAAG
158





YdhC Check
CCGGTTTACGACCATAACGGTCGG
159


Internal







CusA N20 Up
ATAGATCCAGCCAACACCCGGTTTTAGAGCTAGAAATAGCAAG
160





CusA N20 Low
CGGGTGTTGGCTGGATCTATACTAGTATTATACCTAGGACTGAG
161





CusA SSDNA
CAG ATC GTG CTT ACC GCT GCG ATC CAC CAG TGC
162


Repair
ATA TTC ATA GAT CCA GCC AAC ACC CGT TTA TTA





TTA ATT ATC TGG CCC CAG CTC GGC GCT GAC TCC







CusA 200 Up
GGTGATTACCGTTGATGCCGAC
163





CusA Check
GAGAAACCAGTCCTGTAATGAGCG
164


Internal







YhaM_N20_Fwd
GTTGGTATGCCCGCCGACGAGTTTTAGAGCTAGAAATAGCAAG
343





YhaM_N20_Rvs
TCGTCGGCGGGCATACCAACACTAGTATTATACCTAGGACTGAG
344





YhaM_Check_Fwd
CAACATTAACGAATTAAACAACCCG
345





YhaM_Check_Rvs
GTTGCTGTGTGTTTCTCCGTTC
346





YhaM SSDNA
CAC ACC ATC GTG CGT CTC GAT ATG CAC AAT GTT
347


Repair
GGT ATG CCC GCC GAC GAT TGT GAC ACA CGC CCA




CTT CTC ACC GTT CCA GAC TTT GGC TCG AGA GAA




GAG GAT TTC ATC









Whole Genome Sequencing of EKO-35v2

Genomic DNA was extracted using the Purelink Genomic DNA Mini Kit (Invitrogen), according to the manufacturer's guidelines. Quality of the extracted gDNA was assessed using gel electrophoresis. Illumina DNA library preparation was performed using an Illumina Nextera kit by the Microbial Genome Sequencing Center (Pennsylvania, USA), which was followed by Illumina sequencing on a NextSeq 2000 platform. Analysis of the raw reads was performed using Geneious Prime 2021.0.2 (Kearse, M. et al., 2012). Low quality reads were trimmed using an in-suite BBDuk plug-in. Raw wild-type reads were assembled to an NCBI reference genome (Accession No. CP009273.1) with bowtie2. The resulting assembly was used as a reference to assemble the EKO-35v2 mutant reads. Differences between the wild-type BW25113 and EKO-35v2 strains were identified by searching for single nucleotide polymorphisms (SNPs) and deletions using the following thresholds: minimum variant frequency of 0.75, maximum variant P-value of 10−6, and minimum variant P-value of 10−5. The results were confirmed using the breseq (v 0.35.6) pipeline. Three intergenic mutations and three secondary mutations were identified, as summarize in Table 24. The nonsynonymous mutation in yhaM was repaired using CRISPR-Cas9-mediated counterselection, which introduced three intentional silent mutations (yhaM A390T, C393A, C432A) to remove the adjacent PAM site and introduce XhoI-guided screening.









TABLE 24





EKO-35v2 genomic mutations. Single nucleotide polymorphisms were


identified relative to the parent E. coli K-12 genome.







Secondary Mutations













Base Pair





Gene
Mutation
Effect
Gene Function







xylG
A116C
Missense
D-xylose ABC






transporter



ydgK
C231T
Silent
Putative inner






membrane protein











Intergenic Mutations










5′ Flanking
3′ Flanking
Position relative to



gene
Gene
flanking genes
Mutation





ecpR
ykgL
−144/−632
(T)8 → (T)7


cysZ
cysK
 +21/−164
A→ T


kduI
yqeF
−123/+164
T→ C









Phenotypic Profiling of EKO-35

For growth profiling in nutrient-rich conditions, strains were propagated on LB agar for 18 h at 37° C. Single colonies were inoculated into LB and grown at 37° C. until the mid-exponential phase (OD600 nm˜0.6) was reached. All strains were assessed with at least three biological replicates. The cultures were standardized to an OD600 nm˜0.1 in sterile 0.85% saline (w/v). Standardized cultures were diluted 1/200 into LB and 100 μL of the resulting dilution were applied to round-bottom 96-well microtiter plates (VWR). To prevent evaporation, the microtiter plates were sealed (labeling tape, Fisher Scientific). The OD600 nm was measured every 15 minutes over the course of 24 h using a BioTek Synergy H1 microplate reader. Growth was assessed at both 37° C. and 25° C.


Results

Generation of EKO-35: Inactivation of E. coli Drug Efflux Pumps


Inventors' first goal was to generate a simplified genetic background to overcome the challenges associated with the complexities of intact drug efflux networks. To generate the first-generation strain, inventors started with an ΔacrB mutant from the Keio Collection and removed a further 13 pumps using the λ-Red system and 22 additional pumps using CRISPR Cas9-mediated counterselection. As such, EKO-35 of Example 1 (i.e. EKO-35v1) contains 13 flippase recognition target (FRT) sites and 11 secondary mutations. To circumvent genomic mobility due to FRT site-mediated DNA translocation, the inventors created the second-generation strain, EKO-35v2, using only CRISPR Cas9-mediated counterselection. EKO-35v2 is a scarless genetic background with significantly fewer secondary mutations, representing a stable isogenic background devoid of 35 efflux-encoding genes (Table 24).


The efflux genes were inactivated in the following order: ΔyajR; mdtO; ydhC; emrE; yojI; mdtD, sugE; ynfM, emrD, ydeF; mdlA, emrY; mdtK, bcr; mdtG; mdtH, mdlB, macB, yddA; fsr; ydiM; yieO; mdfA; mdtM; mdtJ; emrB, mdtB, mdtL; yebQ; cusA; mdtF; ydeA; acrF; acrB. While generating the strain, inventors identified a missense mutation (K139T) within the gene encoding a putative L-cysteine desulfidase (YhaM). In effort to create a scarless genetic background devoid of secondary mutations, the inventors repaired this mutation. However, an additional missense mutation (N39H) arose within a gene encoding a xylose ABC transporter (XlyG).


Since many of the efflux pump-encoding genes have predicted start codons and are poorly characterized, it is possible that alternative start codons located downstream from the inserted tandem stop codons (Table 26A) could be utilized for a subset of the CRISPR-inactivated pumps. To investigate, inventors profiled the genome of the efflux-deficient strain, which included the inserted stop codons, using the Prodigal prokaryotic gene recognition and translation initiation site identifier (Hyatt et al, 2010). Overall, the program did not predict production of any potentially functional efflux pumps in EKO-35v1 and EKO-35v2, which supports the notion that the tandem stop codons were sufficient to prematurely terminate translation, and that alternate start codons would not be utilized (Tables 26A and 26B). Indeed, Prodigal analysis of the wild-type strain's genome predicted production of all pumps (Table 26B). In addition, inventors also took advantage of new developments in protein structure predictions, and carefully analyzed AlphaFold-generated models of each efflux pump to ascertain whether the predicted start codons were correct based on the structural features of the proteins. Such an analysis indicated the inserted stop codons were sufficient to inactivate the different genes. This strain was subsequently designated Efflux KnockOut-35 version 2 (EKO-35v2), and was used for phenotypic characterization and construction of an efflux platform, as described below. The EKO-35v2 genome sequence (SEQ ID NO: 255) confirmed successful disruption of the 35 efflux-encoding genes, including successful repair of yhaM, and also revealed two additional secondary mutations, one of which encoded missense mutations and one silent substitutions (Table 24).


Characterizing EKO-35: Phenotypic Analysis

With the intent of using EKO-35 as a simplified genetic background to study the functions of drug efflux pumps, inventors' second goal was to fully characterize EKO-35v1 and v2 prior to further investigations. Other efflux-deficient backgrounds (e.g., tolC mutants) display pleiotropic phenotypes, including severe growth defects in minimal M9 medium with glucose supplied as the carbon source. Indeed, tolC inactivation causes periplasmic accumulation of enterobactin in this low-iron growth medium, which underlies this conditionally essential phenotype. In addition, tolC mutants exhibit membrane stress and depletion of essential metabolites, resulting in ‘metabolic shutdown’ in minimal glucose medium. Phenotypic analysis of EKO-35v1 growth kinetics under standard laboratory conditions, nutrient-rich Lysogeny broth, revealed EKO-35v1 exhibited a 1 h extended lag phase. To assess the impact of the secondary mutations and genomic mobility on the growth kinetics of EKO-35v1, the growth kinetics of EKO-35v2 were also profiled. Compared to the wild-type strain, EKO-35v2 shows no significant difference in the lag phase of growth or doubling time (FIG. 19, Table 25). As such, inventors conclude the previously observed phenotypic differences between the parent strain and EKO-35v1 were due to genomic limitations of the strain, rather than loss of efflux-encoding genes. Therefore, both EKO-35v1 and EKO-35v2 are useful platforms for investigating drug efflux.









TABLE 25







Measurement of growth kinetics revealed statistically significant


differences between EKO-35v2 and the wild-type strain. Generation


time and the duration of the lag phase for each strain are


shown in minutes. The measurements represent the mean ±


standard deviation for three biological replicates.











Generation




Strain
time (min)
Lag phase (min)
Final OD600 nm







Nutrient-rich medium at 37° C.













K-12
29.66 ± 1.067
207.85 ± 0.663
0.501 ± 0.010


EKO-35v1
32.04 ± 1.531
256.15 ± 0.946
0.415 ± 0.008


EKO-35v2
 30.50 ± 0.7512
209.09 ± 1.234
0.496 ± 0.021


P-valueEKO-35v1
5.54 × 10−3
1.99 × 10−19
5.29 × 10−10 


P-valueEKO-35v2
1.15 × 10−1*
3.82 × 10−2 
5.29 × 10−1*





*non-significant P-values.


Statistical significance was assessed using a two-tailed Student's t-test (P-value ≤ 0.05).













TABLE 26A







Prediction of protein-coding genes using Prodigal prokaryotic gene


recognition and translation initiation site identifier. A consensus sequence (60%


threshold) of the efflux-deficient strain genome assembly, containing the tandem stop


codons, was utilized as the query fasta. As a control, the wild-type E. coli K-12


genome, without any CRISPR modifications, was also used (GenBank: CP009273.1).


The Prodigal results were searched for efflux-encoding genes using BLASTP (cutoff


threshold E < 1.0 e−50). Predicted peptide size in EKO-35 is denoted as the length of


the truncated peptide as a fraction of the total protein size.


EKO-35 Genome and EKO-35v2 Genome














Predicted
Predicted

SEQ




Translation Start
Peptide
Predicted
ID


Gene
Predicted RBS
Site
Size
Stop Site
NO:





acrB










acrD










acrF










mdtF










macB










emrB










mdtL










mdtK










bcr










ydeA










mdtM










yddA










yebQ










emrE
AGGA/GGAG/
MNPYIYLG [...]
233
GFTN*
244



GAGG









mdtD










sugE










ynfM










emrD
Unknown
MKRQRNVN [...]
234
PISN*
245





ydeF










mdtJ
AGGAG
MYIYWILL [...]
235
GNGN*
245





ydiM
AGxAG
MKNPYFPT [...]
236
QTNN*
246





mdtB
AGGAG
MQVLPPSS [...]
237
DYPN*
247





mdlA










emrY










mdfA










fsr
Unknown
MAMSEQPQ [...]
238
PVVN*
249





mdtG
GGA/GAG/AGG
MSPCENDT [...]
239
SALN*
250





mdtH
GGAGG
MSRVSQAR [...]
240
GWAN*
251





yieO
AGGA
MSDKKKRS [...]
241
LTVN*
252





mdlB










mdtO










yojI










ydhC
GGA/GAG/AGG
MQPGKRFL [...]
242
PAFN*
253





cusA
GGAG/GAGG
MIEWIIRR [...]
243
GPDN*
254
















TABLE 26B







Prediction of protein-coding genes using Prodigal prokaryotic gene


recognition and translation initiation site identifier. A consensus sequence


(60% threshold) of the efflux-deficient strain genome assembly, containing


the tandem stop codons, was utilized as the query fasta. As a control, the


wild-type E. coli K-12 genome, without any CRISPR modifications, was also


used (GenBank: CP009273.1). The Prodigal results were searched for efflux-


encoding genes using BLASTP (cutoff threshold E < 1.0 e−50). Predicted peptide


size in EKO-35 is denoted as the length of the truncated peptide as a


fraction of the total protein size.


K-12 Genome












Predicted Translation



Gene
Predicted RBS
Start Site
SEQ ID NO:





acrB
AGGAG
MPNFFIDR [....]
199





acrD
GGAG/GAGG
MANFFIDR [....]
200





acrF
GGA/GAG/AGG
MANFFIRR [....]
201





mdtF
GGA/GAG/AGG
MANYFIDR [....]
202





macB
AGGAG
MTPLLELK [....]
203





emrB
GGAG/GAGG
MQQQKPLE [....]
204





mdtL
AGGA/GGAG/GAGG
MSRFLICS [....]
205





mdtK
GGA/GAG/AGG
MQKYISEA [....]
206





bcr
AGGAG
MTTRQHSS [....]
207





ydeA
Unknown
MTTNTVSR [....]
208





mdtM
AGGAG
MPRFFTRH [....]
209





yddA
Unknown
MITIPITL [....]
210





yebQ
Unknown
MPKVQADG [....]
211





emrE
AGGA/GGAG/GAGG
MNPYIYLG [....]
212





mdtD
GGAG/GAGG
MTDLPDST [....]
213





sugE
GGAG/GAGG
MSWIILVI [....]
214





ynfM
AGGA
MSRTTTVD [...]
215





emrD
Unknown
MKRQRNVN [...]
216





ydeF
GGA/GAG/AGG
MNLSLRRS [...]
217





mdtJ
AGGAG
MYIYWILL [...]
218





ydiM
AGxAG
MKNPYFPT [...]
219





mdtB
AGGAG
MQVLPPSS [...]
220





mdlA
AGGA
MRLFAQLS [...]
221





emrY
GGA/GAG/AGG
MAITKSTP [...]
222





mdfA
Unknown
MQNKLASG [...]
223





fsr
Unknown
MAMSEQPQ [...]
224





mdtG
GGA/GAG/AGG
MSPCENDT [...]
225





mdtH
GGAGG
MSRVSQAR [...]
226





yieO
AGGA
MSDKKKRS [...]
227





mdlB
AGGAG
MRSFSQLW [...]
228





mdtO
GGA/GAG/AGG
MSALNSLP [...]
229





yojI
Unknown
MELLVLVW [...]
230





ydhC
GGA/GAG/AGG
MQPGKRFL [...]
231





cusA
GGAG/GAGG
MIEWIIRR [...]
232









While the present disclosure has been described with reference to what are presently considered to be the preferred example, it is to be understood that the disclosure is not limited to the disclosed example. To the contrary, the disclosure is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims.


All publications, patents and patent applications are herein incorporated by reference in their entirety to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated by reference in its entirety.


REFERENCES



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Claims
  • 1. An Escherichia coli strain comprising at least 20 of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA.
  • 2. The Escherichia coli strain of claim 1, comprising at least 34 of the inactivated genes.
  • 3. The Escherichia coli strain of claim 1, comprising all 35 inactivated genes.
  • 4. The Escherichia coli strain of claim 1, wherein the Escherichia coli strain is deposited under IDAC accession number 310522-01 or IDAC accession number 070623-01, or an Escherichia coli comprising a nucleic acid having the sequence as shown in SEQ ID NO: 255.
  • 5. The Escherichia coli strain of claim 1, further comprising an open variant of outer membrane ferric siderophore transporter FhuA.
  • 6. The Escherichia coli strain of claim 3, wherein at least one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated, optionally under the control of a constitutive promoter.
  • 7. The Escherichia coli strain of claim 6, wherein one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated.
  • 8. The Escherichia coli strain of claim 5, wherein at least one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated.
  • 9. The Escherichia coli strain of claim 8, wherein one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated.
  • 10. The Escherichia coli strain of claim 1, wherein inactivation comprises deletion of the gene, or introducing a mutation into the gene to ablate expression of the gene or eliminate efflux pump activity of the protein expressed by the gene.
  • 11. A method for identifying a compound that is an antibacterial agent, comprising (a) i) contacting the compound with an Escherichia coli strain of comprising at least 20 of inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA (Strain A) and with wild-type Escherichia coli; and/orii) contacting the compound with Strain A and an Escherichia coli strain comprising inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, wherein at least one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated (Strain B); and/oriii) contacting the compound with Strain A and an Escherichia coli strain comprising inactivated genes acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, wherein one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, is reactivated (Strain C); and(b) detecting viability of each of the Escherichia coli; wherein the compound is identified as an antibacterial agent if the compound decreases viability of wild-type less than Strain A;optionally wherein the compound is identified as an antibacterial agent if the compound decreases viability of Strain B less than Strain A;optionally wherein the compound is identified as an antibacterial agent if the wild-type Escherichia coli or Strain B is resistant to the compound, and the compound decreases the viability of Strain A.
  • 12. The method of claim 11, wherein the decrease in viability of wild-type or Strain B after contacting the compound is at most 10%, 20%, 30%, 40%, 50%, 60%, 70%, or 80%, and the viability of Strain A is at least 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or 100%.
  • 13. The method of claim 11, wherein the compound is identified as an antibacterial agent if the compound decreases the viability of Strain A at a faster rate than the decrease in viability of wild-type or Strain B.
  • 14. The method of claim 11, wherein the compound decreases the viability of Strain C less than Strain A, thereby identifying specificity of the compound for an efflux pump encoded by the reactivated gene, optionally the compound has a lower minimum inhibitory concentration (MIC) in Strain A than Strain C.
  • 15. The method of claim 11, wherein the contacting comprises incubating the Escherichia coli in a suitable culturing media for optimal Escherichia coli growth.
  • 16. The method of claim 11, wherein the contacting comprises incubating the Escherichia coli in nutrient-limiting culturing media.
  • 17. The method of claim 15, wherein the contacting comprises incubating the Escherichia coli for at least 24 h, 48 h, 72 h, or 96 h.
  • 18. The method of claim 11, wherein the culturing media is a media having a pH of about 2, about 3, about 4, or about 5.
  • 19. A method for creating an Escherichia coli strain producing one or more efflux pump, comprising reactivating one of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA in the Escherichia coli strain of claim 3.
  • 20. The method of claim 19, wherein the reactivation comprises introducing one or more of acrB, acrD, acrF, mdtF, macB, emrB, mdtL, mdtK, bcr, ydeA, mdtM, yddA, yebQ, emrE, mdtD, sugE, ynfM, emrD, ydeF, mdtJ, ydiM, mdtB, mdlA, emrY, mdfA, fsr, mdtG, mdtH, yieO, mdlB, mdtO, yojI, yajR, ydhC, and cusA, optionally by reversing the inactivation, optionally by re-introducing the gene back in genome with the same promoter or a different promoter, at the same locus or a different locus, optionally by introducing a knock down-resistant version of the gene.
CROSS REFERENCE TO RELATED APPLICATION

The present disclosure claims priority from U.S. provisional application No. 63/352,569 filed on Jun. 15, 2022, which is hereby incorporated by reference in its entirety.

Provisional Applications (1)
Number Date Country
63352569 Jun 2022 US