Orientia tsutsugamushi is highly susceptible to the RNA polymerase switch region inhibitor corallopyronin a In Vitro and In Vivo

Scrub typhus is a potentially lethal infection caused by the obligate intracellular bacterium; Orientia tsutsugamushi; Reports on the emergence of doxycycline-resistant strains highlight the urgent need to develop novel antiinfectives against scrub typhus. Corallopyronin A (CorA) is a novel α-pyrone compound synthesized by the myxobacterium; Corallococcus coralloides; that was characterized as a noncompetitive inhibitor of the switch region of the bacterial RNA polymerase (RNAP). We investigated the antimicrobial action of CorA against the human-pathogenic Karp strain of; O. tsutsugamushi; in vitro; and; in vivo; The MIC of CorA against; O. tsutsugamushi; was remarkably low (0.0078 μg/ml), 16-fold lower than that against; Rickettsia typhi; In the lethal intraperitoneal; O. tsutsugamushi; mouse infection model, a minimum daily dose of 100 μg CorA protected 100% of infected mice. Two days of treatment were sufficient to confer protection. In contrast to BALB/c mice, SCID mice succumbed to the infection despite treatment with CorA or tetracycline, suggesting that antimicrobial treatment required synergistic action of the adaptive immune response. Similar to tetracycline, CorA did not prevent latent infection of; O. tsutsugamushi; in vivo; However, latency was not caused by acquisition of antimicrobial resistance, since; O. tsutsugamushi; reisolated from latently infected BALB/c mice remained fully susceptible to CorA. No mutations were found in the CorA-binding regions of the β and β' RNAP subunit genes; rpoB; and; rpoC; Inhibition of the RNAP switch region of; O. tsutsugamushi; by CorA is therefore a novel and highly potent target for antimicrobial therapy for scrub typhus.