Infections
'Trojan horse' may aid fight against antibiotic resistance
Sign up now: Get ST's newsletters delivered to your inbox
Antibiotic resistance in infections such as pneumonia, bloodstream infections and wound or surgical site infections is a common problem.
This is especially since all antibiotics that are currently used to treat these infections belong to the same class and have similar modes of action.
However, the discovery of Cefiderocol, a new antibiotic with a Trojan horse mechanism of action that acts on these infections, has proved to be a game changer, said Associate Professor David Lye, director at the Infectious Disease Research and Training Office in the National Centre for Infectious Diseases (NCID).
A Trojan horse refers to any kind of deception that involves getting a target (the bacteria) to willingly allow an enemy (the antibiotic) into a secure place (the cell of the bacteria).
Cefiderocol acts on the channel that transports potassium across the cell membrane.
Potassium is a salt that is very important to the cell's function.
Cefiderocol enters the bacteria via the potassium channel and kills the bacteria once it is inside, Prof Lye said.
Traditionally, antibiotics destroy the integrity of the bacterial membranes and cause the cells to burst.
However, some of these bacteria soon adopt a unique structure of their outer membrane, preventing certain drugs and antibiotics from entering the cell, resulting in resistance.
A clinical trial on Cefiderocol, aptly named Gamechanger, investigates this new mode of action.
The trial is led by Professor David Paterson, director at The University of Queensland Centre for Clinical Research.
Retiree Ang Hwee Kheng, 55, who was recruited to be part of the trial earlier this month when he was hospitalised as bacteria was detected in his blood, said the trial process has been smooth so far.
"I wanted to join the trial to contribute to medicine so that better care can be given to others in the future," Mr Ang told The Straits Times in a phone call.
His doctor recommended that he join the trial and Mr Ang did not have any reservations in doing so.
Mr Ang takes the antibiotic via an intravenous drip and does not have to pay for medical tests or antibiotics since they are funded by the trial.
Ongoing study
NURTURE (NUh Repository of TissUe and data for Research in Endocrinology) is the National University Hospital's (NUH) initiative to build a secure biorepository of tissue and health records data for research in the National University Health System (NUHS). This provides resources to NUHS' investigators for diabetes-related studies ranging from genetics and diagnosis to diets/lifestyles and clinical care treatment.
Those who want to be part of the study can call 9072-4185/9071-9782 during office hours or send an e-mail to NUH_nurture@nuhs.edu.sg
