Project Summary
Controlling medical device associated infections is an unmet challenge due to high-level tolerance to
antibiotics. An important mechanism of such tolerance is the formation of persister cells, which are non-
growing phenotypic variants of bacterial cells. Because conventional antibiotics attack bacteria by inhibiting cell
growth related behaviors such as cell wall and protein syntheses, they are not effective against persister cells.
The capability to escape antibiotic treatment by persister formation and reestablish the bacterial population
after treatment is an important intrinsic mechanism of bacterial multidrug tolerance, which leads to chronic
infections and facilitates the development of multidrug resistance through acquired mechanisms based on
mutations and drug resistance genes. Despite the significance of persister cells, the mechanism of persister
formation is still not well understood and control of persister cells remains challenging. One major hurdle to
persister research is the lack of an animal model of bacterial persistence that is essential for understanding
host response to persister cells and for testing new antimicrobials and biomaterials for persister control.
To address this grand challenge, this team will construct the first in vivo model to control and monitor
persister formation using blue light. An Escherichia coli strain will be engineered using synthetic biology.
Exposure to blue light will induce the toxin gene hipA and repress the antitoxin gene hipB in this strain, leading
to high-level persister formation. This process will be reversed by moving cells to the dark, resulting in persister
wakeup and reversion to normal cells. Additional components will be included to label all cells with
constitutively expressed green fluorescence protein (GFP) and normal cells with bioluminescence expressed
under a growth-rate-dependent promoter. After in vitro test, the constructed strain will be validated in an in vivo
mouse model of subcutaneous biomaterial infection with an engineered device that generates blue light
wirelessly. Persister formation and antibiotic treatment will be tested in this model. The effects will be
monitored using whole-animal imaging and the results will be corroborated with microbiological and
histopathological analyses after the mice are euthanized.
This research team aims to better control persistent infections such as those associated with implanted
medical devices. This project will lead to an important millstone toward this ultimate goal by constructing the
first animal model of bacterial persistence. With the capability to control and monitor persister formation
noninvasively and in real-time, this system will be useful for both fundamental study of bacterial physiology and
for drug discovery and biomaterial design against this antibiotic tolerant population. Thus, this project falls well
within NIH’s definition of being contributive to "improve people's health and save lives”.