# Evaluation of MMV Pandemic Response Box compounds to identify potent compounds against clinically relevant bacterial and fungal clinical isolates in vitro

## TL;DR

This study tests compounds from the MMV Pandemic Response Box against drug-resistant bacteria and fungi, identifying several effective candidates.

## Contribution

The study evaluates MMV Pandemic Box compounds against clinically relevant multidrug-resistant bacterial and fungal isolates, identifying novel potent inhibitors.

## Key findings

- MMV1634390 showed complete bactericidal effect against A. baumannii in a persister assay.
- MMV1782110, eberconazole, amorolfine, and luliconazole exhibited potent antifungal activity against MDR fungal species.
- Erevacycline and epetraborole inhibited both A. baumannii and P. aeruginosa at 10 μM.

## Abstract

Multidrug resistant bacterial and fungal pathogens are resistant to a number of significant front-line drugs, hence, identification of new inhibitory agents to combat them is crucial. In this study, we aim to evaluate the activity of Pandemic Box compounds from Malaria Medicines Venture (MMV) against A. baumannii and P. aeruginosa bacterial, C. auris, C. albicans and A. niger fungal clinical isolates.

Isolates were initially screened with 201 antibacterial and 46 antifungal compounds (10 μM) using a microbroth dilution in triplicates to determine MIC. A persister assay was performed for bacterial pathogens.

Out of 201 antibacterial compounds, twenty-nine and seven compounds inhibited the growth of A. baumannii and P. aeruginosa at 10 μM, respectively. MMV1580854, MMV1579788, eravacycline and epetraborole inhibited both the bacterial test isolates. In a persister assay, MMV1634390 showed complete bactericidal effect against A. baumannii. With antifungal activity compounds, C. auris responded to15 compounds, Six compounds inhibited C. albicans and one was effective against A. niger at 10 μM. The ratio of Minimum Fungicidal Concentration (MFC): Minimum Inhibitory Concentration (MIC) of MMV1782110 was 2 against C. auris. Eberconazole, amorolfine and luliconazole are fungicidal targeting C. albicans at a MFC: MIC ratio of 2.

Five compounds from MMV Pandemic Box were found to be inhibiting colistin and ceftazidime resistant A. baumannii clinical isolate, also against colistin and β-lactam resistant P. aeruginosa clinical isolate. MMV1634390 showed complete bactericidal effect against A. baumannii in a persister assay. MMV1782110, Eberconazole, amorolfine and luliconazole exhibited potent anti-fungal activity. Further investigations are warranted to identify the targets and mechanism.

•MMV Pandemic Response Box compounds were evaluated against MDR bacterial and fungal pathogens isolated from patients.•MMV1634390 compound was highly bactericidal against A. baumannii, whereas eravacycline and epetraborole were against both A. baumannii and P. aeruginosa.•Few compounds were fungicidal against MDR Candida and Aspergillus fungal species.•A novel compound MMV1782110 showed excellent inhibitory activity against Candida auris.

MMV Pandemic Response Box compounds were evaluated against MDR bacterial and fungal pathogens isolated from patients.

MMV1634390 compound was highly bactericidal against A. baumannii, whereas eravacycline and epetraborole were against both A. baumannii and P. aeruginosa.

Few compounds were fungicidal against MDR Candida and Aspergillus fungal species.

A novel compound MMV1782110 showed excellent inhibitory activity against Candida auris.