Genome-wide screen reveals glycerol-induced aminoglycoside potentiation against Staphylococcus aureus via boosting GlpK-initiated energy metabolism.

Potentiation of existing antibiotics represents a promising strategy for combating the global health crisis of antibiotic resistance. Here we report that 1 min co-treatment with glycerol markedly enhances aminoglycoside efficacy against stationary-phase Staphylococcus aureus cells. This rapid combined treatment also effectively eliminates S. aureus biofilms and persister cells, methicillin-resistant S. aureus clinical isolates in vitro, and S. aureus in a mouse skin infection model. The potentiation is achieved through rapid enhancement of proton motive force-dependent aminoglycoside uptake. Atmospheric and room temperature plasma (ARTP)-based genome-wide mutagenesis screens further reveal the genetic basis of this potentiation, highlighting a central role for glycerol kinase (GlpK). Mechanistically, GlpK initiates glycerol catabolism and boosts cellular energy metabolism, thereby increasing proton motive force-driven aminoglycoside uptake. Unlike widely reported long-term adjuvant treatments, our approach offers an immediate potentiation strategy and may open avenues to develop glycerol as an aminoglycoside adjuvant, given its "generally recognized as safe" characteristic. Our study also illustrates the potential of ARTP-based genome-wide mutagenesis in antibiotic resistance and stress biology research.