Positron emission tomography (PET) is an emerging tool under clinical investigation for the detection of bacterial infections. The ability to identify the site of infection and the pathogen's potential susceptibility to subsequent treatment approaches can streamline treatment and prevent misuse of antibiotics. Previous studies identified TREN-CAM as a promising scaffold for radiometal labeling using the positron-emitting radionuclide 68Ga. Here, we investigate the suitability of 67/68Ga-labeled TREN-CAM and enterobactin for the noninvasive imaging of an Escherichia coli infection. In vitro uptake experiments with 67GaGaIII-TREN-CAM demonstrate superior uptake in E. coli K12 and Pseudomonas aeruginosa PAO1 when compared with 67GaGaIII-DFO, a compound currently under clinical investigation for infection imaging. Selectivity experiments indicate that 67GaGaIII-TREN-CAM is recognized by the active transmembrane transport machinery for natFeIII-Ent. Using a soft tissue E. coli infection model, we demonstrate that 68GaGaIII-TREN-CAM selectively accumulates in infected tissue. Notably, 68GaGaIII-TREN-CAM provides better infection-to-inflammation contrast, accelerated blood clearance, and lower off-target accumulation compared to 68GaGaIII-Ent and 68GaGaIII-citrate. The potential of 68GaGaIII-TREN-CAM to serve as a tool to monitor the therapeutic efficacy of cefiderocol is also evaluated, offering insight into its utility in guiding antibiotic treatment.
Joaqui‐Joaqui et al. (Wed,) studied this question.