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Schoenmakers JWA, López-Álvarez M, IJpma FFA, Wouthuyzen-Bakker M, McNamara JO, van Oosten M, Jutte PC, van Dijl JM. A fluorogenic micrococcal nuclease-based probe for fast detection and optical imaging of Staphylococcus aureus in prosthetic joint and fracture-related infections. Eur J Nucl Med Mol Imaging 2024; 51:2988-2997. [PMID: 37962617 PMCID: PMC11300479 DOI: 10.1007/s00259-023-06499-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Staphylococcus aureus is the most common and impactful multi-drug resistant pathogen implicated in (periprosthetic) joint infections (PJI) and fracture-related infections (FRI). Therefore, the present proof-of-principle study was aimed at the rapid detection of S. aureus in synovial fluids and biofilms on extracted osteosynthesis materials through bacteria-targeted fluorescence imaging with the 'smart-activatable' DNA-based AttoPolyT probe. This fluorogenic oligonucleotide probe yields large fluorescence increases upon cleavage by micrococcal nuclease, an enzyme secreted by S. aureus. METHODS Synovial fluids from patients with suspected PJI and extracted osteosynthesis materials from trauma patients with suspected FRI were inspected for S. aureus nuclease activity with the AttoPolyT probe. Biofilms on osteosynthesis materials were imaged with the AttoPolyT probe and a vancomycin-IRDye800CW conjugate (vanco-800CW) specific for Gram-positive bacteria. RESULTS 38 synovial fluid samples were collected and analyzed. Significantly higher fluorescence levels were measured for S. aureus-positive samples compared to, respectively, other Gram-positive bacterial pathogens (p < 0.0001), Gram-negative bacterial pathogens (p = 0.0038) and non-infected samples (p = 0.0030), allowing a diagnosis of S. aureus-associated PJI within 2 h. Importantly, S. aureus-associated biofilms on extracted osteosynthesis materials from patients with FRI were accurately imaged with the AttoPolyT probe, allowing their correct distinction from biofilms formed by other Gram-positive bacteria detected with vanco-800CW within 15 min. CONCLUSION The present study highlights the potential clinical value of the AttoPolyT probe for fast and accurate detection of S. aureus infection in synovial fluids and biofilms on extracted osteosynthesis materials.
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Affiliation(s)
- Jorrit W A Schoenmakers
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700RB, Groningen, The Netherlands
- Department of Orthopaedics, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Marina López-Álvarez
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700RB, Groningen, The Netherlands
| | - Frank F A IJpma
- Department of Surgery, Division of Trauma Surgery, University of Groningen (UMCG), Groningen, The Netherlands
| | - Marjan Wouthuyzen-Bakker
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700RB, Groningen, The Netherlands
| | | | - Marleen van Oosten
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700RB, Groningen, The Netherlands
| | - Paul C Jutte
- Department of Orthopaedics, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Jan Maarten van Dijl
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700RB, Groningen, The Netherlands.
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2
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Yi Z, Xu X, Meng X, Liu C, Zhou Q, Gong D, Zha Z. Emerging markers for antimicrobial resistance monitoring. CHINESE CHEM LETT 2023. [DOI: 10.1016/j.cclet.2023.108238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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3
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Streeter SS, Hebert KA, Bateman LM, Ray GS, Dean RE, Geffken KT, Resnick CT, Austin DC, Bell JE, Sparks MB, Gibbs SL, Samkoe KS, Gitajn IL, Elliott JT, Henderson ER. Current and Future Applications of Fluorescence Guidance in Orthopaedic Surgery. Mol Imaging Biol 2023; 25:46-57. [PMID: 36447084 PMCID: PMC10106269 DOI: 10.1007/s11307-022-01789-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/01/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022]
Abstract
Fluorescence-guided surgery (FGS) is an evolving field that seeks to identify important anatomic structures or physiologic phenomena with helpful relevance to the execution of surgical procedures. Fluorescence labeling occurs generally via the administration of fluorescent reporters that may be molecularly targeted, enzyme-activated, or untargeted, vascular probes. Fluorescence guidance has substantially changed care strategies in numerous surgical fields; however, investigation and adoption in orthopaedic surgery have lagged. FGS shows the potential for improving patient care in orthopaedics via several applications including disease diagnosis, perfusion-based tissue healing capacity assessment, infection/tumor eradication, and anatomic structure identification. This review highlights current and future applications of fluorescence guidance in orthopaedics and identifies key challenges to translation and potential solutions.
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Affiliation(s)
- Samuel S Streeter
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA.
| | - Kendra A Hebert
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
| | - Logan M Bateman
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA.,Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA
| | - Gabrielle S Ray
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Ryan E Dean
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Kurt T Geffken
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Corey T Resnick
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Daniel C Austin
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - John-Erik Bell
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Michael B Sparks
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Summer L Gibbs
- Oregon Health & Science University, Portland, OR, 97239, USA
| | - Kimberley S Samkoe
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA
| | - I Leah Gitajn
- Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA
| | - Jonathan Thomas Elliott
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA.,Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA.,Dartmouth Cancer Center, Dartmouth Health, Lebanon, NH, 03756, USA
| | - Eric R Henderson
- Thayer School of Engineering, Dartmouth College, Hanover, NH, 03755, USA.,Department of Orthopaedics, Dartmouth Health, Lebanon, NH, 03756, USA.,Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, USA.,Dartmouth Cancer Center, Dartmouth Health, Lebanon, NH, 03756, USA
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4
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López-Álvarez M, Heuker M, Sjollema KA, van Dam GM, van Dijl JM, IJpma FFA, van Oosten M. Bacteria-targeted fluorescence imaging of extracted osteosynthesis devices for rapid visualization of fracture-related infections. Eur J Nucl Med Mol Imaging 2022; 49:2276-2289. [PMID: 35079847 PMCID: PMC9165280 DOI: 10.1007/s00259-022-05695-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/19/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Fracture-related infection (FRI) is a serious complication in orthopedic trauma surgery worldwide. Especially, the distinction of infection from sterile inflammation and the detection of low-grade infection are highly challenging. The objective of the present study was to obtain proof-of-principle for the use of bacteria-targeted fluorescence imaging to detect FRI on extracted osteosynthesis devices as a step-up towards real-time image-guided trauma surgery. METHODS Extracted osteosynthesis devices from 13 patients, who needed revision surgery after fracture treatment, were incubated with a near-infrared fluorescent tracer composed of the antibiotic vancomycin and the fluorophore IRDye800CW (i.e., vanco-800CW). Subsequently, the devices were imaged, and vanco-800CW fluorescence signals were correlated to the results of microbiological culturing and to bacterial growth upon replica plating of the imaged devices on blood agar. RESULTS Importantly, compared to culturing, the bacteria-targeted fluorescence imaging of extracted osteosynthesis devices with vanco-800CW allows for a prompt diagnosis of FRI, reducing the time-to-result from days to less than 30 min. Moreover, bacteria-targeted imaging can provide surgeons with real-time visual information on the presence and extent of infection. CONCLUSION Here, we present the first clinical application of fluorescence imaging for the detection of FRI. We conclude that imaging with vanco-800CW can provide early, accurate, and real-time visual diagnostic information on FRI in the clinical setting, even in the case of low-grade infections.
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Affiliation(s)
- Marina López-Álvarez
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO BOX 30001, 9700 RB, Groningen, The Netherlands
| | - Marjolein Heuker
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO BOX 30001, 9700 RB, Groningen, The Netherlands
| | - Klaas A Sjollema
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gooitzen M van Dam
- Departments of Surgery, Nuclear Medicine and Molecular Imaging, Medical Imaging Center Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- TRACER Europe B.V./AxelaRx, Groningen, The Netherlands
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO BOX 30001, 9700 RB, Groningen, The Netherlands.
| | - Frank F A IJpma
- Department of Surgery, Division of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marleen van Oosten
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO BOX 30001, 9700 RB, Groningen, The Netherlands
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6
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Payne JAE, Tailhades J, Ellett F, Kostoulias X, Fulcher AJ, Fu T, Leung R, Louch S, Tran A, Weber SA, Schittenhelm RB, Lieschke GJ, Qin CH, Irima D, Peleg AY, Cryle MJ. Antibiotic-chemoattractants enhance neutrophil clearance of Staphylococcus aureus. Nat Commun 2021; 12:6157. [PMID: 34697316 PMCID: PMC8546149 DOI: 10.1038/s41467-021-26244-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/22/2021] [Indexed: 01/28/2023] Open
Abstract
The pathogen Staphylococcus aureus can readily develop antibiotic resistance and evade the human immune system, which is associated with reduced levels of neutrophil recruitment. Here, we present a class of antibacterial peptides with potential to act both as antibiotics and as neutrophil chemoattractants. The compounds, which we term 'antibiotic-chemoattractants', consist of a formylated peptide (known to act as chemoattractant for neutrophil recruitment) that is covalently linked to the antibiotic vancomycin (known to bind to the bacterial cell wall). We use a combination of in vitro assays, cellular assays, infection-on-a-chip and in vivo mouse models to show that the compounds improve the recruitment, engulfment and killing of S. aureus by neutrophils. Furthermore, optimizing the formyl peptide sequence can enhance neutrophil activity through differential activation of formyl peptide receptors. Thus, we propose antibiotic-chemoattractants as an alternate approach for antibiotic development.
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Affiliation(s)
- Jennifer A E Payne
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia.
- ARC Centre of Excellence for Innovations in Peptide and Protein Science, Monash University, Clayton, Victoria, 3800, Australia.
- EMBL Australia, Monash University, Clayton, Victoria, 3800, Australia.
| | - Julien Tailhades
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia
- ARC Centre of Excellence for Innovations in Peptide and Protein Science, Monash University, Clayton, Victoria, 3800, Australia
- EMBL Australia, Monash University, Clayton, Victoria, 3800, Australia
| | - Felix Ellett
- BioMEMS Resource Center, Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Shriners Hospital for Children, and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Xenia Kostoulias
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria, 3800, Australia
| | - Alex J Fulcher
- Monash Micro Imaging, Monash University, Clayton, Victoria, 3800, Australia
| | - Ting Fu
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, 3052, Australia
| | - Ryan Leung
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia
| | - Stephanie Louch
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia
| | - Amy Tran
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia
| | - Severin A Weber
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia
- EMBL Australia, Monash University, Clayton, Victoria, 3800, Australia
| | - Ralf B Schittenhelm
- Monash Proteomics and Metabolomics Facility, Monash University, Clayton, Victoria, 3800, Australia
| | - Graham J Lieschke
- Australian Regenerative Medicine Institute, Monash University, Clayton, Victoria, 3800, Australia
| | - Chengxue Helena Qin
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, 3052, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, 3004, Australia
| | - Daniel Irima
- BioMEMS Resource Center, Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Shriners Hospital for Children, and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Anton Y Peleg
- Infection and Immunity Program, Monash Biomedicine Discovery Institute and Department of Microbiology, Monash University, Clayton, Victoria, 3800, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, 3004, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, 3004, Australia
| | - Max J Cryle
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia.
- ARC Centre of Excellence for Innovations in Peptide and Protein Science, Monash University, Clayton, Victoria, 3800, Australia.
- EMBL Australia, Monash University, Clayton, Victoria, 3800, Australia.
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Wang TSA, Chen PL, Chen YCS, Hung HM, Huang JY. Selectively Targeting and Differentiating Vancomycin-Resistant Staphylococcus aureus via Dual Synthetic Fluorescent Probes. ACS Infect Dis 2021; 7:2584-2590. [PMID: 34410687 DOI: 10.1021/acsinfecdis.1c00235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Many Staphylococcus bacteria are pathogenic and harmful to humans. Noticeably, some Staphylococcus, including vancomycin-resistant S. aureus (VRSA), have become notoriously resistant to antibiotics and have spread rapidly, becoming threats to public health. Here, we designed a dual fluorescent probe scheme combining siderophores and antibiotics as the guiding units to selectively target VRSA and vancomycin-sensitive S. aureus (VSSA) in complex bacterial samples. Siderophore-mediated iron uptake is the key pathway by which S. aureus acquires iron in limited environments. Therefore, the siderophore-derivative probe could differentiate between S. aureus and other bacteria. Moreover, by fine-tuning the vancomycin-derivative probes, we could selectively target only VSSA, further differentiating VRSA and VSSA. Finally, by combining the siderophore-derivative probe and the vancomycin-derivative probe, we successfully targeted and differentiated between VRSA and VSSA in complicated bacterial mixtures.
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Affiliation(s)
| | - Pin-Lung Chen
- Department of Chemistry, National Taiwan University, Taipei, 10617, Taiwan (R.O.C.)
| | - Yi-Chen Sarah Chen
- Department of Chemistry, National Taiwan University, Taipei, 10617, Taiwan (R.O.C.)
| | - Hsuan-Min Hung
- Department of Chemistry, National Taiwan University, Taipei, 10617, Taiwan (R.O.C.)
| | - Jhih-Yi Huang
- Department of Chemistry, National Taiwan University, Taipei, 10617, Taiwan (R.O.C.)
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Raineri EJM, Altulea D, van Dijl JM. Staphylococcal trafficking and infection - from 'nose to gut' and back. FEMS Microbiol Rev 2021; 46:6321165. [PMID: 34259843 PMCID: PMC8767451 DOI: 10.1093/femsre/fuab041] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/11/2021] [Indexed: 12/12/2022] Open
Abstract
Staphylococcus aureus is an opportunistic human pathogen, which is a leading cause of infections worldwide. The challenge in treating S. aureus infection is linked to the development of multidrug-resistant strains and the mechanisms employed by this pathogen to evade the human immune defenses. In addition, S. aureus can hide asymptomatically in particular ‘protective’ niches of the human body for prolonged periods of time. In the present review, we highlight recently gained insights in the role of the human gut as an endogenous S. aureus reservoir next to the nasopharynx and oral cavity. In addition, we address the contribution of these ecological niches to staphylococcal transmission, including the roles of particular triggers as modulators of the bacterial dissemination. In this context, we present recent advances concerning the interactions between S. aureus and immune cells to understand their possible roles as vehicles of dissemination from the gut to other body sites. Lastly, we discuss the factors that contribute to the switch from colonization to infection. Altogether, we conclude that an important key to uncovering the pathogenesis of S. aureus infection lies hidden in the endogenous staphylococcal reservoirs, the trafficking of this bacterium through the human body and the subsequent immune responses.
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Affiliation(s)
- Elisa J M Raineri
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dania Altulea
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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