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Kunz Coyne AJ, Stamper K, Bleick C, Kebriaei R, Lehman SM, Rybak MJ. Synergistic bactericidal effects of phage-enhanced antibiotic therapy against MRSA biofilms. Microbiol Spectr 2024; 12:e0321223. [PMID: 38411110 PMCID: PMC10986480 DOI: 10.1128/spectrum.03212-23] [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: 08/30/2023] [Accepted: 01/10/2024] [Indexed: 02/28/2024] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) causes biofilm-related medical device infections. Phage-antibiotic combinations offer potential therapy due to proven in vitro antibiofilm efficacy. We evaluated phage-antibiotic synergy against biofilms using modified checkerboard and 24-h time-kill assays. Humanized-simulated daptomycin (DAP) (10, 8, and 6 mg/kg q24h) and ceftaroline (CPT) (600 mg q12h) were combined with Intesti13, Sb-1, and Romulus phages (tMOI 1, q12h). Assays were conducted in 168-h biofilm reactor models against DAP non-susceptible (DNS) vancomycin intermediate S. aureus (VISA) MRSA D712 and DAP-susceptible MRSA 8014. Synergistic activity and bactericidal activity were defined as ≥2log10 CFU/mL reduction from antibiotic-only regimens and ≥3log10 CFU/mL decrease from baseline at 24 h. Differences were analyzed by one-way analysis of variance with Tukey's post hoc test (P ≤ 0.05 is considered significant). Surviving bacteria were examined for antibiotic minimum biofilm inhibitory concentration (MBIC) changes and phage susceptibility. In 168-h biofilm models, humanized DAP 10 mg/kg + CPT, combined with a 2-phage cocktail (Intesti13 + Sb-1) against D712, and a 3-phage cocktail (Intesti13 + Sb-1 + Romulus) against 8014, demonstrated synergistic bactericidal activity. At 168 h, bacteria were minimally detectable [2log10 CFU/cm2 (-Δ4.23 and -Δ4.42 log10 CFU/cm2; both P < 0.001)]. Antibiotic MBIC remained unchanged compared to baseline across various time points. None of the tested bacteria at 168 h exhibited complete phage resistance. This study reveals bactericidal efficacy of DAP + CPT with 2-phage and 3-phage cocktails against DNS VISA and MRSA isolates (D712 and 8014) in biofilm models, maintaining susceptibility. Further research is needed for diverse strains and durations, aligning with infection care. IMPORTANCE The prevalence of biofilm-associated medical device infections caused by methicillin-resistant Staphylococcus aureus (MRSA) presents a pressing medical challenge. The latest research demonstrates the potential of phage-antibiotic combinations (PACs) as a promising solution, notably in vitro antibiofilm efficacy. By adopting modified checkerboard and 24-h time-kill assays, the study investigated the synergistic action of phages combined with humanized-simulated doses of daptomycin (DAP) and ceftaroline (CPT). The results were promising: a combination of DAP, CPT, and either a 2-phage or 3-phage cocktail effectively exhibited bactericidal activity against both DAP non-susceptible vancomycin intermediate S. aureus MRSA and DAP-susceptible MRSA strains within 168-h biofilm models. Moreover, post-treatment evaluations revealed no discernible rise in antibiotic resistance or complete phage resistance. This pioneering work suggests the potential of PACs in addressing MRSA biofilm infections, setting the stage for further expansive research tailored to diverse bacterial strains and treatment durations.
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Affiliation(s)
- Ashlan J. Kunz Coyne
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Kyle Stamper
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Callan Bleick
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Razieh Kebriaei
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Susan M. Lehman
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Michael J. Rybak
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
- Department of Pharmacy Services, Detroit Receiving Hospital, Detroit Medical Center, Detroit, Michigan, USA
- Department of Medicine, Division of Infectious Diseases, Wayne State University, Detroit, Michigan, USA
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Tzalis S, Ioannou P, Billiari E, Kofteridis DP, Karakonstantis S. Daptomycin as an option for lock therapy: a systematic literature review. Future Microbiol 2023; 18:917-928. [PMID: 37622290 DOI: 10.2217/fmb-2023-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Aim: To review preclinical and clinical data relevant to daptomycin lock therapy in catheter-related bloodstream infection (CRBSI). Methods: Systematic review in PubMed, Scopus and clinical trial registries. Results: Preclinical data demonstrate daptomycin lock solution stability and compatibility with heparin, good biofilm penetration, bactericidal activity against biofilm-embedded bacteria, and high efficacy in vitro and in animal catheter infection models. Clinical data remain limited (two case reports and five case series totaling n = 65 CRBSI episodes), albeit promising (successful catheter salvage in about 80% of cases). Conclusion: Despite theoretical advantages of daptomycin, clinical data remain scarce. Comparative studies versus alternative lock solutions are needed, as well as studies to define optimal daptomycin lock regimen (including optimal concentration, dwell time and lock duration).
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Affiliation(s)
- Sotirios Tzalis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, 71500,Greece
| | - Petros Ioannou
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, 71500,Greece
- School of Medicine, University of Crete, Heraklion, Crete, 71500, Greece
- Infectious Diseases, University Hospital of Heraklion, Heraklion, Crete, 71500, Greece
| | - Eleni Billiari
- School of Medicine, University of Crete, Heraklion, Crete, 71500, Greece
| | - Diamantis P Kofteridis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, 71500,Greece
- School of Medicine, University of Crete, Heraklion, Crete, 71500, Greece
- Infectious Diseases, University Hospital of Heraklion, Heraklion, Crete, 71500, Greece
| | - Stamatis Karakonstantis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, 71500,Greece
- Infectious Diseases, University Hospital of Heraklion, Heraklion, Crete, 71500, Greece
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Erickson P, Jetley G, Amin P, Mejevdiwala A, Patel A, Cheng K, Parekkadan B. A cell culture system to model pharmacokinetics using adjustable-volume perfused mixing chambers. Toxicol In Vitro 2023; 91:105623. [PMID: 37236431 PMCID: PMC10526707 DOI: 10.1016/j.tiv.2023.105623] [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: 12/21/2022] [Revised: 04/03/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
The pharmacokinetic (PK) profile of a drug is an essential factor in determining its efficacy, yet it is often neglected during in vitro cell culture experiments. Here, we present a system in which standard well plate cultures may be "plugged in" and perfused with PK drug profiles. Timed drug boluses or infusions are passed through a mixing chamber that simulates the PK volume of distribution specific to the desired drug. The user-specified PK drug profile generated by the mixing chamber passes through the incubated well plate culture, exposing cells to in vivo-like PK drug dynamics. The effluent stream from the culture may then optionally be fractionated and collected by a fraction collector. This low-cost system requires no custom parts and perfuses up to six cultures in parallel. This paper demonstrates a range of PK profiles the system can produce using a tracer dye, describes how to find the correct mixing chamber volumes to mimic PK profiles of drugs of interest, and presents a study exploring the effects of differing PK exposure on a model of lymphoma treatment with chemotherapy.
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Affiliation(s)
- Patrick Erickson
- Department of Chemical and Biochemical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Gunjan Jetley
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Param Amin
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Aamena Mejevdiwala
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Ashna Patel
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Kelli Cheng
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Biju Parekkadan
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA; Department of Medicine, Rutgers Biomedical Health Sciences, New Brunswick, NJ 08852, USA.
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Daffinee KE, Piehl EC, Bleick C, LaPlante KL. Eradication of Staphylococcus epidermidis within Biofilms: Comparison of Systemic versus Supratherapeutic Concentrations of Antibiotics. Antimicrob Agents Chemother 2023; 67:e0010823. [PMID: 37154699 PMCID: PMC10269123 DOI: 10.1128/aac.00108-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/15/2023] [Indexed: 05/10/2023] Open
Abstract
Biofilm-forming bacterial infections result in clinical failure, recurring infections, and high health care costs. The antibiotic concentrations needed to eradicate biofilm require further research. We aimed to model an in vitro prosthetic joint infection (PJI) to elucidate the activity of traditional systemic concentrations versus supratherapeutic concentrations to eradicate a Staphylococcus epidermidis biofilm PJI. We evaluated S. epidermidis high-biofilm-forming (ATCC 35984) and low-biofilm-forming (ATCC 12228) isolates in an in vitro pharmacodynamic biofilm reactor model with chromium cobalt coupons to simulate prosthetic joint infection. Vancomycin, daptomycin, levofloxacin, and minocycline were used alone and combined with rifampin to evaluate the effect of biofilm eradication. We simulated three exposures: (i) humanized systemic dosing alone, (ii) supratherapeutic doses (1,000× MIC), and (iii) and dosing in combination with rifampin. Resistance development was monitored throughout the study. Simulated humanized systemic doses of a lipoglycopeptide (daptomycin), a fluoroquinolone (levofloxacin), a tetracycline (minocycline), and a glycopeptide (vancomycin) alone failed to eradicate a formed S. epidermidis biofilm. Supratherapeutic doses of vancomycin (2,000 μg/mL) and minocycline (15 μg/mL) with or without rifampin (15 μg/mL) failed to eradicate biofilms. However, a levofloxacin supratherapeutic dose (125 μg/mL) with rifampin eradicated the high-biofilm-producing isolate by 48 h. Interestingly, supratherapeutic-dose exposures of daptomycin (500 μg/mL) alone eradicated high- and low-biofilm-forming isolates in established biofilms. The concentrations needed to eradicate biofilms on foreign materials are not obtained with systemic dosing regimens. The failure of systemic dosing regimens to eradicate biofilms validates clinical findings with recurring infections. The addition of rifampin to supratherapeutic dosing regimens does not result in synergy. Supratherapeutic daptomycin dosing may be effective at the site of action to eradicate biofilms. Further studies are needed.
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Affiliation(s)
- K. E. Daffinee
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
| | - E. C. Piehl
- College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
| | - C. Bleick
- College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
| | - K. L. LaPlante
- College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
- Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, Rhode Island, USA
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Morrisette T, Stamper KC, Lev KL, Kebriaei R, Holger DJ, Abdul-Mutakabbir JC, Kunz Coyne AJ, Rybak MJ. Evaluation of Omadacycline Alone and in Combination with Rifampin against Staphylococcus aureus and Staphylococcus epidermidis in an In Vitro Pharmacokinetic/Pharmacodynamic Biofilm Model. Antimicrob Agents Chemother 2023; 67:e0131722. [PMID: 37222591 PMCID: PMC10269082 DOI: 10.1128/aac.01317-22] [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: 09/30/2022] [Accepted: 03/27/2023] [Indexed: 05/25/2023] Open
Abstract
Biofilm-associated infections lead to substantial morbidity. Omadacycline (OMC) is a novel aminomethylcycline with potent in vitro activity against Staphylococcus aureus and Staphylococcus epidermidis, but data surrounding its use in biofilm-associated infections are lacking. We investigated the activity of OMC alone and in combination with rifampin (RIF) against 20 clinical strains of staphylococci in multiple in vitro biofilm analyses, including an in vitro pharmacokinetic/pharmacodynamic (PK/PD) CDC biofilm reactor (CBR) model (simulating human exposures). The observed MICs for OMC demonstrated potent activity against the evaluated strains (0.125 to 1 mg/L), with an increase of MICs generally observed in the presence of biofilm (0.25 to >64 mg/L). Furthermore, RIF was shown to reduce OMC biofilm MICs (bMICs) in 90% of strains, and OMC plus RIF combination in biofilm time-kill analyses (TKAs) exhibited synergistic activity in most of the strains. Within the PK/PD CBR model, OMC monotherapy primarily displayed bacteriostatic activity, while RIF monotherapy generally exhibited initial bacterial eradication, followed by rapid regrowth likely due to the emergence of RIF resistance (RIF bMIC, >64 mg/L). However, the combination of OMC plus RIF produced rapid and sustained bactericidal activity in nearly all the strains (3.76 to 4.03 log10 CFU/cm2 reductions from starting inoculum in strains in which bactericidal activity was reached). Furthermore, OMC was shown to prevent the emergence of RIF resistance. Our data provide preliminary evidence that OMC in combination with RIF could be a viable option for biofilm-associated infections with S. aureus and S. epidermidis. Further research involving OMC in biofilm-associated infections is warranted.
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Affiliation(s)
- Taylor Morrisette
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Kyle C. Stamper
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Katherine L. Lev
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Razieh Kebriaei
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Dana J. Holger
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Jacinda C. Abdul-Mutakabbir
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Ashlan J. Kunz Coyne
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Michael J. Rybak
- Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
- Division of Infectious Diseases, Department of Medicine, Wayne State University, Detroit, Michigan, USA
- Department of Pharmacy, Detroit Receiving Hospital, Detroit, Michigan, USA
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Antonello RM, Canetti D, Riccardi N. Daptomycin synergistic properties from in vitro and in vivo studies: a systematic review. J Antimicrob Chemother 2022; 78:52-77. [PMID: 36227704 DOI: 10.1093/jac/dkac346] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/21/2022] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Daptomycin is a bactericidal lipopeptide antibiotic approved for the treatment of systemic infections (i.e. skin and soft tissue infections, bloodstream infections, infective endocarditis) caused by Gram-positive cocci. It is often prescribed in association with a partner drug to increase its bactericidal effect and to prevent the emergence of resistant strains during treatment; however, its synergistic properties are still under evaluation. METHODS We performed a systematic review to offer clinicians an updated overview of daptomycin synergistic properties from in vitro and in vivo studies. Moreover, we reported all in vitro and in vivo data evaluating daptomycin in combination with other antibiotic agents, subdivided by antibiotic classes, and a summary graph presenting the most favourable combinations at a glance. RESULTS A total of 92 studies and 1087 isolates (723 Staphylococcus aureus, 68 Staphylococcus epidermidis, 179 Enterococcus faecium, 105 Enterococcus faecalis, 12 Enterococcus durans) were included. Synergism accounted for 30.9% of total interactions, while indifferent effect was the most frequently observed interaction (41.9%). Antagonistic effect accounted for 0.7% of total interactions. The highest synergistic rates against S. aureus were observed with daptomycin in combination with fosfomycin (55.6%). For S. epidermidis and Enterococcus spp., the most effective combinations were daptomycin plus ceftobiprole (50%) and daptomycin plus fosfomycin (63.6%) or rifampicin (62.8%), respectively. FUTURE PERSPECTIVES We believe this systematic review could be useful for the future updates of guidelines on systemic infections where daptomycin plays a key role.
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Affiliation(s)
- Roberta Maria Antonello
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50121, Italy
| | - Diana Canetti
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan 20132, Italy
| | - Niccolò Riccardi
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa 56124, Italy
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Antibiofilm Combinatory Strategy: Moxifloxacin-Loaded Nanosystems and Encapsulated N-Acetyl-L-Cysteine. Pharmaceutics 2022; 14:pharmaceutics14112294. [PMID: 36365113 PMCID: PMC9699636 DOI: 10.3390/pharmaceutics14112294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 11/29/2022] Open
Abstract
Bacterial biofilms of Staphylococcus aureus, formed on implants, have a massive impact on the increasing number of antimicrobial resistance cases. The current treatment for biofilm-associated infections is based on the administration of antibiotics, failing to target the biofilm matrix. This work is focused on the development of multiple lipid nanoparticles (MLNs) encapsulating the antibiotic moxifloxacin (MOX). The nanoparticles were functionalized with d-amino acids to target the biofilm matrix. The produced formulations exhibited a mean hydrodynamic diameter below 300 nm, a low polydispersity index, and high encapsulation efficiency. The nanoparticles exhibited low cytotoxicity towards fibroblasts and low hemolytic activity. To target bacterial cells and the biofilm matrix, MOX-loaded MLNs were combined with a nanosystem encapsulating a matrix-disruptive agent: N-acetyl-L-cysteine (NAC). The nanosystems alone showed a significant reduction of both S. aureus biofilm viability and biomass, using the microtiter plate biofilm model. Further, biofilms grown inside polyurethane catheters were used to assess the effect of combining MOX-loaded and NAC-loaded nanosystems on biofilm viability. An increased antibiofilm efficacy was observed when combining the functionalized MOX-loaded MLNs and NAC-loaded nanosystems. Thus, nanosystems as carriers of bactericidal and matrix-disruptive agents are a promising combinatory strategy towards the eradication of S. aureus biofilms.
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Antibiofilm activity of 3,3'-diindolylmethane on Staphylococcus aureus and its disinfection on common food-contact surfaces. FOOD SCIENCE AND HUMAN WELLNESS 2022. [DOI: 10.1016/j.fshw.2022.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Haj CE, Benavent E, Sierra Y, Soldevila L, Rigo-Bonnin R, Torrejón B, Gomez-Junyent J, Rosselló I, Murillo O. Comparative efficacy of dalbavancin alone and with rifampicin against in vitro biofilms in a pharmacodynamic model with methicillin-resistant Staphylococcus aureus. Int J Antimicrob Agents 2022; 60:106664. [PMID: 36002115 DOI: 10.1016/j.ijantimicag.2022.106664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/18/2021] [Accepted: 08/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The anti-biofilm efficacy of dalbavancin has been evaluated in static models. Using an in vitro pharmacokinetic/pharmacodynamic model, we evaluated the comparative activity of dalbavancin alone and with rifampicin against biofilm-embedded methicillin-resistant S. aureus (MRSA). METHODS Two MRSA strains (HUB-4/HUB-5) were evaluated with the Calgary Device System and the dynamic CDC-Biofilm Reactor over 144 h. Dosage regimens simulated the human pharmacokinetics of dalbavancin (1500mg, single dose), vancomycin (1000mg/12 h) and linezolid (600mg/12 h), alone and with rifampicin (600mg/24 h). Efficacy was evaluated by assessing log10 CFU/mL changes (ΔlogCFU/mL) and we screened for resistance. RESULTS The minimal biofilm inhibitory/eradication concentrations of dalbavancin were 0.25/16 mg/L (HUB-4) and 0.25/8mg/L (HUB-5), respectively. In the pharmacokinetic/pharmacodynamic analysis, dalbavancin alone showed limited efficacy, but without resistance developing. Adding rifampicin improved the activities of dalbavancin, vancomycin, and linezolid, but rifampicin-resistant strains appeared over time in all cases. Dalbavancin-rifampicin was bactericidal against HUB-4 in the absence of resistance at 72 h and 144 h (ΔlogCFU/mL: -3.54±0.83, -4.32±0.12, respectively), an effect that was only achieved by linezolid-rifampicin at 144h (-3.33 ± 0.66). Against HUB-5, dalbavancin-rifampicin activity was impaired by rifampicin resistance to a greater extent than other combinations and had no bactericidal effect. CONCLUSIONS The anti-biofilm efficacy of dalbavancin was improved significantly by adding rifampicin. Although no dalbavancin resistance occurred, rifampicin resistance appeared in all combination therapies and decreased their efficacy over time. Dalbavancin-rifampicin in vitro treatment appears as promising anti-biofilm therapy, but further studies should evaluate the in vivo efficacy and the risk of resistance.
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Affiliation(s)
- Cristina El Haj
- Infectious Diseases Service, Laboratory of Experimental Infection, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Eva Benavent
- Infectious Diseases Service, Laboratory of Experimental Infection, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Yanik Sierra
- Infectious Diseases Service, Laboratory of Experimental Infection, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain; Department of Microbiology, Hospital Universitari de Bellvitge, IDIBELL, Spain
| | - Laura Soldevila
- Infectious Diseases Service, Laboratory of Experimental Infection, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Raul Rigo-Bonnin
- Department of Clinical Laboratory, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Benjamin Torrejón
- Centres Científics i Tecnològics, Universitat de Barcelona, Barcelona, Spain
| | - Joan Gomez-Junyent
- Infectious Diseases Service, Laboratory of Experimental Infection, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain
| | - Irantzu Rosselló
- Medical Department, Angelini Pharma España S.L.U., Barcelona, Spain
| | - Oscar Murillo
- Infectious Diseases Service, Laboratory of Experimental Infection, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain.
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Linezolid for the Treatment of Urinary Tract Infections Caused by Vancomycin-Resistant Enterococci. PHARMACY 2021; 9:pharmacy9040175. [PMID: 34842791 PMCID: PMC8628880 DOI: 10.3390/pharmacy9040175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022] Open
Abstract
Vancomycin-resistant enterococci (VRE) account for a large proportion of hospital-acquired infections. Determining optimal treatment of VRE urinary tract infections (UTIs) is challenging. The purpose of this study was to determine if a difference in efficacy or safety exists between linezolid and non-linezolid treatments for VRE UTIs. This retrospective cohort evaluated patients admitted between 1 June 2012–30 November 2017 who were treated for VRE UTI. Patients must have had at least one sign, symptom, or laboratory confirmation of UTI to be included. The primary endpoint of this study was difference in clinical cure between linezolid and non-linezolid treatment options. Secondary endpoints included 30-day recurrence, 30-day infection-related readmission, inpatient mortality, infection-related hospital length of stay (LOS), and time to appropriate therapy. A total of 45 patients (33 linezolid and 12 non-linezolid) were included. Clinical cure occurred in 71.4% linezolid and 58.3% non-linezolid (p = 0.476). No patients had a 30-day infection-related readmission or 30-day recurrence. Of the 45 patients, 6 (13.3%) patients died during admission, and 5 of those deaths were in the linezolid group (p = 1.000). No significant difference was found for clinical cure between linezolid and non-linezolid treatment options for VRE UTIs.
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Kia C, Cusano A, Messina J, Muench LN, Chadayammuri V, McCarthy MB, Umejiego E, Mazzocca AD. Effectiveness of topical adjuvants in reducing biofilm formation on orthopedic implants: an in vitro analysis. J Shoulder Elbow Surg 2021; 30:2177-2183. [PMID: 33529773 DOI: 10.1016/j.jse.2020.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/27/2020] [Accepted: 12/05/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND HYPOTHESIS The treatment of periprosthetic joint infection is complicated by the presence of residual biofilm, which resists eradication owing to bacterial adherence to orthopedic implants. The purpose of this study was to compare Bactisure (Zimmer Biomet, Warsaw, IN, USA), povidone-iodine (Betadine), and chlorhexidine gluconate solution (Irrisept; Irrimax, Gainesville, FL, USA) in reducing biofilm formation of Staphylococcus aureus, Staphylococcus epidermidis, and Cutibacterium acnes inoculated on cobalt-chrome, titanium, and stainless steel disks, representing metals commonly used for shoulder arthroplasty. The hypothesis was that there would be no significant difference in biofilm reduction among the 3 topical adjuvants. METHODS Strains of S aureus (ATCC 35556), S epidermidis (ATCC 35984), and C acnes (LMG 16711) were grown on cobalt-chrome, titanium, and stainless steel disks. For each strain, the disks were divided into 4 groups: (1) control, (2) povidone-iodine (Betadine), (3) chlorhexidine gluconate (Irrisept), and (4) Bactisure. Bacteria were grown on 5% sheep blood agar plates. Biofilm eradication was quantified using adenosine triphosphate bioluminescence and compared with controls 48 and 72 hours after implementation of the topical adjuvant. RESULTS At 72 hours after implementation of the topical adjuvant, a statistically significant reduction in colony-forming units was observed for all topical adjuvants across all tested metals, as compared with their respective control. With respect to the topical adjuvants themselves, Bactisure more consistently demonstrated the most significant reduction in colony-forming units across all bacteria when the tested medium was adjusted for, with the exception of S aureus, which showed similar results to Betadine at 72 hours. CONCLUSION By use of commonly encountered topical adjuvants on S aureus-, S epidermidis-, and C acnes-inoculated disks of various implant metals, a significant reduction in biofilm production was observed. Bactisure, a recent Food and Drug Administration-approved topical adjuvant, demonstrated the overall greatest efficacy of the agents studied.
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Affiliation(s)
- Cameron Kia
- Department of Orthopedic Surgery, UConn Health, Farmington, CT, USA
| | - Antonio Cusano
- Department of Orthopedic Surgery, UConn Health, Farmington, CT, USA.
| | - James Messina
- Department of Orthopedic Surgery, UConn Health, Farmington, CT, USA
| | - Lukas N Muench
- Department of Orthopedic Surgery, UConn Health, Farmington, CT, USA; Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany
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12
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Plota M, Sazakli E, Giormezis N, Gkartziou F, Kolonitsiou F, Leotsinidis M, Antimisiaris SG, Spiliopoulou I. In Vitro Anti-Biofilm Activity of Bacteriophage K (ATCC 19685-B1) and Daptomycin against Staphylococci. Microorganisms 2021; 9:1853. [PMID: 34576751 PMCID: PMC8468654 DOI: 10.3390/microorganisms9091853] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present study was to investigate anti-staphylococcal activity of daptomycin and bacteriophage K, alone or in combination, against biofilm-producers and non-producers S. aureus and S. epidermidis strains, under biofilm forming and cells' proliferation conditions. Daptomycin and bacteriophage K (ATCC 19685B1), in different concentrations, were tested against 10 Staphylococcus aureus and 10 S. epidermidis, characterized by phenotypes and genotypes. The quantitative microtiter plate (crystal violet, CV), methylthiazoltetrazolium (MTT), and growth curve (GC) assays were performed. No statistically significant difference was found between species, whereas daptomycin alone performed better using medium and high concentrations of the drug and bacteriophage K was more active against strains with higher susceptibility, by CV and MTT assays. Best results were achieved using both agents combined in high concentrations. Bacteriophage K was effective within 3.8 and 2.4 h, depending on the concentration used, by the GC assay. Combination of daptomycin with bacteriophage K was more effective against staphylococci, depending on the concentrations used and strains' susceptibility. Further studies are needed to evaluate if this approach might be a choice for prevention or therapy of biofilm-associated infections.
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Affiliation(s)
- Maria Plota
- Department of Microbiology, School of Medicine, University of Patras, 26504 Patras, Greece; (M.P.); (F.K.)
- National Reference Centre for Staphylococci, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Eleni Sazakli
- Laboratory of Public Health, School of Medicine, University of Patras, 26504 Patras, Greece; (E.S.); (M.L.)
| | - Nikolaos Giormezis
- National Reference Centre for Staphylococci, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Foteini Gkartziou
- Institute of Chemical Engineering Sciences, FORTH/ICE-HT, Platani, 26504 Patras, Greece; (F.G.); (S.G.A.)
| | - Fevronia Kolonitsiou
- Department of Microbiology, School of Medicine, University of Patras, 26504 Patras, Greece; (M.P.); (F.K.)
- National Reference Centre for Staphylococci, School of Medicine, University of Patras, 26504 Patras, Greece;
| | - Michalis Leotsinidis
- Laboratory of Public Health, School of Medicine, University of Patras, 26504 Patras, Greece; (E.S.); (M.L.)
| | - Sophia G. Antimisiaris
- Institute of Chemical Engineering Sciences, FORTH/ICE-HT, Platani, 26504 Patras, Greece; (F.G.); (S.G.A.)
- Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece
| | - Iris Spiliopoulou
- National Reference Centre for Staphylococci, School of Medicine, University of Patras, 26504 Patras, Greece;
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13
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Barber KE, Shammout Z, Smith JR, Kebriaei R, Morrisette T, Rybak MJ. Biofilm Time-Kill Curves to Assess the Bactericidal Activity of Daptomycin Combinations against Biofilm-Producing Vancomycin-Resistant Enterococcus faecium and faecalis. Antibiotics (Basel) 2021; 10:897. [PMID: 34438947 PMCID: PMC8388763 DOI: 10.3390/antibiotics10080897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION E. faecium and E. faecalis are responsible for 13.9% of hospital-acquired infections with frequent resistance to vancomycin (82.6% of E. faecium, 9.5% of E. faecalis). Medical device infections secondary to enterococci often require combination therapy due to impaired activity against biofilm embedded cells. In vitro data demonstrate synergistic activity of daptomycin combinations. Using a novel, biofilm time-kill approach, we evaluated whether daptomycin combinations maintained synergy against biofilm-producing E. faecium and E. faecalis. METHODS Broth microdilution (BMD) and biofilm MIC (bMIC) values for daptomycin, ampicillin, ceftriaxone, fosfomycin, and rifampin were determined against biofilm-producing E. faecium and E. faecalis. Daptomycin combination bMIC values were determined in the presence of biologic concentrations of other antimicrobials. Synergy was evaluated against two E. faecalis (R6981, R7808) and two E. faecium (5938 and 8019) using a previously described biofilm time-kill method. Synergy was defined as ≥2 log10 CFU/cm2 reduction over the most active agent alone. Bactericidal activity was defined as ≥3 log10 CFU/cm2 reduction. RESULTS Daptomycin bMICs were 2-8-fold higher than BMD. In the presence of other antimicrobials, daptomycin bMICs were reduced ≥ two-fold in dilutions. Ceftriaxone and ampicillin demonstrated the most potent combinations with daptomycin, yielding synergy against three of four strains. Daptomycin plus rifampin was synergistic against E. faecium 5938 and E. faecalis 6981 and produced bactericidal kill. The combination of daptomycin plus fosfomycin displayed synergy solely against E. faecalis 6981. CONCLUSIONS Daptomycin combinations with beta-lactams demonstrated promising synergistic activity against both E. faecium and E. faecalis. While daptomycin plus rifampin yielded bactericidal results, the effect was not seen across all organisms. These combinations warrant further evaluation to determine the optimal dose and response.
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Affiliation(s)
- Katie E. Barber
- Anti-Infective Research Laboratory, School of Medicine, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI 48201, USA; (Z.S.); (J.R.S.); (R.K.); (T.M.); (M.J.R.)
- Department of Pharmacy Practice, School of Pharmacy, The University of Mississippi, 2500 North State Street, Jackson, MS 39216, USA
| | - Zade Shammout
- Anti-Infective Research Laboratory, School of Medicine, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI 48201, USA; (Z.S.); (J.R.S.); (R.K.); (T.M.); (M.J.R.)
| | - Jordan R. Smith
- Anti-Infective Research Laboratory, School of Medicine, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI 48201, USA; (Z.S.); (J.R.S.); (R.K.); (T.M.); (M.J.R.)
- Department of Clinical Sciences, Fred Wilson School of Pharmacy, High Point University, 1 University Parkway, High Point, NC 27268, USA
| | - Razieh Kebriaei
- Anti-Infective Research Laboratory, School of Medicine, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI 48201, USA; (Z.S.); (J.R.S.); (R.K.); (T.M.); (M.J.R.)
| | - Taylor Morrisette
- Anti-Infective Research Laboratory, School of Medicine, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI 48201, USA; (Z.S.); (J.R.S.); (R.K.); (T.M.); (M.J.R.)
| | - Michael J. Rybak
- Anti-Infective Research Laboratory, School of Medicine, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI 48201, USA; (Z.S.); (J.R.S.); (R.K.); (T.M.); (M.J.R.)
- Department of Internal Medicine, School of Medicine, Wayne State University, 540 E. Canfield St., Detroit, MI 48201, USA
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14
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Gil J, Pastar I, Houghten RA, Padhee S, Higa A, Solis M, Valdez J, Head CR, Michaels H, Lenhart B, Simms C, Williams B, Cudic P, Davis SC. Novel Cyclic Lipopeptides Fusaricidin Analogs for Treating Wound Infections. Front Microbiol 2021; 12:708904. [PMID: 34367114 PMCID: PMC8343139 DOI: 10.3389/fmicb.2021.708904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/21/2021] [Indexed: 12/01/2022] Open
Abstract
Both acute and chronic cutaneous wounds are often difficult to treat due to the high-risk for bacterial contamination. Once hospitalized, open wounds are at a high-risk for developing hospital-associated infections caused by multi drug-resistant bacteria such as Staphylococcus aureus and Pseudomonas aeruginosa. Treating these infections is challenging, not only because of antibiotic resistance, but also due to the production of biofilms. New treatment strategies are needed that will help in both stimulating the wound healing process, as well as preventing and eliminating bacterial wound infections. Fusaricidins are naturally occurring cyclic lipopeptides with antimicrobial properties that have shown to be effective against a variety of fungi and Gram-positive bacteria, with low toxicity. Continuing with our efforts toward the identification of novel cyclic lipopeptides Fusaricidin analogs, herein we report the synthesis and evaluation of the antimicrobial activity for two novel cyclic lipopeptides (CLP), CLP 2605-4 and CLP 2612-8.1 against methicillin resistant S. aureus and P. aeruginosa, respectively, in in vivo porcine full thickness wound model. Both CLPs were able to reduce bacterial counts by approximately 3 log CFU/g by the last assessment day. Peptide 2612-8.1 slightly enhanced the wound healing, however, wounds treated with peptide 2605-4, have shown higher levels of inflammation and impaired wound healing process. This study highlights the importance of identifying new antimicrobials that can combat bacterial infection while not impeding tissue repair.
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Affiliation(s)
- Joel Gil
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Irena Pastar
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | | | - Shruti Padhee
- Torrey Pines Institute for Molecular Studies, San Diego, CA, United States
| | - Alexander Higa
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Michael Solis
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Jose Valdez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Cheyanne R. Head
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Heather Michaels
- Torrey Pines Institute for Molecular Studies, San Diego, CA, United States
| | - Brian Lenhart
- Torrey Pines Institute for Molecular Studies, San Diego, CA, United States
| | - Colin Simms
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Brandon Williams
- Department of Chemistry and Biochemistry Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Predrag Cudic
- Department of Chemistry and Biochemistry Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Stephen C. Davis
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
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15
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Tiseo G, Arena F, Borrè S, Campanile F, Falcone M, Mussini C, Pea F, Sganga G, Stefani S, Venditti M. Diagnostic stewardship based on patient profiles: differential approaches in acute versus chronic infectious syndromes. Expert Rev Anti Infect Ther 2021; 19:1373-1383. [PMID: 33970746 DOI: 10.1080/14787210.2021.1926986] [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: 12/27/2022]
Abstract
Introduction: New diagnostics may be useful in clinical practice, especially in contexts of high prevalence of multidrug-resistant organisms (MDRO). However, misuse of diagnostic tools may lead to increased costs and worse patient outcome. Conventional and new techniques should be appropriately positioned in diagnostic algorithms to guide an appropriate use of antimicrobial therapy.Areas covered: A panel of experts identified 4 main areas in which the implementation of diagnostic stewardship is needed. Among chronic infections, bone and prosthetic joint infections and subacute-chronic intravascular infections and endocarditis represent common challenges for clinicians. Among acute infections, bloodstream infections and community-acquired pneumonia may be associated with high mortality and require appropriate diagnostic approach.Expert opinion: Diagnostic stewardship aims to improve the appropriate use of microbiological diagnostics to guide therapeutic decisions through appropriate and timely diagnostic testing. Here, diagnostic algorithms based on different patient profiles are proposed for chronic and acute clinical syndromes. In each clinical scenario, combining conventional and new diagnostic techniques is crucial to make a rapid and accurate diagnosis and to guide the selection of antimicrobial therapy. Barriers related to the implementation of new rapid diagnostic tools, such as high initial costs, may be overcome through their rational and structured use.
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Affiliation(s)
- Giusy Tiseo
- Infectious Disease Unit, Azienda Ospedaliera Universitaria Pisana, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabio Arena
- Infectious Disease Unit, Azienda Ospedaliera Universitaria Pisana, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Silvio Borrè
- Infectious Diseases Unit, Sant'Andrea Hospital Vercelli, Vercelli, Italy
| | - Floriana Campanile
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Marco Falcone
- Infectious Disease Unit, Azienda Ospedaliera Universitaria Pisana, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Cristina Mussini
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Modena, Italy
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,SSD Clinical Pharmacology, University Hospital IRCCS Policlinico Sant'Orsola, Bologna, Italy
| | - Gabriele Sganga
- Emergency Surgery, Fondazione Policlinico Agostino Gemelli IRCCS of Rome, Rome, Italy
| | - Stefania Stefani
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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16
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Payne JAE, Kulkarni K, Izore T, Fulcher AJ, Peleg AY, Aguilar MI, Cryle MJ, Del Borgo MP. Staphylococcus aureus entanglement in self-assembling β-peptide nanofibres decorated with vancomycin. NANOSCALE ADVANCES 2021; 3:2607-2616. [PMID: 36134162 PMCID: PMC9419598 DOI: 10.1039/d0na01018a] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/23/2021] [Indexed: 06/16/2023]
Abstract
The increasing resistance of pathogenic microbes to antimicrobials and the shortage of antibiotic drug discovery programs threaten the clinical use of antibiotics. This threat calls for the development of new methods for control of drug-resistant microbial pathogens. We have designed, synthesised and characterised an antimicrobial material formed via the self-assembly of a population of two distinct β-peptide monomers, a lipidated tri-β-peptide (β3-peptide) and a novel β3-peptide conjugated to a glycopeptide antibiotic, vancomycin. The combination of these two building blocks resulted in fibrous assemblies with distinctive structures determined by atomic force microscopy and electron microscopy. These fibres inhibited the growth of methicillin resistant Staphylococcus aureus (MRSA) and associated directly with the bacteria, acting as a peptide nanonet with fibre nucleation sites on the bacteria observed by electron microscopy and confocal microscopy. Our results provide insights into the design of peptide based supramolecular assemblies with antibacterial activity and establish an innovative strategy to develop self-assembled antimicrobial materials for future biomedical application.
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Affiliation(s)
- Jennifer A E Payne
- Infection and Immunity Program, The Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University Clayton Victoria 3800 Australia
- EMBL Australia, Monash University Clayton Victoria 3800 Australia
- The ARC Centre of Excellence for Innovations in Peptide and Protein Science, Monash University Clayton Victoria 3800 Australia
| | - Ketav Kulkarni
- Department of Biochemistry and Molecular Biology, Monash University Clayton Victoria 3800 Australia
| | - Thierry Izore
- Infection and Immunity Program, The Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University Clayton Victoria 3800 Australia
- EMBL Australia, Monash University Clayton Victoria 3800 Australia
| | - Alex J Fulcher
- Monash Micro Imaging, Monash University Clayton Victoria 3800 Australia
| | - Anton Y Peleg
- Infection and Immunity Program, Monash Biomedicine Discovery Institute, Department of Microbiology, Monash University Clayton Victoria 3800 Australia
- Department of Infectious Diseases, The Alfred Hospital, Central Clinical School, Monash University Melbourne Victoria 3004 Australia
| | - Marie-Isabel Aguilar
- Department of Biochemistry and Molecular Biology, Monash University Clayton Victoria 3800 Australia
| | - Max J Cryle
- Infection and Immunity Program, The Monash Biomedicine Discovery Institute, Department of Biochemistry and Molecular Biology, Monash University Clayton Victoria 3800 Australia
- EMBL Australia, Monash University Clayton Victoria 3800 Australia
- The ARC Centre of Excellence for Innovations in Peptide and Protein Science, Monash University Clayton Victoria 3800 Australia
| | - Mark P Del Borgo
- Department of Pharmacology, Monash University Clayton Victoria 3800 Australia
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17
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New-Generation Antibiotics for Treatment of Gram-Positive Infections: A Review with Focus on Endocarditis and Osteomyelitis. J Clin Med 2021; 10:jcm10081743. [PMID: 33920526 PMCID: PMC8074169 DOI: 10.3390/jcm10081743] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/24/2021] [Accepted: 04/03/2021] [Indexed: 01/03/2023] Open
Abstract
Infective endocarditis, osteomyelitis, and osteosynthesis-associated infections are mostly caused by Gram-positive bacteria. They are often difficult to treat and are associated with a poor prognosis. In the past 20 years, nine antibiotic drugs with predominant activity against Gram-positive bacteria have been introduced and approved by the Food and Drug Administration or the European Medicines Agency: ceftaroline, daptomycin, telavancin, dalbavancin, oritavancin, linezolid, tedizolid, delafloxacin, and omadacycline. This narrative review aims to provide an overview on these antibiotics with a special focus on their use in infective endocarditis, osteomyelitis, and osteosynthesis-associated infections. Although some of these approved antibiotics are promising, they should not be used as first- or second-line therapy, awaiting more clinical data.
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18
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Etemadi S, Barhaghi MHS, Leylabadlo HE, Memar MY, Mohammadi AB, Ghotaslou R. The synergistic effect of turmeric aqueous extract and chitosan against multidrug-resistant bacteria. New Microbes New Infect 2021; 41:100861. [PMID: 33898041 PMCID: PMC8054179 DOI: 10.1016/j.nmni.2021.100861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 11/25/2022] Open
Abstract
We aimed to investigate the antibacterial and antibiofilm effects of turmeric and chitosan against the planktonic and biofilm forms of multidrug-resistant (MDR) bacteria. A group of MDR bacteria, including clinical isolates of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas, carbapenem-resistant Enterobacteriaceae and AmpC-producing Enterobacteriaceae, were collected by phenotypic and genotypic assays. The broth microdilution method was used to investigate the MIC of turmeric aqueous extract and chitosan. To investigate the synergistic effect of the combination of these natural compounds, we used the checkerboard assay. According to the results of this study, turmeric and chitosan showed inhibitory effects on MDR bacteria, especially on the planktonic form of methicillin-resistant S. aureus as a Gram-positive compared to tested Gram-negative bacteria (carbapenem-resistant Pseudomonas, carbapenem-resistant Enterobacteriaceae and AmpC-producing Enterobacteriaceae). The antibiofilm effect of turmeric and chitosan was found more often in carbapenem-resistant Pseudomonas isolates. There was no significant difference between the tested Gram-negative bacteria because most of the tested strains were inhibited in 512 and 1024 μg/mL concentrations of chitosan and turmeric aqueous extract. In this study, turmeric aqueous extract and chitosan exhibited significant antibacterial and antibiofilm properties. However, the effect of these compounds should be investigated using in vivo models for use in pharmaceutical and disinfectant formulations.
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Affiliation(s)
- S Etemadi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M H S Barhaghi
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - H E Leylabadlo
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Y Memar
- Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A B Mohammadi
- Department of Traditional Medicine, Faculty of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - R Ghotaslou
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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19
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Manoharan RK, Gangadaran P, Ayyaru S, Ahn BC, Ahn YH. Self-healing functionalization of sulfonated hafnium oxide and copper oxide nanocomposite for effective biocidal control of multidrug-resistant bacteria. NEW J CHEM 2021. [DOI: 10.1039/d1nj00323b] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The combination of copper and sulfonated hafnium oxide nanoparticles could be used as an alternative antimicrobial agent to combat multidrug resistant bacteria and membrane biofouling.
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Affiliation(s)
| | - Prakash Gangadaran
- Department of Nuclear Medicine
- School of Medicine
- Kyungpook National University
- Kyungpook National University Hospital
- Daegu
| | - Sivasankaran Ayyaru
- Department of Civil Engineering
- Yeungnam University
- Gyeongsan
- Republic of Korea
| | - Byeong-Cheol Ahn
- Department of Nuclear Medicine
- School of Medicine
- Kyungpook National University
- Kyungpook National University Hospital
- Daegu
| | - Young-Ho Ahn
- Department of Civil Engineering
- Yeungnam University
- Gyeongsan
- Republic of Korea
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20
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Sivaranjani M, Liu F, White AP. Synergistic activity of tetrasodium EDTA, ethanol and chlorhexidine hydrochloride against planktonic and biofilm cells of clinically relevant pathogens. J Glob Antimicrob Resist 2020; 24:148-157. [PMID: 33383260 DOI: 10.1016/j.jgar.2020.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/12/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Biofilms associated with implantable medical devices and wounds are clinically relevant, often requiring repeated use of antibiotics without success. A search for non-antibiotic antimicrobial and antibiofilm solutions is warranted, in line with antimicrobial stewardship. Our study aimed to evaluate the broad-spectrum antimicrobial efficacy of tetrasodium EDTA, ethanol and chlorhexidine hydrochloride (HCl) alone and in combination against clinically relevant planktonic and biofilm cells of bacterial and fungal pathogens. METHODS MICs and MBCs were determined for tetrasodium EDTA, ethanol and chlorhexidine HCl against planktonic cells of test pathogens. The MBEC Assay® biofilm inoculator device was used to evaluate the biofilm eradication ability of test antimicrobials alone and in combination against clinically relevant pathogens. The checkerboard microbroth dilution assay was performed to analyze the synergism between test antimicrobials. RESULTS Against planktonic cells, the combination of tetrasodium EDTA with ethanol or chlorhexidine HCl resulted in synergistic to indifferent activity, with no antagonism observed. Against mature biofilms, all combinations were synergistic. The MBEC of each test antimicrobial was decreased from 4- to -64-fold when used in combination as compared to when agents were used alone. We optimised the concentration of antimicrobials to achieve rapid eradication of pre-formed biofilms. A triple combination of 3% tetrasodium EDTA, 20% ethanol and 2.5 μg/mL chlorhexidine HCl completely eradicated 48-h-old biofilms of all test strains within 2 h. CONCLUSION All three antimicrobial agents can be used together for prevention and treatment of biofilms and biofilm-related infections. The observed in vitro efficacy should be tested further through in vivo and clinical studies.
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Affiliation(s)
- Murugesan Sivaranjani
- Vaccine and Infectious Disease Organization, Saskatoon, Saskatchewan, Canada; Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Fangning Liu
- Vaccine and Infectious Disease Organization, Saskatoon, Saskatchewan, Canada
| | - Aaron P White
- Vaccine and Infectious Disease Organization, Saskatoon, Saskatchewan, Canada; Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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21
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Vasilchenko AS, Julian WT, Lapchinskaya OA, Katrukha GS, Sadykova VS, Rogozhin EA. A Novel Peptide Antibiotic Produced by Streptomyces roseoflavus Strain INA-Ac-5812 With Directed Activity Against Gram-Positive Bacteria. Front Microbiol 2020; 11:556063. [PMID: 33072016 PMCID: PMC7533577 DOI: 10.3389/fmicb.2020.556063] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/19/2020] [Indexed: 12/25/2022] Open
Abstract
In this work, we report the isolation and detailed functional characterization for the new non-ribosomally synthesized antibiotic 5812-A/C, which was derived from metabolites of Streptomyces roseoflavus INA-Ac-5812. According to its chemical structure, the studied 5812-A/C preliminary is composed of a cyclic peptide part covalently bounded with an arabinose residue. N-terminal amino acid sequencing of the native peptide has identified its partial structure of Leu-Asp-Gly-Ser-Gly and consisting of a Tyr residue that is supposed to have a two-component peptide nature for the molecule studied. However, the structural analysis of the antibiotic complex derived from S. roseoflavus INA-Ac-5812 is still ongoing. The mechanism of action of 5812-A/C was assessed in comparison with its most related analog, the lipopeptide antibiotic daptomycin, given the presence in both antimicrobials of an L-kynurenine amino acid residue. The inhibitory activity of 5812-A/C against Gram-positive bacteria including methicillin-resistant strain of Staphylococcus aureus was similar to daptomycin. The mechanism of action of 5812-A/C was associated with the disruption of membrane integrity, which differs in comparison with daptomycin and is most similar to the antimicrobial membrane-disturbing peptides. However, 5812-A/C demonstrated a calcium-dependent mode of action. In addition, unlike daptomycin, 5812-A/C was able to penetrate mature biofilms and inhibit the metabolic activity of embedded S. aureus cells. At the same time, 5812-A/C has no hemolytic activity toward erythrocyte, but possessed weak cytotoxic activity represented by heterochromatin condensation in human buccal epithelium cells. The biological properties of the peptide 5812-A/C suggest its classification as a calcium-dependent antibiotic effective against a wide spectrum of Gram-positive pathogenic bacteria.
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Affiliation(s)
- Alexey S Vasilchenko
- Laboratory of Antimicrobial Resistance, Institute of Environmental and Agricultural Biology (X-BIO), Tyumen State University, Tyumen, Russia
| | - William T Julian
- Laboratory of Antimicrobial Resistance, Institute of Environmental and Agricultural Biology (X-BIO), Tyumen State University, Tyumen, Russia
| | | | | | | | - Eugene A Rogozhin
- Gause Institute of New Antibiotics, Moscow, Russia.,Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
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Gidari A, Sabbatini S, Schiaroli E, Perito S, Francisci D, Baldelli F, Monari C. Tedizolid-Rifampicin Combination Prevents Rifampicin-Resistance on in vitro Model of Staphylococcus aureus Mature Biofilm. Front Microbiol 2020; 11:2085. [PMID: 32983061 PMCID: PMC7484889 DOI: 10.3389/fmicb.2020.02085] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/07/2020] [Indexed: 12/14/2022] Open
Abstract
Staphylococcus aureus infections associated with implanted medical devices are difficult to treat and require long-lasting antibiotic therapies, especially when device removal is not possible or easy such as in the case of joint prostheses. Biofilm formation is a major cause of treatment failure and infection recurrence. This study aimed to test, for the first time, the in vitro combination of tedizolid plus rifampicin on methicillin-sensitive (MSSA ATCC 6538) and methicillin-resistant (MRSA ATCC 43300) S. aureus mature biofilm. Here, we demonstrated that the combination of tedizolid with rifampicin significantly disaggregated pre-formed biofilm of both strains, reduced their metabolic activity and exerted bactericidal activity at clinically meaningful concentrations. Notably, tedizolid was able to completely prevent the emergence of resistance to rifampicin. Moreover these effects were similar to those obtained with daptomycin plus rifampicin, a well-known and widely used combination. Preliminary results on some MRSA clinical isolates confirmed the efficacy of this combination in reducing biofilm biomass and preventing rifampicin resistance onset. Further in vivo studies are needed to confirm the validity of this promising therapeutic option that can be useful against biofilm-associated S. aureus infections.
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Affiliation(s)
- Anna Gidari
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Elisabetta Schiaroli
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Stefano Perito
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Franco Baldelli
- Department of Medicine, Clinic of Infectious Diseases, University of Perugia, Perugia, Italy
| | - Claudia Monari
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
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Jahanbakhsh S, Singh NB, Yim J, Kebriaei R, Smith JR, Lev K, Tran TT, Rose WE, Arias CA, Rybak MJ. Impact of Daptomycin Dose Exposure Alone or in Combination with β-Lactams or Rifampin against Vancomycin-Resistant Enterococci in an In Vitro Biofilm Model. Antimicrob Agents Chemother 2020; 64:e02074-19. [PMID: 32094136 PMCID: PMC7179592 DOI: 10.1128/aac.02074-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/19/2020] [Indexed: 12/22/2022] Open
Abstract
Enterococcus faecium strains are commonly resistant to vancomycin and β-lactams. In addition, E. faecium often causes biofilm-associated infections and these infections are difficult to treat. In this context, we investigated the activity of dosing regimens using daptomycin (DAP) (8, 10, 12, and 14 mg/kg of body weight/day) alone and in combination with ceftaroline (CPT), ampicillin (AMP), ertapenem (ERT), and rifampin (RIF) against 2 clinical strains of biofilm-producing vancomycin-resistant Enterococcus faecium (VREfm), namely, strains S447 and HOU503, in an in vitro biofilm model. HOU503 harbors common LiaS and LiaR substitutions, whereas S447 lacks mutations associated with the LiaFSR pathway. MIC results demonstrated that both strains were susceptible to DAP and resistant to CPT, AMP, ERT, and RIF. The 168-h pharmacokinetic/pharmacodynamic (PK/PD) CDC biofilm reactor models (simulating human antibiotic exposures) were used with titanium and polyurethane coupons to evaluate the efficacy of antibiotic combinations. DAP 12 and 14 achieved bactericidal activity against S447 but lacked such effect against HOU503. Addition of ERT and RIF enhanced DAP activity, allowing DAP 8 and 10 plus ERT or RIF to produce bactericidal activity against both strains at 168 h. While DAP 8 and 10 plus CPT improved killing, they did not reach bactericidal reduction against S447. Combination of AMP, CPT, ERT, or RIF resulted in enhanced and bactericidal activity for DAP against HOU503 at 168 h. Our data provide further support for the use of combinations of DAP with AMP, ERT, CPT, and RIF in infections caused by biofilm producing VREfm. Further research involving DAP combinations against biofilm-producing enterococci is warranted.
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Affiliation(s)
- Seyedehameneh Jahanbakhsh
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Nivedita B Singh
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Juwon Yim
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Razieh Kebriaei
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Jordan R Smith
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Katherine Lev
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - T T Tran
- School of Pharmacy and Department of Medicine, University of Wisconsin-Madison, Wisconsin, USA
| | - Warren E Rose
- School of Pharmacy and Department of Medicine, University of Wisconsin-Madison, Wisconsin, USA
| | - Cesar A Arias
- Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, UTHealth McGovern Medical School, Houston, Texas, USA
- Center for Infectious Diseases, UTHealth School of Public Health, Universidad El Bosque, Bogota, Colombia
- Molecular Genetics and Antimicrobial Resistance Unit-International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia
| | - Michael J Rybak
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
- School of Medicine, Wayne State University, Detroit, Michigan, USA
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Manoharan RK, Mahalingam S, Gangadaran P, Ahn YH. Antibacterial and photocatalytic activities of 5-nitroindole capped bimetal nanoparticles against multidrug resistant bacteria. Colloids Surf B Biointerfaces 2020; 188:110825. [PMID: 32006909 DOI: 10.1016/j.colsurfb.2020.110825] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
The emergence of antibiotic resistance to commercially- available antibiotics is becoming a major health crisis worldwide. Non-antibiotic strategies are needed to combat biofilm-associated infectious diseases caused by multidrug resistant (MDR) bacterial pathogens. In this study, MBR1 was isolated from a membrane bioreactor used in wastewater treatment plants, and the resistance profile was explored. 5-Nitroindole (5 N)-capped CuO/ZnO bimetal nanoparticles (5 NNP) were synthesized using a one pot method to improve the antibacterial and antibiofilm activities of 5 N against Gram-negative (Escherichia coli ATCC700376 and Pseudomonas aeruginosa PA01) and positive (Staphylococcus aureus ATCC6538) human pathogens. 5 NNP containing 1 mM of 5 N exhibited strong antibacterial and antibiofilm properties to most MDR bacteria. In addition, the photocatalytic activity of CuO/ZnO reduced bacterial cell growth by 1.8 log CFU/mL maximum when exposed to visible light. Scanning electron microscopy showed that 5 NNP reduced the cell density and biofilm attachment of MBR1 by >90% under static conditions. In addition to the antimicrobial and antibiofilm activities, 5 NNP inhibited the persister cell formation of MDR bacterial strains P. aeruginosa, MBR1, E. coli and S. aureus. Therefore, it is speculated that 5 NNP potentially inhibits biofilm and persister cells; hence, 5 NNP could be an alternative agent to combat MDR infectious diseases using a non-antibiotic therapeutic approach.
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Affiliation(s)
| | - Shanmugam Mahalingam
- Department of Civil Engineering, Yeungnam University, Gyeongsan, 38541, Republic of Korea
| | - Prakash Gangadaran
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, 41944, Republic of Korea
| | - Young-Ho Ahn
- Department of Civil Engineering, Yeungnam University, Gyeongsan, 38541, Republic of Korea.
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25
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Britt NS, Hazlett DS, Horvat RT, Liesman RM, Steed ME. Activity of pulmonary vancomycin exposures versus planktonic and biofilm isolates of methicillin-resistant Staphylococcus aureus from cystic fibrosis sputum. Int J Antimicrob Agents 2020; 55:105898. [PMID: 31931147 DOI: 10.1016/j.ijantimicag.2020.105898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/30/2019] [Accepted: 01/04/2020] [Indexed: 11/30/2022]
Abstract
Vancomycin is commonly used to treat methicillin-resistant Staphylococcus aureus (MRSA) infections in patients with cystic fibrosis (CF) lung disease. However, there are limited data to support the in vitro activity of this agent against MRSA isolated from CF sputum. The primary objective of this study was to evaluate the activity of vancomycin at pulmonary concentrations (intravenous and inhaled) against four clinical MRSA CF sputum isolates in planktonic and biofilm time-kill (TK) experiments. Vancomycin minimum inhibitory concentrations (MICs) were determined for these isolates at standard inoculum (SI) (~106 CFU/mL) and high inoculum (HI) (~108 CFU/mL) as well as in biofilms cultivated using physiological medium representing the microenvironment of the CF lung. Vancomycin concentrations of 10, 25, 100 and 275 µg/mL were evaluated in TK experiments against planktonic MRSA at varying inocula and versus biofilm MRSA. Vancomycin MICs increased from 0.5 µg/mL when tested at SI to 8-16 µg/mL at HI. Vancomycin MICs were further increased to 16-32 µg/mL in biofilm studies. In TK experiments, vancomycin displayed bactericidal activity (≥3 log10 killing at 24 h) against 1/4 and 0/4 planktonic MRSA isolates at SI and HI, respectively, whereas vancomycin was bactericidal against 0/4 isolates against MRSA biofilms. Based on these findings, vancomycin monotherapy appears unlikely to eradicate MRSA from the respiratory tract of patients with CF, even at high concentrations similar to those observed with inhaled therapy. Novel vancomycin formulations with enhanced biofilm penetration or combination therapy with other potentially synergistic agents should be explored.
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Affiliation(s)
- Nicholas S Britt
- Department of Pharmacy Practice, University of Kansas School of Pharmacy, Lawrence, Kansas, USA; Department of Internal Medicine, Division of Infectious Diseases, University of Kansas School of Medicine, Kansas City, Kansas, USA.
| | - Daniel S Hazlett
- Department of Pharmacy Practice, University of Kansas School of Pharmacy, Lawrence, Kansas, USA
| | - Rebecca T Horvat
- Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Rachael M Liesman
- Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Molly E Steed
- Department of Pharmacy Practice, University of Kansas School of Pharmacy, Lawrence, Kansas, USA
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Controlled Release of Vancomycin and Tigecycline from an Orthopaedic Implant Coating Prevents Staphylococcus aureus Infection in an Open Fracture Animal Model. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1638508. [PMID: 31915682 PMCID: PMC6930786 DOI: 10.1155/2019/1638508] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/22/2019] [Accepted: 08/06/2019] [Indexed: 01/20/2023]
Abstract
Introduction Treatment of open fractures routinely involves multiple surgeries and delayed definitive fracture fixation because of concern for infection. If implants were made less susceptible to infection, a one-stage procedure with intramedullary nailing would be more feasible, which would reduce morbidity and improve outcomes. Methods In this study, a novel open fracture mouse model was developed using Staphylococcus aureus (S. aureus) and single-stage intramedullary fixation. The model was used to evaluate whether implants coated with a novel “smart” polymer coating containing vancomycin or tigecycline would be colonized by bacteria in an open fracture model infected with S. aureus. In vivo bioluminescence, ex vivo CFUs, and X-ray images were evaluated over a 42-day postoperative period. Results We found evidence of a markedly decreased bacterial burden with the local release of vancomycin and tigecycline from the PEG-PPS polymer compared to polymer alone. Vancomycin was released in a controlled fashion and maintained local drug concentrations above the minimum inhibition concentration for S. aureus for greater than 7 days postoperatively. Bacteria were reduced 139-fold from implants containing vancomycin and undetected from the bone and soft tissue. Tigecycline coatings led to a 5991-fold reduction in bacteria isolated from bone and soft tissue and 15-fold reduction on the implants compared to polymer alone. Antibiotic coatings also prevented osteomyelitis and implant loosening as observed on X-ray. Conclusion Vancomycin and tigecycline can be encapsulated in a polymer coating and released over time to maintain therapeutic levels during the perioperative period. Our results suggest that antibiotic coatings can be used to prevent implant infection and osteomyelitis in the setting of open fracture. This novel open fracture mouse model can be used as a powerful in vivo preclinical tool to evaluate and optimize the treatment of open fractures before further studies in humans.
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27
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Di Domenico EG, Rimoldi SG, Cavallo I, D’Agosto G, Trento E, Cagnoni G, Palazzin A, Pagani C, Romeri F, De Vecchi E, Schiavini M, Secchi D, Antona C, Rizzardini G, Dichirico RB, Toma L, Kovacs D, Cardinali G, Gallo MT, Gismondo MR, Ensoli F. Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis. BMC Microbiol 2019; 19:228. [PMID: 31638894 PMCID: PMC6802308 DOI: 10.1186/s12866-019-1596-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Infective endocarditis (IE) is associated with high rates of mortality. Prolonged treatments with high-dose intravenous antibiotics often fail to eradicate the infection, frequently leading to high-risk surgical intervention. By providing a mechanism of antibiotic tolerance, which escapes conventional antibiotic susceptibility profiling, microbial biofilm represents a key diagnostic and therapeutic challenge for clinicians. This study aims at assessing a rapid biofilm identification assay and a targeted antimicrobial susceptibility profile of biofilm-growing bacteria in patients with IE, which were unresponsive to antibiotic therapy. RESULTS Staphylococcus aureus was the most common isolate (50%), followed by Enterococcus faecalis (25%) and Streptococcus gallolyticus (25%). All microbial isolates were found to be capable of producing large, structured biofilms in vitro. As expected, antibiotic treatment either administered on the basis of antibiogram or chosen empirically among those considered first-line antibiotics for IE, including ceftriaxone, daptomycin, tigecycline and vancomycin, was not effective at eradicating biofilm-growing bacteria. Conversely, antimicrobial susceptibility profile of biofilm-growing bacteria indicated that teicoplanin, oxacillin and fusidic acid were most effective against S. aureus biofilm, while ampicillin was the most active against S. gallolyticus and E. faecalis biofilm, respectively. CONCLUSIONS This study indicates that biofilm-producing bacteria, from surgically treated IE, display a high tolerance to antibiotics, which is undetected by conventional antibiograms. The rapid identification and antimicrobial tolerance profiling of biofilm-growing bacteria in IE can provide key information for both antimicrobial therapy and prevention strategies.
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Affiliation(s)
- Enea Gino Di Domenico
- Clinical Pathology and Microbiology, San Gallicano Dermatology Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Sara Giordana Rimoldi
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Ilaria Cavallo
- Clinical Pathology and Microbiology, San Gallicano Dermatology Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Giovanna D’Agosto
- Clinical Pathology and Microbiology, San Gallicano Dermatology Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Elisabetta Trento
- Clinical Pathology and Microbiology, San Gallicano Dermatology Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Giovanni Cagnoni
- UOC Cardiochirurgia, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Alessandro Palazzin
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Cristina Pagani
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Francesca Romeri
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Elena De Vecchi
- Laboratory of Clinical Chemistry and Microbiology, IRCCS Orthopedic Institute Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Monica Schiavini
- Dipartimento di Malattie Infettive, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Daniela Secchi
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Carlo Antona
- UOC Cardiochirurgia, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Giuliano Rizzardini
- Dipartimento di Malattie Infettive, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Rita Barbara Dichirico
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Luigi Toma
- Department of Research, Advanced Diagnostics, and Technological Innovation, Translational Research Area, Regina Elena National Cancer Institute IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Daniela Kovacs
- Cutaneous Physiopathology Lab, San Gallicano Dermatologic Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Giorgia Cardinali
- Cutaneous Physiopathology Lab, San Gallicano Dermatologic Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Maria Teresa Gallo
- Clinical Pathology and Microbiology, San Gallicano Dermatology Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
| | - Maria Rita Gismondo
- Laboratorio di Microbiologia Clinica, Virologia e Diagnostica delle Bioemergenze, Azienda Socio Sanitaria Territoriale Fatebenefratelli-Sacco, Polo Universitario, Via G.B. Grassi 74, 20157 Milan, Italy
| | - Fabrizio Ensoli
- Clinical Pathology and Microbiology, San Gallicano Dermatology Institute, IRCCS, Istituti Fisioterapici Ospitalieri (IFO), via Elio Chianesi, 53 00144 Rome, Italy
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Wu S, Liu Y, Lei L, Zhang H. Antisense yycG Regulation of Antibiotic Sensitivity of Methicillin-Resistant Staphylococcus aureus in Chronic Osteomyelitis. Surg Infect (Larchmt) 2019; 20:472-479. [PMID: 31038392 DOI: 10.1089/sur.2019.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an urgent medical problem in osteomyelitis. The YycFG two-component regulatory system (TCS) allows bacteria to adapt rapidly to physical, chemical, and biological stresses. The recombinant plasmid shuttle vector was used to overexpress an antisense RNA (asRNA) to inhibit target gene expression by sequence-specific double-stranded RNA complex degradation. In the current study, antisense yycG RNA (ASyycG)-overexpression MRSA clinical isolates were constructed. Methods: Bacterial growth was monitored, and biofilm biomass was determined by crystal violet microtiter assay. Quantitative reverse transcription polymerase chain reaction analysis was used to identify expression of yycF/G/H and icaA/D in MRSA and ASyycG strains. The expression of YycG protein was quantified by Western blot assays. The antibiotic resistance of ASyycG strains was compared with that of the MRSA strains. Results: The ASyycG strains showed a decrease in growth rate compared with the MRSA strains. Of note, overexpression of ASyycG led to a reduction in biofilm formation and adhesion force. ASyycG strains had decreased expressions of the yycF/G/H and icaA/D. Furthermore, Western blot data showed that expression of the YycG protein decreased by 40% in ASyycG strains compared with MRSA strains. In addition, the effect of yycG asRNA improved the susceptibility of ASyycG strains to cefoxitin. Conclusions: The ASyycG strains inhibited biofilm organization and increased antibiotic sensitivity, which may be attributed to altered intracellular polysaccharide construction.
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Affiliation(s)
- Shizhou Wu
- 1Department of Orthopedics, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.,2State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yunjie Liu
- 3West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Lei Lei
- 2State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hui Zhang
- 1Department of Orthopedics, West China Hospital, West China Medical School, Sichuan University, Chengdu, China
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Sweeney E, Lovering A, Bowker K, MacGowan A, Nelson S. Anin vitrobiofilm model ofStaphylococcus aureusinfection of bone. Lett Appl Microbiol 2019; 68:294-302. [PMID: 30770577 DOI: 10.1111/lam.13131] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/15/2019] [Accepted: 02/07/2019] [Indexed: 12/18/2022]
Affiliation(s)
- E. Sweeney
- School of Life Sciences University of Warwick Coventry UK
| | - A.M. Lovering
- Bristol Centre for Antimicrobial Research & Evaluation North Bristol NHS Trust Department of Infection Sciences Southmead Hospital Westbury‐on‐Trym Bristol UK
| | - K.E. Bowker
- Bristol Centre for Antimicrobial Research & Evaluation North Bristol NHS Trust Department of Infection Sciences Southmead Hospital Westbury‐on‐Trym Bristol UK
| | - A.P. MacGowan
- Bristol Centre for Antimicrobial Research & Evaluation North Bristol NHS Trust Department of Infection Sciences Southmead Hospital Westbury‐on‐Trym Bristol UK
| | - S.M. Nelson
- Department of Applied Sciences University of the West of England Bristol UK
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30
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Marusza W, Olszanski R, Sierdzinski J, Ostrowski T, Szyller K, Mlynarczyk G, Netsvyetayeva I. Treatment of late bacterial infections resulting from soft-tissue filler injections. Infect Drug Resist 2019; 12:469-480. [PMID: 30863129 PMCID: PMC6390860 DOI: 10.2147/idr.s186996] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Purpose Late bacterial infections (LBIs) after esthetic facial augmentation using hyaluronic acid (HA) fillers are relatively rare yet severe complications that are difficult to treat. No adequate treatment standards have hitherto been formulated. We have bridged this gap by formulating a treatment scheme based on the principles of treating foreign-body implantation-related infections and treating bacterial growth in the form of biofilm. The objective of this study was to evaluate the efficacy of a comprehensive scheme for treating LBI complications after facial augmentation using cross-linked HA fillers. Methods A total of 22 patients with LBI symptoms at a site of cross-linked HA injection underwent treatment and observation. The comprehensive treatment scheme formulated by Marusza and Netsvyetayeva (M&N scheme) comprised draining the lesion, dissolution of cross-linked HA with hyaluronidase, broad-spectrum antibiotic combination therapy, and use of probiotics. While 17 patients underwent the M&N scheme, the remaining five were treated with other schemes. Statistical analysis of the data was performed using Mann–Whitney U and χ2 nonparametric tests with SAS 9.4 software. Results All 17 patients who underwent the M&N scheme experienced resolution of symptoms, with no recurrence of infection at the HA-injection sites. Conclusion To treat LBI at a site of cross-linked HA administration, the principles applicable to infections resulting from implantation of a foreign body must be followed. The treatment period should be sufficiently long for complete resolution of symptoms. The efficacy of treatment is considered proven if 2 months have elapsed without recurrence since the symptoms resolved. The M&N scheme is recommended for use as the first therapeutic option for treating LBI related to soft-tissue fillers.
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Affiliation(s)
| | | | - Janusz Sierdzinski
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Ostrowski
- Department of General and Endocrine Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Grazyna Mlynarczyk
- Department of Microbiology, Medical University of Warsaw, Warsaw, Poland,
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Bai JR, Wu YP, Elena G, Zhong K, Gao H. Insight into the effect of quinic acid on biofilm formed byStaphylococcus aureus. RSC Adv 2019; 9:3938-3945. [PMID: 35518066 PMCID: PMC9060517 DOI: 10.1039/c8ra09136f] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 01/22/2019] [Indexed: 01/08/2023] Open
Abstract
The biofilm formation of Staphylococcus aureus on food contact surfaces is the main risk of food contamination. In the present study, we firstly investigated the inhibitory effect of quinic acid (QA) on biofilm formed by S. aureus. Crystal violet staining assay and microscopy analysis clearly showed that QA at sub-MIC concentrations was able to significantly reduce the biofilm biomass and cause a collapse on biofilm architecture. Meanwhile, fibrinogen binding assay showed that QA had obviously effect on the S. aureus bacteria adhesion. XTT reduction assay and confocal laser scanning microscopic images revealed that QA significantly decreased metabolic activity and viability of biofilm cells. In addition, qRT-PCR analysis explored the potential inhibitory mechanism of QA against biofilm formation, which indicated that QA significantly repressed the gene sarA and activated the gene agrA. Moreover, QA exhibited a highly ability to reduce the number of sessile S. aureus cells adhered on the stainless steel. So, it was suggested that QA could be used as a promising antibiofilm agent to control biofilm formation of S. aureus. QA effectively inhibited S. aureus biofilm formation. The key genes of biofilm inhibition induced by QA were agrA and sarA.![]()
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Affiliation(s)
- Jin-Rong Bai
- College of Light Industry
- Textile and Food Engineering and Healthy Food Evaluation Research Center
- Sichuan University
- Chengdu 610065
- P. R. China
| | - Yan-Ping Wu
- College of Light Industry
- Textile and Food Engineering and Healthy Food Evaluation Research Center
- Sichuan University
- Chengdu 610065
- P. R. China
| | - Grosu Elena
- College of Light Industry
- Textile and Food Engineering and Healthy Food Evaluation Research Center
- Sichuan University
- Chengdu 610065
- P. R. China
| | - Kai Zhong
- College of Light Industry
- Textile and Food Engineering and Healthy Food Evaluation Research Center
- Sichuan University
- Chengdu 610065
- P. R. China
| | - Hong Gao
- College of Light Industry
- Textile and Food Engineering and Healthy Food Evaluation Research Center
- Sichuan University
- Chengdu 610065
- P. R. China
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Bishop AR, Kim S, Squire MW, Rose WE, Ploeg HL. Vancomycin elution, activity and impact on mechanical properties when added to orthopedic bone cement. J Mech Behav Biomed Mater 2018; 87:80-86. [DOI: 10.1016/j.jmbbm.2018.06.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 02/02/2023]
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Multiple Low Frequency Ultrasound Enhances Bactericidal Activity of Vancomycin against Methicillin-Resistant Staphylococcus aureus Biofilms. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6023101. [PMID: 30364019 PMCID: PMC6186328 DOI: 10.1155/2018/6023101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/16/2018] [Indexed: 11/17/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) biofilm infections are difficult to treat due to the high antimicrobial resistance of biofilm. Therefore, new treatments are needed for more effective bacteria clearance. This study was to investigate whether low frequency ultrasound (LFU) can enhance the activity of antimicrobial agents against MRSA biofilm infection. Broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of vancomycin (VAN), linezolid (LIN), and levofloxacin (LEV) against three clinical isolated strains, including one methicillin-susceptible Staphylococcus aureus (MSSA) strain and two MRSA strains. Effects of various influencing factors, such as antimicrobial agents, drug concentrations, ultrasonic intensity, and single (S-LFU, 5 or 15 min) or multiple ultrasound (M-LFU, 5 min every 8 h), on the inhibition of biofilms were investigated. The bactericidal effects of S-LFU or M-LFU on MRSA or MSSA biofilms were determined by colony counts. Right after ultrasound, synergistic effects were observed in groups of S-LFU combined with three antimicrobial agents against MSSA biofilm, but for MRSA biofilm, only S-LFU plus VAN had synergistic effect. At the time point of 24 h, M-LFU plus VAN treatment had synergistic bactericidal effect against MRSA and MSSA biofilms, and the synergy showed that VAN is concentration-dependent, but no synergistic effects were observed in all S-LFU combination groups. In conclusion, combination of M-LFU and antimicrobial agents had a better synergistic effect than S-LFU against MRSA or MSSA biofilm. LFU may be useful in treating biofilm infection in the future.
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Jahanbakhsh S, Singh NB, Yim J, Rose WE, Rybak MJ. Evaluation of Telavancin Alone and Combined with Ceftaroline or Rifampin against Methicillin-Resistant Staphylococcus aureus in an In Vitro Biofilm Model. Antimicrob Agents Chemother 2018; 62:e00567-18. [PMID: 29784849 PMCID: PMC6105779 DOI: 10.1128/aac.00567-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/15/2018] [Indexed: 12/11/2022] Open
Abstract
Infections caused by biofilm-producing methicillin-resistant Staphylococcus aureus (MRSA) bacteria are challenging due to increasing antibiotic resistance. Synergistic activities of lipopeptides and lipoglycopeptides with β-lactams have been demonstrated for MRSA, but little is known about biofilm-embedded organisms. Our objective was to evaluate two telavancin (TLV) dosage regimens (7.5 mg/kg of body weight and 10 mg/kg every 24 h [q24h]) alone and in combination with ceftaroline (CPT) (600 mg every 8 h [q8h]) or rifampin (RIF) (450 mg every 12 h [q12h]) against two biofilm-producing MRSA strains (494 and N315). Pharmacokinetic/pharmacodynamic CDC biofilm reactor models with polyurethane coupons were used to evaluate the efficacies of the antibiotic combinations over 72 h. Overall, there were no significant differences observed between the two TLV dosing regimens either alone or in combination with RIF or CPT against these strains. Both TLV dosing regimens and CPT alone demonstrated killing but did not reach bactericidal reduction at 72 h. However, both TLV regimens in combination with RIF demonstrated enhanced activity against both strains, with a rapid decrease in CFU/ml at 4 h that was bactericidal and maintained over the 72-h experiment (-Δ3.75 log10 CFU/ml from baseline; P < 0.0001). Of interest, no enhanced activity was observed for TLV combined with CPT. No development of resistance was observed in any of the combination models. However, resistance to RIF developed as early as 24 h, with MIC values exceeding 32 mg/liter. Our results show that TLV plus RIF displayed therapeutic improvement against biofilm-producing MRSA. These results suggest that TLV at 7.5 and 10 mg/kg q24h are equally effective in eradicating biofilm-associated MRSA strains in vitro.
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Affiliation(s)
- Seyedehameneh Jahanbakhsh
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Nivedita B Singh
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Juwon Yim
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Warren E Rose
- School of Pharmacy and Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michael J Rybak
- Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA
- School of Medicine, Wayne State University, Detroit, Michigan, USA
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Yan Q, Karau MJ, Raval YS, Patel R. In vitro activity of oritavancin in combination with rifampin or gentamicin against prosthetic joint infection-associated methicillin-resistant Staphylococcus epidermidis biofilms. Int J Antimicrob Agents 2018; 52:608-615. [PMID: 30048689 DOI: 10.1016/j.ijantimicag.2018.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/28/2018] [Accepted: 07/14/2018] [Indexed: 11/17/2022]
Abstract
This study evaluated the in vitro activity of oritavancin in combination with rifampin or gentamicin against methicillin-resistant Staphylococcus epidermidis (MRSE) biofilms. Oritavancin, rifampin, and gentamicin were tested against 20 MRSE isolates recovered from prosthetic joint infection (PJI). Time-kill studies were used to evaluate the activities of the three antimicrobial agents individually vs. combinations of oritavancin with rifampin or gentamicin against MRSE biofilms formed on Teflon coupons. At 24 h, the combination of oritavancin and rifampin resulted in a significant (P≤0.001) reduction in biofilm density compared with either antimicrobial alone for 85% (17/20) of isolates. Oritavancin combined with gentamicin showed a significant (P≤0.001) reduction in biofilm density compared with either antimicrobial alone against 55% (11/20) of isolates at 24 h. Synergy (defined as a ≥2 log10 cfu/cm2 decrease at 24 h for the antimicrobial combination compared with the most active single antimicrobial) was observed against 65% (13/20) of the isolates for oritavancin in combination with rifampin and 35% (7/20) of the isolates for oritavancin in combination with gentamicin. Oritavancin in combination with rifampin or gentamicin demonstrated bactericidal activity (defined as a ≥3 log10 cfu/cm2 reduction at 24 h from the starting biofilm bacterial density) for 85% (17/20) and 80% (16/20) isolates, respectively. Our study suggests that oritavancin and rifampin combination therapy may be an option for antimicrobial management of PJIs caused by MRSE.
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Affiliation(s)
- Qun Yan
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Melissa J Karau
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Yash S Raval
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
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Ma Z, Lasek-Nesselquist E, Lu J, Schneider R, Shah R, Oliva G, Pata J, McDonough K, Pai MP, Rose WE, Sakoulas G, Malik M. Characterization of genetic changes associated with daptomycin nonsusceptibility in Staphylococcus aureus. PLoS One 2018; 13:e0198366. [PMID: 29879195 PMCID: PMC5991675 DOI: 10.1371/journal.pone.0198366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022] Open
Abstract
The extensive use of daptomycin (DAP) for treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the last decade has led to the emergence of DAP non-susceptible (DNS) Staphylococcus aureus strains. A better understanding of the molecular changes underlying DAP-non-susceptibility is required for early diagnosis and intervention with alternate combination therapies. The phenotypic changes associated with DNS strains have been well established. However, the genotypic changes—especially the kinetics of expression of the genes responsible for DAP-non-susceptibility are not well understood. In this study, we used three clinically derived isogenic pairs of DAP-susceptible (DAP-S) and DNS S. aureus strains to study gene expression profiles with the objective of identifying the potential genotypic changes associated with DAP-nonsusceptibility. We determined the expression profiles of genes involved in cell membrane (CM) charge, autolysis, cell wall (CW) synthesis, and penicillin binding proteins in DAP-S and DNS isogenic pairs. Our results demonstrate characteristic expression profiles for mprF, dltABCD, vraS, femB, and pbp2a genes, which are common to all the DNS S. aureus strains tested. Whole genome sequencing of DAP-S and DNS clinical isolates of S. aureus showed non-synonymous mutations in all DNS strains in genes involved in CM charge, CM composition, CW thickness and CW composition. To conclude, this study unravels some of the complex molecular changes involved in the development of DAP-nonsusceptibility by demonstrating distinct differences in gene expression profiles and mutations in the DNS S. aureus strains. This knowledge will aid in rapid identification of DNS S. aureus in clinical settings.
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Affiliation(s)
- Zhuo Ma
- Albany College of Pharmacy and Health Sciences, Albany, New York, United States of America
| | - Erica Lasek-Nesselquist
- Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Jackson Lu
- Albany College of Pharmacy and Health Sciences, Albany, New York, United States of America
| | - Ryan Schneider
- Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Riddhi Shah
- Albany College of Pharmacy and Health Sciences, Albany, New York, United States of America
| | - George Oliva
- Albany College of Pharmacy and Health Sciences, Albany, New York, United States of America
| | - Janice Pata
- Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Kathleen McDonough
- Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Manjunath P. Pai
- Albany College of Pharmacy and Health Sciences, Albany, New York, United States of America
| | - Warren E. Rose
- Universtiy of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin, United States of America
| | - George Sakoulas
- Center for Immunity, Infection & Inflammation, UCSD School of Medicine, La Jolla, California, United States of America
| | - Meenakshi Malik
- Albany College of Pharmacy and Health Sciences, Albany, New York, United States of America
- * E-mail:
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El Haj C, Murillo O, Ribera A, Lloberas N, Gómez-Junyent J, Tubau F, Fontova P, Cabellos C, Ariza J. Evaluation of linezolid or trimethoprim/sulfamethoxazole in combination with rifampicin as alternative oral treatments based on an in vitro pharmacodynamic model of staphylococcal biofilm. Int J Antimicrob Agents 2018; 51:854-861. [PMID: 29374577 DOI: 10.1016/j.ijantimicag.2018.01.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 01/18/2018] [Indexed: 11/30/2022]
Abstract
Combinations of linezolid (LZD) or trimethoprim/sulfamethoxazole (SXT) plus rifampicin (RIF) are alternative oral treatments for staphylococcal prosthetic joint infections (PJIs) when fluoroquinolones are not possible to use, but there is limited evidence regarding their activity. This study evaluated the efficacy of LZD and SXT, alone and in combination with RIF, against Staphylococcus aureus in an in vitro pharmacokinetic/pharmacodynamic biofilm model. Using the CDC Biofilm Reactor® system, simulated regimens of LZD (600 mg every 12 h), SXT (160/800 mg every 8 h) and levofloxacin (LVX) (750 mg/day), alone and in combination with RIF (600 mg/day), were evaluated against one methicillin-susceptible S. aureus (MSSA) and one methicillin-resistant S. aureus (MRSA) strain. Antibiotic efficacy was evaluated by the decrease in planktonic bacterial counts from medium and biofilm-embedded bacteria from coupons over 56 h. Resistant strains were screened. In both strains, SXT alone was ineffective and LZD presented low activity, but no resistance emerged. Combinations with RIF significantly increased the antibiofilm efficacy against MSSA (Δlog CFU/mL 56h-0h: SXT + RIF, -2.9 and LZD + RIF, -3.1), but RIF-resistant strains appeared with SXT + RIF. Against MRSA, LZD + RIF (-3.1) protected against the emergence of resistance and was more effective than SXT + RIF (-0.6; P <0.05), in which RIF-resistant strains were again detected. LVX + RIF confirmed its high efficacy against biofilm-embedded bacteria, this being the most effective therapy (-5.1 against MSSA). The emergence of RIF-resistant strains with SXT + RIF poses serious concerns for its use in clinical practice. Interestingly, LZD + RIF appears to be an appropriate alternative for PJI caused by LVX-resistant S. aureus.
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Affiliation(s)
- Cristina El Haj
- Laboratory of Experimental Infection, Infectious Diseases Service, IDIBELL-Hospital Universitari Bellvitge, University of Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Oscar Murillo
- Laboratory of Experimental Infection, Infectious Diseases Service, IDIBELL-Hospital Universitari Bellvitge, University of Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alba Ribera
- Laboratory of Experimental Infection, Infectious Diseases Service, IDIBELL-Hospital Universitari Bellvitge, University of Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Lloberas
- Nephrology Service and Laboratory of Experimental Nephrology, University of Barcelona, Campus Bellvitge, Pavelló de Govern, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Gómez-Junyent
- Laboratory of Experimental Infection, Infectious Diseases Service, IDIBELL-Hospital Universitari Bellvitge, University of Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Fe Tubau
- Department of Microbiology, IDIBELL-Hospital Universitari Bellvitge, Barcelona, Spain; Department of Microbiology, CIBERES ISCIII, Madrid, Spain
| | - Pere Fontova
- Nephrology Service and Laboratory of Experimental Nephrology, University of Barcelona, Campus Bellvitge, Pavelló de Govern, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carme Cabellos
- Laboratory of Experimental Infection, Infectious Diseases Service, IDIBELL-Hospital Universitari Bellvitge, University of Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Ariza
- Laboratory of Experimental Infection, Infectious Diseases Service, IDIBELL-Hospital Universitari Bellvitge, University of Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain
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Arnaiz de Las Revillas F, Fernandez-Sampedro M, Arnaiz-García AM, Gutierrez-Cuadra M, Armiñanzas C, Pulitani I, Ponton A, Tascon V, García I, Fariñas MC. Daptomycin treatment in Gram-positive vascular graft infections. Int J Infect Dis 2018; 68:69-73. [PMID: 29373845 DOI: 10.1016/j.ijid.2018.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 01/10/2018] [Accepted: 01/15/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Daptomycin is a bactericidal antibiotic approved for the treatment of skin and soft tissue infections and right-side endocarditis. However, there is a lack of published data outlining its usefulness in vascular graft infections (VGI). The aim of this study was to describe the clinical experience of daptomycin use in the treatment of VGI caused by Gram-positive bacteria. METHODS This was a retrospective cohort study of patients diagnosed with VGI receiving daptomycin at a tertiary care hospital during the period January 2010 to December 2012. RESULTS Of a total 1066 consecutive patients who had undergone vascular grafts (VG), 25 were diagnosed with VGI. Fifteen of these patients (11 prosthetic VG, three autologous VG, one both types) received daptomycin (median dose 6.7mg/kg/day, range 4.1-7.1mg/kg/day; median age 69 years, range 45-83 years; 80% male). The infected bypass was removed in 13 cases. The most common reason for selecting daptomycin was kidney failure (53%). The Gram-positive organisms isolated were coagulase-negative Staphylococcus (n=10), Staphylococcus aureus (n=3) (two methicillin-resistant S. aureus), Enterococcus faecium (n=2), and Enterococcus faecalis (n=1). The mean follow-up was 69 months (interquartile range 48-72 months). Ten patients (66.7%) achieved complete healing of the VGI. A recurrence of the infection was observed in 100% of patients in whom the bypass was not removed. Among patients who did not achieve complete healing, one needed a supracondylar amputation and one died as a consequence of infection. Five patients received treatment with rifampicin in addition to daptomycin and they were all cured. CONCLUSIONS The use of daptomycin and surgery for Gram-positive VGI was effective and well tolerated, and this may be a good alternative for the treatment of VGI in patients with peripheral arterial disease in whom renal insufficiency is common.
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Affiliation(s)
| | - Marta Fernandez-Sampedro
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Ana María Arnaiz-García
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Manuel Gutierrez-Cuadra
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Carlos Armiñanzas
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Ivana Pulitani
- Cardiovascular Surgery Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Alejandro Ponton
- Cardiovascular Surgery Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Valentin Tascon
- Cardiovascular Surgery Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Ivan García
- Cardiovascular Surgery Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - María Carmen Fariñas
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
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Werth BJ. Exploring the pharmacodynamic interactions between tedizolid and other orally bioavailable antimicrobials against Staphylococcus aureus and Staphylococcus epidermidis. J Antimicrob Chemother 2018; 72:1410-1414. [PMID: 28158617 DOI: 10.1093/jac/dkw588] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/22/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives Tedizolid is an orally bioavailable oxazolidinone with once-daily dosing and broad-spectrum Gram-positive activity. Combination therapy is commonly indicated to improve efficacy against difficult-to-treat pathogens and biofilms. There are no studies describing the pharmacodynamic interactions between tedizolid and other orally bioavailable antimicrobials. Methods MICs of tedizolid, rifampicin, trimethoprim/sulfamethoxazole, doxycycline and moxifloxacin were determined by broth microdilution against a convenience sample of 45 staphylococcal isolates. Seven MRSA isolates and three Staphylococcus epidermidis were evaluated by time-kill using concentrations equal to 0.5× the MIC. These strains had variable susceptibility to the investigated antimicrobials. Synergy was defined as a ≥2 log 10 cfu/mL reduction of the combination over the most active single agent, antagonism was defined as ≥1 log 10 cfu/mL growth compared with the most active single agent, and other interactions were indifferent. Results Three of 45 strains tested were non-susceptible to tedizolid (MIC = 1 mg/L), but the MIC 90 was 0.5 mg/L. Interactions between tedizolid and other agents were largely indifferent (80%). Tedizolid was synergistic with doxycycline and rifampicin against 2/10 and 3/10 strains, respectively. Tedizolid was antagonistic with moxifloxacin against 3/10 strains. Other interactions were indifferent. Conclusions The addition of rifampicin to tedizolid appears to be the most likely to improve activity but synergy was not universal. The combination of tedizolid plus moxifloxacin should be avoided due to the risk of antagonism. The addition of other orally bioavailable anti-staphylococcal agents to tedizolid may be unlikely to improve killing but further research is warranted to assess the impact of these combinations on resistance prevention, or against biofilm-embedded organisms.
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41
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Chitosan as an effective inhibitor of multidrug resistant Acinetobacter baumannii. Carbohydr Polym 2017; 178:347-351. [DOI: 10.1016/j.carbpol.2017.09.055] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/07/2017] [Accepted: 09/14/2017] [Indexed: 11/21/2022]
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42
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Sharafutdinov IS, Trizna EY, Baidamshina DR, Ryzhikova MN, Sibgatullina RR, Khabibrakhmanova AM, Latypova LZ, Kurbangalieva AR, Rozhina EV, Klinger-Strobel M, Fakhrullin RF, Pletz MW, Bogachev MI, Kayumov AR, Makarewicz O. Antimicrobial Effects of Sulfonyl Derivative of 2(5 H)-Furanone against Planktonic and Biofilm Associated Methicillin-Resistant and -Susceptible Staphylococcus aureus. Front Microbiol 2017; 8:2246. [PMID: 29209288 PMCID: PMC5701942 DOI: 10.3389/fmicb.2017.02246] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/31/2017] [Indexed: 01/15/2023] Open
Abstract
The gram-positive opportunistic bacterium Staphylococcus aureus is one of the most common causatives of a variety of diseases including skin and skin structure infection or nosocomial catheter-associated infections. The biofilm formation that is an important virulence factor of this microorganism renders the antibiotic therapy ineffective, because biofilm-embedded bacteria exhibit strongly increased tolerance to antimicrobials. Here, we describe a novel 3-chloro-5(S)-[(1R,2S,5R)-2-isopropyl-5-methylcyclohexyloxy]-4-[4-methylphenylsulfonyl]-2(5H)-furanone (F105), possessing a sulfonyl group and l-menthol moiety. Minimal inhibitory and bactericidal concentration values (MIC and MBC) of F105 were 10 and 40 mg/L, respectively, suggesting F105 biocidal properties. F105 exhibits pronounced activity against biofilm-embedded S. aureus and increases the efficacy of aminoglycosides (amikacin, gentamicin, and kanamycin) and benzalkonium chloride with fractional inhibitory concentration index values of 0.33–0.44 and 0.29, respectively, suggesting an alternative external treatment option, e.g., for wound infections. Moreover, low concentrations (0.5–1.3 mg/L) of F105 reduced the MICs of these antimicrobials twofold. By using confocal laser scanning microscopy and CFU counting, we show explicitly that F105 also restores the antimicrobial activity of gentamicin and ampicillin against S. aureus biofilms by several orders of magnitude. Biofilm structures were not destroyed but sterilized, with embedded cells being almost completely killed at twofold MBC. While F105 is quite toxic (CC50/MBC ratio 0.2), our data suggest that the F105 chemotype might be a promising starting point for the development of complex topical agents for combined anti-staphylococcal biofilm-therapies restoring the efficacy of some antibiotics against difficult to treat S. aureus biofilm.
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Affiliation(s)
| | - Elena Y Trizna
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Diana R Baidamshina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Maria N Ryzhikova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Regina R Sibgatullina
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Alsu M Khabibrakhmanova
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Liliya Z Latypova
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Almira R Kurbangalieva
- Biofunctional Chemistry Laboratory, Alexander Butlerov Institute of Chemistry, Kazan Federal University, Kazan, Russia
| | - Elvira V Rozhina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Mareike Klinger-Strobel
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Rawil F Fakhrullin
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Mathias W Pletz
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Mikhail I Bogachev
- Biomedical Engineering Research Centre, Saint Petersburg Electrotechnical University, Saint Petersburg, Russia
| | - Airat R Kayumov
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
| | - Oliwia Makarewicz
- Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
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Fernández-Rivero ME, Del Pozo JL, Ramírez P, Valentín E, Ruiz-Gaitán A, Pemán J, Cantón E. Time-kill assays of amphotericin B plus anidulafungin against Candida tropicalis biofilms formed on two different biomaterials. Int J Artif Organs 2017; 41:0. [PMID: 29048702 DOI: 10.5301/ijao.5000652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the fungicidal activity by time-killing assays of amphotericin B (AMB) combined with anidulafungin (ANF) against biofilms of 2 clinical isolates of Candida tropicalis and the reference strain ATCC® 750, developed on polytetrafluoroethylene (PTFE) and titanium, using the CDC Biofilm Reactor (CBR) as an in vitro model. METHODS Biofilms were developed for 24 hours on the disk surfaces and then exposed to AMB (40 mg/L), ANF (8 mg/L), alone and combined. At predetermined time points after drug exposure, biofilms were removed from the disk surface by vortexing-sonication to quantify viable biofilm cells. RESULTS Drug activity was dependent on strain and time. After exposure to AMB, the mean decrease in viable cells attached to PTFE was 2.23 ± 0.89 Log10 cfu/cm2 (range 0.6-3.56 Log10), and on titanium 2.91 ± 1.04 (range 1.49-4.51 Log10). The reduction with ANF was 0.78 ± 0.5 (0.03-1.58 Log10) on PTFE and 0.8 ± 2.26 (0.42-1.16 Log10) on titanium. The reduction obtained with the combination of AMB + ANF was 1.8 ± 1.07 (0.22-3.54 Log10) on PTFE and 1.97 ± 0.49 (1.36-2.84 Log10) on titanium. The interaction was classified as indifferent with a tendency to antagonism. CONCLUSIONS The activity of antifungal agents depends on the biomaterial surfaces the biofilm forming capacity of the isolate. AMB + ANF is less effective than AMB alone on both surfaces. Thus, the combination of these antifungals does not seem to add additional benefits to the treatment of C. tropicalis biofilm-related infections.
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Affiliation(s)
| | - José L Del Pozo
- Severe Infection Research Group, Medical Research Institute La Fe, Valencia - Spain
- Department of Clinical Microbiology, Clinic University of Navarra, Pamplona - Spain
| | - Paula Ramírez
- Department of Critical Care, Hospital La Fe, Valencia - Spain
| | - Eulogio Valentín
- Severe Infection Research Group, Medical Research Institute La Fe, Valencia - Spain
- Department of Microbiology and Ecology, University of Valencia, Burjassot, Valencia - Spain
| | - Alba Ruiz-Gaitán
- Severe Infection Research Group, Medical Research Institute La Fe, Valencia - Spain
| | - Javier Pemán
- Severe Infection Research Group, Medical Research Institute La Fe, Valencia - Spain
- Department of Clinical Microbiology, Hospital La Fe, Valencia - Spain
| | - Emilia Cantón
- Severe Infection Research Group, Medical Research Institute La Fe, Valencia - Spain
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Investigation of chitosan’s antibacterial activity against vancomycin resistant microorganisms and their biofilms. Carbohydr Polym 2017; 174:369-376. [DOI: 10.1016/j.carbpol.2017.06.087] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/02/2017] [Accepted: 06/21/2017] [Indexed: 11/22/2022]
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Fernández-Rivero ME, del Pozo JL, Valentín A, Fornes V, Molina de Diego A, Pemán J, Cantón E. Actividad de la anfotericina B y la anidulafungina, solas y combinadas, frente a biopelículas de Candida tropicalis formadas sobre Teflon ® y titanio. Rev Iberoam Micol 2017; 34:175-179. [DOI: 10.1016/j.riam.2017.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 12/27/2016] [Accepted: 01/20/2017] [Indexed: 10/19/2022] Open
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Costa EM, Silva S, Tavaria FK, Pintado MM. Insights into chitosan antibiofilm activity against methicillin-resistant Staphylococcus aureus. J Appl Microbiol 2017; 122:1547-1557. [PMID: 28370752 DOI: 10.1111/jam.13457] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/07/2017] [Accepted: 03/24/2017] [Indexed: 12/01/2022]
Abstract
AIMS Chitosan is a natural compound that has been validated as a viable antimicrobial agent against Staphylococcus aureus. With this work we sought to evaluate the planktonic and sessile sensitivity of methicillin-resistant S. aureus to chitosan's activity and evaluate if methicillin-resistant S. aureus (MRSA) would be more or less sensitive to chitosan's activity than methicillin-sensitive S. aureus (MSSA). METHODS AND RESULTS A group comprised of reference strains and clinical multiresistant isolates of MSSA and MRSA were used. Methicilin resistance effect upon chitosan activity was assessed in planktonic setting and in different phases of sessile colonization, namely adhesion, biofilm formation and mature biofilm through biomass and metabolism inhibition. The results obtained showed that S. aureus methicillin resistance mechanism did not impair chitosan's activity as the highest bacterial susceptibility was registered for MRSA. Chitosan was highly effective in inhibiting MSSA and MRSA strains in both planktonic and sessile settings with biofilm inhibition percentages reaching as high as 90% for MRSA. CONCLUSIONS Staphylococcus aureus methicillin resistance did not impair chitosan's antimicrobial and antibiofilm activities and MRSA and MSSA were inhibited both in planktonic and sessile settings at low concentrations with great efficacy. SIGNIFICANCE AND IMPACT OF THE STUDY Considering the obtained results chitosan shows potential as an alternative for the control of biofilm-related recalcitrant MRSA infections.
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Affiliation(s)
- E M Costa
- CBQF - Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Porto, Portugal
| | - S Silva
- CBQF - Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Porto, Portugal
| | - F K Tavaria
- CBQF - Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Porto, Portugal
| | - M M Pintado
- CBQF - Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Porto, Portugal
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Hu Y, Hegde V, Johansen D, Loftin AH, Dworsky E, Zoller SD, Park HY, Hamad CD, Nelson GE, Francis KP, Scaduto A, Bernthal NM. Combinatory antibiotic therapy increases rate of bacterial kill but not final outcome in a novel mouse model of Staphylococcus aureus spinal implant infection. PLoS One 2017; 12:e0173019. [PMID: 28245229 PMCID: PMC5330510 DOI: 10.1371/journal.pone.0173019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 02/12/2017] [Indexed: 12/04/2022] Open
Abstract
Background Management of spine implant infections (SII) are challenging. Explantation of infected spinal hardware can destabilize the spine, but retention can lead to cord compromise and biofilm formation, complicating management. While vancomycin monotherapy is commonly used, in vitro studies have shown reduced efficacy against biofilm compared to combination therapy with rifampin. Using an established in vivo mouse model of SII, we aim to evaluate whether combination therapy has increased efficacy compared to both vancomycin alone and infected controls. Methods An L-shaped, Kirschner-wire was transfixed into the L4 spinous process of 12-week-old C57BL/6 mice, and inoculated with bioluminescent Staphylococcus aureus. Mice were randomized into a vancomycin group, a combination group with vancomycin plus rifampin, or a control group receiving saline. Treatment began on post-operative day (POD) 7 and continued through POD 14. In vivo imaging was performed to monitor bioluminescence for 35 days. Colony-forming units (CFUs) were cultured on POD 35. Results Bioluminescence peaked around POD 7 for all groups. The combination group had a 10-fold decrease in signal by POD 10. The vancomycin and control groups reached similar levels on POD 17 and 21, respectively. On POD 25 the combination group dropped below baseline, but rebounded to the same level as the other groups, demonstrating a biofilm-associated infection by POD 35. Quantification of CFUs on POD 35 confirmed an ongoing infection in all three groups. Conclusions Although both therapies were initially effective, they were not able to eliminate implant biofilm bacteria, resulting in a rebound infection after antibiotic cessation. This model shows, for the first time, why histologic-based, static assessments of antimicrobials can be misleading, and the importance of longitudinal tracking of infection. Future studies can use this model to test combinations of antibiotic therapies to see if they are more effective in eliminating biofilm prior to human trials.
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Affiliation(s)
- Yan Hu
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Vishal Hegde
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Daniel Johansen
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Amanda H. Loftin
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Erik Dworsky
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Stephen D. Zoller
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Howard Y. Park
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Christopher D. Hamad
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - George E. Nelson
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Kevin P. Francis
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Anthony Scaduto
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
| | - Nicholas M. Bernthal
- Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Santa Monica, California, United States of America
- * E-mail:
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El Haj C, Murillo O, Ribera A, Garcia-Somoza D, Tubau F, Cabellos C, Cabo J, Ariza J. The anti-biofilm effect of macrolides in a rat model of S. aureus foreign-body infection: Might it be of clinical relevance? Med Microbiol Immunol 2016; 206:31-39. [DOI: 10.1007/s00430-016-0479-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 09/10/2016] [Indexed: 01/22/2023]
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Purrello SM, Garau J, Giamarellos E, Mazzei T, Pea F, Soriano A, Stefani S. Methicillin-resistant Staphylococcus aureus infections: A review of the currently available treatment options. J Glob Antimicrob Resist 2016; 7:178-186. [PMID: 27889013 DOI: 10.1016/j.jgar.2016.07.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 07/03/2016] [Accepted: 07/16/2016] [Indexed: 12/16/2022] Open
Abstract
This review is the result of discussions that took place at the 5th MRSA Working Group Consensus Meeting and explores the possible treatment options available for different types of infections due to methicillin-resistant Staphylococcus aureus (MRSA), focusing on those antibiotics that could represent a valid alternative to vancomycin. In fact, whilst vancomycin remains a viable option, its therapy is moving towards individualised dosing. Other drugs, such as the new lipoglycopeptides (oritavancin, dalbavancin and telavancin) and fifth-generation cephalosporins (ceftaroline and ceftobiprole), are showing good in vitro potency and in vivo efficacy, especially for patients infected with micro-organisms with higher vancomycin minimum inhibitory concentrations (MICs). Tedizolid is an attractive agent for use both in hospital and community settings, but the post-marketing data will better clarify its potential. Daptomycin and linezolid have shown non-inferiority to vancomycin in the treatment of MRSA bacteraemia and non-inferiority/superiority to vancomycin in the treatment of hospital-acquired pneumonia. Thus, several options are available, but more data from clinical practice, especially for invasive infections, are needed to assign specific roles to each antibiotic and to definitely include them in the new antibacterial armamentarium.
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Affiliation(s)
- S M Purrello
- Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMAR Lab), Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - J Garau
- Department of Medicine, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - E Giamarellos
- 4th Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - T Mazzei
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Firenze, Firenze, Italy
| | - F Pea
- Institute of Clinical Pharmacology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy; Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - A Soriano
- Department of Infectious Diseases, IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain
| | - S Stefani
- Medical Molecular Microbiology and Antibiotic Resistance Laboratory (MMAR Lab), Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
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New Insight into Daptomycin Bioavailability and Localization in Staphylococcus aureus Biofilms by Dynamic Fluorescence Imaging. Antimicrob Agents Chemother 2016; 60:4983-90. [PMID: 27297479 DOI: 10.1128/aac.00735-16] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/03/2016] [Indexed: 01/07/2023] Open
Abstract
Staphylococcus aureus is one of the most frequent pathogens responsible for biofilm-associated infections (BAI), and the choice of antibiotics to treat these infections remains a challenge for the medical community. In particular, daptomycin has been reported to fail against implant-associated S. aureus infections in clinical practice, while its association with rifampin remains a good candidate for BAI treatment. To improve our understanding of such resistance/tolerance toward daptomycin, we took advantage of the dynamic fluorescence imaging tools (time-lapse imaging and fluorescence recovery after photobleaching [FRAP]) to locally and accurately assess the antibiotic diffusion reaction in methicillin-susceptible and methicillin-resistant S. aureus biofilms. To provide a realistic representation of daptomycin action, we optimized an in vitro model built on the basis of our recently published in vivo mouse model of prosthetic vascular graft infections. We demonstrated that at therapeutic concentrations, daptomycin was inefficient in eradicating biofilms, while the matrix was not a shield to antibiotic diffusion and to its interaction with its bacterial target. In the presence of rifampin, daptomycin was still present in the vicinity of the bacterial cells, allowing prevention of the emergence of rifampin-resistant mutants. Conclusions derived from this study strongly suggest that S. aureus biofilm resistance/tolerance toward daptomycin may be more likely to be related to a physiological change involving structural modifications of the membrane, which is a strain-dependent process.
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