Wayne State University, Anti-Infective Research Laboratory, Detroit, Michigan 48201, USA.
Antimicrob Agents Chemother. 2010 Oct;54(10):4329-34. doi: 10.1128/AAC.00455-10. Epub 2010 Aug 9.
Biofilm formation is an important virulence factor that allows bacteria to resist host responses and antibacterial agents. The aim of the study was to assess the in vitro activities of several antimicrobials alone or in combination against two Staphylococcus aureus isolates in a novel pharmacokinetic/pharmacodynamic (PK/PD) model of biofilm for 3 days. One methicillin-susceptible S. aureus strain (SH1000) and one methicillin-resistant S. aureus strain (N315) were evaluated in a modified biofilm reactor with polystyrene coupons. Simulated regimens included vancomycin (VAN) plus rifampin (RIF), moxifloxacin (MOX), and high doses (10 mg/kg of body weight/day) of daptomycin (DAP) alone or combined with RIF or clarithromycin (CLA). Against viable planktonic bacteria (PB) and biofilm-embedded bacteria (BB) of SH1000, neither DAP nor MOX alone was bactericidal. In contrast, the combination of DAP or MOX with CLA significantly increased the activity of the two agents against both PB and BB (P < 0.01), and DAP plus CLA reached the limit of detection at 72 h. Against PB of N315, DAP alone briefly achieved bactericidal activity at 24 h, whereas sustained bactericidal activity was observed at 32 h with VAN plus RIF. Overall, only a minimal reduction was observed with both regimens against BB (<2.8 log(10) CFU/ml). Finally, the combination of DAP and RIF was bactericidal against both PB and BB, achieving the limit of detection at 72 h. In conclusion, we developed a novel in vitro PK/PD model to assess the activities of antimicrobials against mature bacterial biofilm. Combinations of DAP or MOX with CLA were the most effective regimens and may represent promising options to treat persistent infections caused by S. aureus biofilms.
生物膜形成是一种重要的毒力因子,使细菌能够抵抗宿主反应和抗菌剂。本研究的目的是在一种新的药代动力学/药效学(PK/PD)模型中评估几种抗菌药物单独或联合应用对两种金黄色葡萄球菌分离株的体外活性,该模型用于 3 天的生物膜。使用聚苯乙烯小室在改良的生物膜反应器中评估了一株耐甲氧西林的金黄色葡萄球菌(SH1000)和一株耐甲氧西林的金黄色葡萄球菌(N315)。模拟方案包括万古霉素(VAN)加利福平(RIF)、莫西沙星(MOX)和高剂量(10mg/kg 体重/天)达托霉素(DAP)单独或与 RIF 或克拉霉素(CLA)联合应用。对于 SH1000 的活浮游菌(PB)和生物膜包埋菌(BB),DAP 或 MOX 单独均无杀菌作用。相比之下,DAP 或 MOX 与 CLA 的联合应用显著增加了两种药物对 PB 和 BB 的活性(P < 0.01),并且 DAP 加 CLA 在 72 小时达到检测限。对于 N315 的 PB,DAP 单独在 24 小时内短暂达到杀菌活性,而 VAN 加 RIF 在 32 小时时观察到持续的杀菌活性。总体而言,两种方案对 BB 的减少均很小(<2.8log10CFU/ml)。最后,DAP 和 RIF 的联合应用对 PB 和 BB 均具有杀菌作用,在 72 小时时达到检测限。总之,我们开发了一种新的体外 PK/PD 模型来评估抗菌药物对成熟细菌生物膜的活性。DAP 或 MOX 与 CLA 的联合应用是最有效的方案,可能是治疗由金黄色葡萄球菌生物膜引起的持续性感染的有前途的选择。