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达托霉素对耐甲氧西林金黄色葡萄球菌感染的糖尿病足患者局部白细胞介素-6、基质金属蛋白酶-9和金属肽酶抑制剂1的影响。

Effect of daptomycin on local interleukin-6, matrix metalloproteinase-9, and metallopeptidase inhibitor 1 in patients with MRSA-infected diabetic foot.

作者信息

Ambrosch Andreas, Halevy Daniel, Fwity Boushra, Brin Thomas, Lobmann Ralf

机构信息

1Institute of Laboratory Medicine, Microbiology and Hygiene, Hospital Barmherzige Brüder, Regensburg, Germany.

出版信息

Int J Low Extrem Wounds. 2014 Mar;13(1):12-6. doi: 10.1177/1534734614523126.

Abstract

Infection is a major cause of the diabetic foot syndrome that is promoted by the increased burden of multiresistant germs like methicillin-resistant Staphylococcus aureus (MRSA). Maximizing positive outcome for serious MRSA infections requires an aggressive treatment approach and careful monitoring of the healing process. Therefore, we examined 8 patients with MRSA-infected diabetic foot syndrome of Wagner classification grade 2 or 3 (corresponding to the Texas classification stage 2 or 3) during antibiotic treatment with daptomycin. We documented the wound size and obtained samples of wound secretion for analyses of proinflammatory interleukin-6 (IL-6), protease (matrix metalloproteinase-9 [MMP-9]), and antiprotease (metallopeptidase inhibitor 1 [TIMP-1]) activity. During the course of anti-MRSA therapy, we observed a decrease in the concentration of local IL-6 within the first 3 days followed by a decrease of MMP-9 and an increase of TIMP-1. Finally, a reduction of wound size was documented. The present data show that efficient antimicrobial treatment with daptomycin has a number of beneficial effects on wound healing at the molecular level in MRSA-infected diabetic foot ulcers.

摘要

感染是糖尿病足综合征的主要病因,耐多药菌(如耐甲氧西林金黄色葡萄球菌[MRSA])负担增加会促使其发生。要使严重MRSA感染取得最佳治疗效果,需要积极的治疗方法和对愈合过程的密切监测。因此,我们在使用达托霉素进行抗生素治疗期间,对8例瓦格纳分级为2级或3级(相当于德克萨斯分级的2期或3期)的MRSA感染糖尿病足综合征患者进行了检查。我们记录了伤口大小,并采集伤口分泌物样本,以分析促炎白细胞介素-6(IL-6)、蛋白酶(基质金属蛋白酶-9[MMP-9])和抗蛋白酶(金属肽酶抑制剂1[TIMP-1])的活性。在抗MRSA治疗过程中,我们观察到局部IL-6浓度在最初3天内下降,随后MMP-9下降,TIMP-1上升。最后,记录到伤口大小缩小。目前的数据表明,达托霉素进行有效的抗菌治疗在分子水平上对MRSA感染的糖尿病足溃疡的伤口愈合有许多有益作用。

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