Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
J Antimicrob Chemother. 2018 Mar 1;73(3):720-723. doi: 10.1093/jac/dkx432.
Staphylococcus aureus native efflux pump Tet38 confers resistance to tetracycline when overexpressed. tet38 expression is selectively upregulated in infection sites. This study evaluated the effect of Tet38 on tetracycline response in a murine subcutaneous abscess model.
S. aureus MW2 and its tet38 mutant were injected subcutaneously on the opposite flanks of each mouse. The infected mice were treated with tetracycline (10 mg/kg) or PBS (control) intraperitoneally every 12 h. The efficacy of tetracycline against S. aureus was measured by the relative change in viable bacteria in the abscesses 24 h after infection compared with the initial inoculum. Plasmid-based tet38-complemented strains were created and used to infect the mice followed by tetracycline or PBS treatment.
The increased bacterial loads of S. aureus MW2 and its tet38 mutant in the abscess after 24 h were similar. Tetracycline produced significant decreases of both MW2 and the tet38 mutant compared with control. Although the tetracycline MICs for MW2 and the tet38 mutant did not differ in vitro, the antibacterial effect of tetracycline was significantly 2-fold greater in the tet38 mutant compared with the MW2 parental strain in vivo with a decrease of 0.67 ± 0.21 and 0.35 ± 0.19 log10 cfu/abscess, respectively (P < 0.05). The increased tetracycline activity in the tet38 mutant was complemented by plasmid-encoded tet38.
This study demonstrated that selective increased expression of tet38 in an abscess can affect tetracycline efficacy against S. aureus in vivo, highlighting an effect of native efflux pumps on response to therapy not reflected by testing in vitro.
金黄色葡萄球菌天然外排泵 Tet38 在过表达时会导致对四环素的耐药性。tet38 的表达在感染部位被选择性地上调。本研究评估了 Tet38 在小鼠皮下脓肿模型中对四环素反应的影响。
将 MW2 及其 tet38 突变株的金黄色葡萄球菌分别皮下注射到每只小鼠的对侧侧腹。感染小鼠每 12 小时经腹腔给予四环素(10mg/kg)或 PBS(对照)治疗。感染 24 小时后,通过脓肿中存活细菌的相对变化与初始接种物相比来测量四环素对金黄色葡萄球菌的疗效。创建基于质粒的 tet38 互补株并用于感染小鼠,然后进行四环素或 PBS 治疗。
MW2 及其 tet38 突变株在感染 24 小时后在脓肿中的细菌负荷增加相似。与对照组相比,四环素对 MW2 和 tet38 突变株均产生了显著的减少。尽管 MW2 和 tet38 突变株的四环素 MIC 在体外没有差异,但四环素的抗菌作用在体内对 tet38 突变株的效果明显强于 MW2 亲本株,减少分别为 0.67 ± 0.21 和 0.35 ± 0.19 log10 cfu/脓肿(P < 0.05)。质粒编码的 tet38 可补充 tet38 突变株中增加的四环素活性。
本研究表明,脓肿中 tet38 的选择性增加表达可以影响体内四环素对金黄色葡萄球菌的疗效,突出了天然外排泵对治疗反应的影响,这在体外检测中没有反映出来。