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Antimicrobial Agents and Chemotherapy, April 2009, p. 1434-1442, Vol. 53, No. 4
0066-4804/09/$08.00+0 doi:10.1128/AAC.01145-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.
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Université Catholique de Louvain, Louvain Drug Research Institute, Unité de Pharmacologie Cellulaire et Moléculaire,1 Hôpital Erasme, Department of Microbiology, Laboratoire de Référence MRSA-Staphylocoques,2 Hôpital des Enfants Reine Fabiola, Département de Maladies Infectieuses Pédiatriques,3 CHU Saint Pierre-Huderf-CHU Brugmann, Département Interhospitalier de Dermatologie, Université Libre de Bruxelles, Brussels, Belgium4
Received 26 August 2008/ Returned for modification 15 November 2008/ Accepted 17 January 2009
Small-colony variant (SCV) strains of Staphylococcus aureus show reduced antibiotic susceptibility and intracellular persistence, potentially explaining therapeutic failures. The activities of oxacillin, fusidic acid, clindamycin, gentamicin, rifampin, vancomycin, linezolid, quinupristin-dalfopristin, daptomycin, tigecycline, moxifloxacin, telavancin, and oritavancin have been examined in THP-1 macrophages infected by a stable thymidine-dependent SCV strain in comparison with normal-phenotype and revertant isogenic strains isolated from the same cystic fibrosis patient. The SCV strain grew slowly extracellularly and intracellularly (1- and 0.2-log CFU increase in 24 h, respectively). In confocal and electron microscopy, SCV and the normal-phenotype bacteria remain confined in acid vacuoles. All antibiotics tested, except tigecycline, caused a net reduction in bacterial counts that was both time and concentration dependent. At an extracellular concentration corresponding to the maximum concentration in human serum (total drug), oritavancin caused a 2-log CFU reduction at 24 h; rifampin, moxifloxacin, and quinupristin-dalfopristin caused a similar reduction at 72 h; and all other antibiotics had only a static effect at 24 h and a 1-log CFU reduction at 72 h. In concentration dependence experiments, response to oritavancin was bimodal (two successive plateaus of –0.4 and –3.1 log CFU); tigecycline, moxifloxacin, and rifampin showed maximal effects of –1.1 to –1.7 log CFU; and the other antibiotics produced results of –0.6 log CFU or less. Addition of thymidine restored intracellular growth of the SCV strain but did not modify the activity of antibiotics (except quinupristin-dalfopristin). All drugs (except tigecycline and oritavancin) showed higher intracellular activity against normal or revertant phenotypes than against SCV strains. The data may help rationalizing the design of further studies with intracellular SCV strains.
Published ahead of print on 2 February 2009.
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