In-host evolution of Staphylococcus epidermidis in a pacemaker-associated endocarditis resulting in increased antibiotic tolerance.
- Dengler Haunreiter V Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Boumasmoud M Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Häffner N Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Wipfli D Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Leimer N Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Rachmühl C Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Kühnert D Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Achermann Y Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Zbinden R Institute of Medical Microbiology, University of Zurich, 8006, Zurich, Switzerland.
- Benussi S Department of Cardiac Surgery, University Heart Center, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
- Vulin C Institute of Biogeochemistry and Pollutant Dynamics, ETH Zurich, 8092, Zurich, Switzerland.
- Zinkernagel AS Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland. annelies.zinkernagel@usz.ch.
- 2019-03-10
Published in:
- Nature communications. - 2019
Adult
Anti-Bacterial Agents
Bacteremia
Bacterial Proteins
Biofilms
Drug Resistance, Multiple
Drug Tolerance
Endocarditis
Evolution, Molecular
Fluoroquinolones
Glycopeptides
Host-Pathogen Interactions
Humans
INDEL Mutation
Male
Microbial Sensitivity Tests
Pacemaker, Artificial
Peptides, Cyclic
Phylogeny
Polymorphism, Single Nucleotide
Staphylococcal Infections
Staphylococcus epidermidis
beta-Lactams
English
Treatment failure in biofilm-associated bacterial infections is an important healthcare issue. In vitro studies and mouse models suggest that bacteria enter a slow-growing/non-growing state that results in transient tolerance to antibiotics in the absence of a specific resistance mechanism. However, little clinical confirmation of antibiotic tolerant bacteria in patients exists. In this study we investigate a Staphylococcus epidermidis pacemaker-associated endocarditis, in a patient who developed a break-through bacteremia despite taking antibiotics to which the S. epidermidis isolate is fully susceptible in vitro. Characterization of the clinical S. epidermidis isolates reveals in-host evolution over the 16-week infection period, resulting in increased antibiotic tolerance of the entire population due to a prolonged lag time until growth resumption and a reduced growth rate. Furthermore, we observe adaptation towards an increased biofilm formation capacity and genetic diversification of the S. epidermidis isolates within the patient.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1038/s41467-019-09053-9
- PMID 30850614
- Persistent URL
- https://sonar.ch/global/documents/185262
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