Clindamycin Affects Group A Streptococcus Virulence Factors and Improves Clinical Outcome.
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Andreoni F
Division of Infectious Diseases and Hospital Epidemiology.
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Zürcher C
Division of Infectious Diseases and Hospital Epidemiology.
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Tarnutzer A
Division of Infectious Diseases and Hospital Epidemiology.
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Schilcher K
Division of Infectious Diseases and Hospital Epidemiology.
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Neff A
Division of Infectious Diseases and Hospital Epidemiology.
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Keller N
Division of Infectious Diseases and Hospital Epidemiology.
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Marques Maggio E
Division of Clinical Pathology.
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Poyart C
Centre national de référence des Streptocoques, INSERM 1016, Université Paris Descartes, France.
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Schuepbach RA
Division of Surgical Intensive Care, University Hospital Zurich, University of Zurich, Switzerland.
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Zinkernagel AS
Division of Infectious Diseases and Hospital Epidemiology.
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Published in:
- The Journal of infectious diseases. - 2017
English
Group A Streptococcus (GAS) has acquired an arsenal of virulence factors, promoting life-threatening invasive infections such as necrotizing fasciitis. Current therapeutic regimens for necrotizing fasciitis include surgical debridement and treatment with cell wall-active antibiotics. Addition of clindamycin (CLI) is recommended, although clinical evidence is lacking. Reflecting the current clinical dilemma, an observational study showed that only 63% of the patients with severe invasive GAS infection received CLI. This work thus aimed to address whether CLI improves necrotizing fasciitis outcome by modulating virulence factors of CLI-susceptible and CLI-resistant GAS in vitro and in vivo. Treatment with CLI reduced extracellular DNase Sda1 and streptolysin O (SLO) activity in vivo, whereas subinhibitory CLI concentrations induced expression and activity of SLO, DNase, and Streptococcus pyogenes cell envelope protease in vitro. Our in vivo results suggest that CLI should be administered as soon as possible to patients with necrotizing fasciitis, while our in vitro studies emphasize that a high dosage of CLI is essential.
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Language
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Open access status
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bronze
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Persistent URL
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https://sonar.ch/global/documents/9500
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