Format

Send to

Choose Destination
Nat Commun. 2019 Mar 8;10(1):1149. doi: 10.1038/s41467-019-09053-9.

In-host evolution of Staphylococcus epidermidis in a pacemaker-associated endocarditis resulting in increased antibiotic tolerance.

Author information

1
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
2
Antimicrobial Discovery Center, Department of Biology, Northeastern University, 02115, Boston, MA, USA.
3
Institute of Food, Nutrition and Health, ETH Zurich, 8092, Zurich, Switzerland.
4
Max Planck Institute for the Science of Human History, 07745, Jena, Germany.
5
Institute of Medical Microbiology, University of Zurich, 8006, Zurich, Switzerland.
6
Department of Cardiac Surgery, University Heart Center, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
7
Institute of Biogeochemistry and Pollutant Dynamics, ETH Zurich, 8092, Zurich, Switzerland.
8
Department of Environmental Microbiology, Eawag, 8600, Dübendorf, Switzerland.
9
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland. annelies.zinkernagel@usz.ch.

Abstract

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.

PMID:
30850614
PMCID:
PMC6408453
DOI:
10.1038/s41467-019-09053-9
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center