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- Bergsten, H. et al., 2021. Adjunctive rifampicin increases antibiotic efficacy in group A streptococcal tissue infection models. Antimicrob Agents Chemother
Bergsten, H. et al., 2021. Adjunctive rifampicin increases antibiotic efficacy in group A streptococcal tissue infection models. Antimicrob Agents Chemother
7th September 2021
Abstract
Objectives: Biofilm has recently been highlighted as a complicating feature of necrotizing soft tissue infections (NSTI) caused by Streptococcus pyogenes (i.e. group A streptococcus; GAS) contributing to a persistence of bacteria in tissue despite prolonged antibiotic therapy. Here we assessed the standard treatment of benzylpenicillin and clindamycin with or without rifampicin in a tissue-like setting.
Methods: Antibiotic efficacy was evaluated by colony forming units determination in a human organotypic skin model infected for 24 or 48 hours with GAS strains isolated from NSTI patients. Antibiotic effect was also evaluated by micro-calorimetric metabolic assessment in in vitro infections of cellular monolayers providing continuous measurements over time.
Results: Adjunctive rifampicin resulted in enhanced antibiotic efficacy of bacterial clearance in an organotypic skin tissue model: 97.5% vs. 93.9% (p=0.006). Through microcalorimetric measurements, adjunctive rifampicin resulted in decreased metabolic activity and extended lag phase for all clinical GAS strains tested (p<0.05). In addition, a case report is presented of adjunctive rifampicin treatment in an NSTI case with persistent GAS tissue infection.
Conclusion: The findings of this study demonstrate that adjunctive rifampicin enhances clearance of GAS biofilm in an in vitro tissue infection model.
Read more…
Objectives: Biofilm has recently been highlighted as a complicating feature of necrotizing soft tissue infections (NSTI) caused by Streptococcus pyogenes (i.e. group A streptococcus; GAS) contributing to a persistence of bacteria in tissue despite prolonged antibiotic therapy. Here we assessed the standard treatment of benzylpenicillin and clindamycin with or without rifampicin in a tissue-like setting.
Methods: Antibiotic efficacy was evaluated by colony forming units determination in a human organotypic skin model infected for 24 or 48 hours with GAS strains isolated from NSTI patients. Antibiotic effect was also evaluated by micro-calorimetric metabolic assessment in in vitro infections of cellular monolayers providing continuous measurements over time.
Results: Adjunctive rifampicin resulted in enhanced antibiotic efficacy of bacterial clearance in an organotypic skin tissue model: 97.5% vs. 93.9% (p=0.006). Through microcalorimetric measurements, adjunctive rifampicin resulted in decreased metabolic activity and extended lag phase for all clinical GAS strains tested (p<0.05). In addition, a case report is presented of adjunctive rifampicin treatment in an NSTI case with persistent GAS tissue infection.
Conclusion: The findings of this study demonstrate that adjunctive rifampicin enhances clearance of GAS biofilm in an in vitro tissue infection model.
Read more…
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