Cryptic susceptibility to penicillin/β-lactamase inhibitor combinations in emerging multidrug-resistant, hospital-adapted Staphylococcus epidermidis lineages

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  • Xiaoliang Ba
  • Claire L. Raisen
  • Olivier Restif
  • Lina Maria Cavaco
  • Carina Vingsbo Lundberg
  • Jean Y.H. Lee
  • Benjamin P. Howden
  • Bartels, Mette Damkjær
  • Birgit Strommenger
  • Ewan M. Harrison
  • Anders Rhod Larsen
  • Mark A. Holmes
  • Jesper Larsen
Global spread of multidrug-resistant, hospital-adapted Staphylococcus epidermidis lineages underscores the need for new therapeutic strategies. Here we show that many S. epidermidis isolates belonging to these lineages display cryptic susceptibility to penicillin/β-lactamase inhibitor combinations under in vitro conditions, despite carrying the methicillin resistance gene mecA. Using a mouse thigh model of S. epidermidis infection, we demonstrate that single-dose treatment with amoxicillin/clavulanic acid significantly reduces methicillin-resistant S. epidermidis loads without leading to detectable resistance development. On the other hand, we also show that methicillin-resistant S. epidermidis is capable of developing increased resistance to amoxicillin/clavulanic acid during long-term in vitro exposure to these drugs. These findings suggest that penicillin/β-lactamase inhibitor combinations could be a promising therapeutic candidate for treatment of a high proportion of methicillin-resistant S. epidermidis infections, although the in vivo risk of resistance development needs to be further addressed before they can be incorporated into clinical trials.
OriginalsprogEngelsk
Artikelnummer6479
TidsskriftNature Communications
Vol/bind14
Udgave nummer1
Antal sider12
ISSN2041-1723
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This work was supported by the Wellcome Trust under Grant 220540/Z/20/A (E.M.H.). We thank Frederikke Rosenborg Petersen and Emilie Due Jensen for technical assistance during the animal experiments.

Publisher Copyright:
© 2023, Springer Nature Limited.

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