Failures in clinical treatment of Staphylococcus aureus infection with daptomycin are associated with alterations in surface charge, membrane phospholipid asymmetry, and drug binding

被引:257
作者
Jones, Tiffanny [1 ]
Yeaman, Michael R. [1 ,2 ,3 ]
Sakoulas, George [4 ]
Yang, Soo-Jin [1 ]
Proctor, Richard A. [5 ,6 ,7 ]
Sahl, Hans-Georg [8 ]
Schrenzel, Jacques [9 ]
Xiong, Yan Q. [1 ,2 ,3 ]
Bayer, Arnold S. [1 ,2 ,3 ]
机构
[1] Harbor UCLA, LA Biomed Res Inst, Torrance, CA 90502 USA
[2] Harbor UCLA, Med Ctr, Dept Med, Div Infect Dis, Torrance, CA 90502 USA
[3] Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA
[4] New York Med Coll, Dept Med Infect Dis, Valhalla, NY 10595 USA
[5] Univ Wisconsin, Dept Microbiol, Madison, WI USA
[6] Univ Wisconsin, Dept Immunol, Madison, WI USA
[7] Univ Wisconsin, Dept Med, Madison, WI USA
[8] Univ Bonn, Dept Med Microbiol & Immunol, D-5300 Bonn, Germany
[9] Univ Hosp, Dept Internal Med, Geneva, Switzerland
关键词
D O I
10.1128/AAC.00719-07
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Increasingly frequent reports have described the in vivo loss of daptomycin susceptibility in association with clinical treatment failures. The mechanism(s) of daptomycin resistance is not well understood. We studied an isogenic set of Staphylococcus aureus isolates from the bloodstream of a daptomycin-treated patient with recalcitrant endocarditis in which serial strains exhibited decreasing susceptibility to daptomycin. Since daptomycin is a membrane-targeting lipopeptide, we compared a number of membrane parameters in the initial blood isolate (parental) with those in subsequent daptomycin-resistant strains obtained during treatment. In comparison to the parental strain, resistant isolates demonstrated (i) enhanced membrane fluidity, (ii) increased translocation of the positively charged phospholipid lysyl-phosphotidylglycerol to the outer membrane leaflet, (iii) increased net positive surface charge (P < 0.05 versus the parental strain), (iv) reduced susceptibility to daptomycin-induced depolarization, permeabilization, and autolysis (P < 0.05 versus the parental strain), (v) significantly lower surface binding of daptomycin (P < 0.05 versus the parental strain), and (vi) increased cross-resistance to the cationic antimicrobial host defense peptides human neutrophil peptide 1 (hNP-1) and thrombin-induced platelet microbicidal protein 1 (tPMP-1). These data link distinct changes in membrane structure and function with in vivo development of daptomycin resistance in S. aureus. Moreover, the cross-resistance to hNP-1 and tPMP-1 may also impact the capacity of these daptomycin-resistant organisms to be cleared from sites of infection, particularly endovascular foci.
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页码:269 / 278
页数:10
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