Co-therapy using lytic bacteriophage and linezolid: effective treatment in eliminating methicillin resistant Staphylococcus aureus (MRSA) from diabetic foot infections.
Co-therapy using lytic bacteriophage and linezolid: effective treatment in eliminating methicillin resistant Staphylococcus aureus (MRSA) from diabetic foot infections.
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DOI：
10.1371/journal.pone.0056022
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Sandeep Kaur
中科院分区：
文献类型：
--
作者：
Chhibber S;Kaur T;Sandeep Kaur
金黄色葡萄球菌仍然是糖尿病足感染的主要病原体，耐甲氧西林金黄色葡萄球菌(MRSA)菌株的流行使情况进一步复杂化。在感染的足部溃疡中，MRSA的发生率为15%-30%，在许多国家，MRSA的增加趋势令人担忧。糖尿病是一种免疫抑制状态，降低了身体的整体免疫功能，使情况变得更糟的是，耐药菌株造成的伤口在糖尿病患者中是病态的组合。由耐甲氧西林金黄色葡萄球菌引起的足部感染与截肢风险增加、住院时间延长、费用增加和感染相关死亡率增加有关。因此，需要更新、更安全、更有效的治疗策略来治疗MRSA介导的糖尿病足感染。本研究的重点是联合使用裂解噬菌体和利奈唑胺作为糖尿病人群足部感染的有效治疗策略。用四氧嘧啶诱导的糖尿病BALB/c小鼠建立了金黄色葡萄球菌ATCC 43300急性感染模型。在糖尿病小鼠后足部感染的治疗过程中，单独和联合利奈唑胺对MR-10的治疗效果进行了评估，MR-10具有广泛的宿主范围。并对创面愈合过程进行了研究。在解决糖尿病动物后爪感染的过程中，单次给药噬菌体显示出与利奈唑胺类似的效果。然而，使用这两种药物的联合治疗在阻止整个感染过程(细菌负荷、病变评分、足髓过氧化物酶活性和组织病理学分析)方面要有效得多。组织愈合的整个过程也被加速了。已知联合用药可减少耐药突变的出现频率，因此该方法可作为治疗对常规抗生素治疗无效的MRSA介导的糖尿病患者足部感染的有效策略。
Staphylococcus aureus remains the predominant pathogen in diabetic foot infections and prevalence of methicillin resistant S.aureus (MRSA) strains further complicates the situation. The incidence of MRSA in infected foot ulcers is 15–30% and there is an alarming trend for its increase in many countries. Diabetes acts as an immunosuppressive state decreasing the overall immune functioning of body and to worsen the situation, wounds inflicted with drug resistant strains represent a morbid combination in diabetic patients. Foot infections caused by MRSA are associated with an increased risk of amputations, increased hospital stay, increased expenses and higher infection-related mortality. Hence, newer, safer and effective treatment strategies are required for treating MRSA mediated diabetic foot infections. The present study focuses on the use of lytic bacteriophage in combination with linezolid as an effective treatment strategy against foot infection in diabetic population. Acute hindpaw infection with S.aureus ATCC 43300 was established in alloxan induced diabetic BALB/c mice. Therapeutic efficacy of a well characterized broad host range lytic bacteriophage, MR-10 was evaluated alone as well as in combination with linezolid in resolving the course of hindpaw foot infection in diabetic mice. The process of wound healing was also investigated. A single administration of phage exhibited efficacy similar to linezolid in resolving the course of hindpaw infection in diabetic animals. However, combination therapy using both the agents was much more effective in arresting the entire infection process (bacterial load, lesion score, foot myeloperoxidase activity and histopathological analysis). The entire process of tissue healing was also hastened. Use of combined agents has been known to decrease the frequency of emergence of resistant mutants, hence this approach can serve as an effective strategy in treating MRSA mediated foot infections in diabetic individuals who do not respond to conventional antibiotic therapy.
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影响因子：
4.2
作者：
Bull, J. J.;Levin, Bruce R.;DeRouin, Terry;Walker, Nina;Bloch, Craig A.
通讯作者：
Bloch, Craig A.
影响因子：
4.1
作者：
Bedi, Manmeet Sakshi;Verma, Vivek;Chhibber, Sanjay
通讯作者：
Chhibber, Sanjay
影响因子：
4.4
作者：
Chang, HC;Chen, CR;Weng, SF
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Weng, SF
影响因子：
2.8
作者：
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通讯作者：
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影响因子：
4.9
作者：
Capparelli, Rosanna;Parlato, Marianna;Iannelli, Domenico
通讯作者：
Iannelli, Domenico