Drug Combinations against Borrelia burgdorferi Persisters In Vitro: Eradication Achieved by Using Daptomycin, Cefoperazone and Doxycycline.

April 4, 2015 at 7:16 pm

PLoS One. 2015 Mar 25;10(3):e0117207.

Feng J1, Auwaerter PG2, Zhang Y1.

1Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.

2Fisher Center for Environmental Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America.

Abstract

Although most Lyme disease patients can be cured with antibiotics doxycycline or amoxicillin using 2-4 week treatment durations, some patients suffer from persistent arthritis or post-treatment Lyme disease syndrome.

Why these phenomena occur is unclear, but possibilities include host responses, antigenic debris, or B. burgdorferi organisms remaining despite antibiotic therapy.

In vitro, B. burgdorferi developed increasing antibiotic tolerance as morphology changed from typical spirochetal form in log phase growth to variant round body and microcolony forms in stationary phase.

B. burgdorferi appeared to have higher persister frequencies than E. coli as a control as measured by SYBR Green I/propidium iodide (PI) viability stain and microscope counting.

To more effectively eradicate the different persister forms tolerant to doxycycline or amoxicillin, drug combinations were studied using previously identified drugs from an FDA-approved drug library with high activity against such persisters.

Using a SYBR Green/PI viability assay, daptomycin-containing drug combinations were the most effective.

Of studied drugs, daptomycin was the common element in the most active regimens when combined with doxycycline plus either beta-lactams (cefoperazone or carbenicillin) or an energy inhibitor (clofazimine).

Daptomycin plus doxycycline and cefoperazone eradicated the most resistant microcolony form of B. burgdorferi persisters and did not yield viable spirochetes upon subculturing, suggesting durable killing that was not achieved by any other two or three drug combinations.

These findings may have implications for improved treatment of Lyme disease, if persistent organisms or detritus are responsible for symptoms that do not resolve with conventional therapy.

Further studies are needed to validate whether such combination antimicrobial approaches are useful in animal models and human infection.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4373819/pdf/pone.0117207.pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Infecciones en piel y tej blandos, Infecciones osteo-articulares-musculares, Infecciones respiratorias, Medicina del viajero, Metodos diagnosticos, Sepsis, Update. Tags: .

Repeat or persistent Lyme disease: persistence, recrudescence or reinfection with Borrelia Burgdorferi? Rapid urine antigen testing for Streptococcus pneumoniae in adults with community-acquired pneumonia: clinical use and barriers.


Calendar

April 2015
M T W T F S S
« Mar   May »
 12345
6789101112
13141516171819
20212223242526
27282930  

Most Recent Posts


%d bloggers like this: