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In-host evolution of Staphylococcus epidermidis in a pacemaker-associated endocarditis resulting in increased antibiotic tolerance

Author

Listed:
  • Vanina Dengler Haunreiter

    (University Hospital Zurich, University of Zurich)

  • Mathilde Boumasmoud

    (University Hospital Zurich, University of Zurich)

  • Nicola Häffner

    (University Hospital Zurich, University of Zurich)

  • Dennis Wipfli

    (University Hospital Zurich, University of Zurich)

  • Nadja Leimer

    (University Hospital Zurich, University of Zurich
    Northeastern University)

  • Carole Rachmühl

    (University Hospital Zurich, University of Zurich
    Institute of Food, Nutrition and Health, ETH Zurich)

  • Denise Kühnert

    (University Hospital Zurich, University of Zurich
    Max Planck Institute for the Science of Human History)

  • Yvonne Achermann

    (University Hospital Zurich, University of Zurich)

  • Reinhard Zbinden

    (University of Zurich)

  • Stefano Benussi

    (University Heart Center, University Hospital Zurich, University of Zurich)

  • Clement Vulin

    (Institute of Biogeochemistry and Pollutant Dynamics, ETH Zurich
    Department of Environmental Microbiology, Eawag)

  • Annelies S. Zinkernagel

    (University Hospital Zurich, University of Zurich)

Abstract

Treatment failure in biofilm-associated bacterial infections is an important healthcare issue. In vitro studies and mouse models suggest that bacteria enter a slow-growing/non-growing state that results in transient tolerance to antibiotics in the absence of a specific resistance mechanism. However, little clinical confirmation of antibiotic tolerant bacteria in patients exists. In this study we investigate a Staphylococcus epidermidis pacemaker-associated endocarditis, in a patient who developed a break-through bacteremia despite taking antibiotics to which the S. epidermidis isolate is fully susceptible in vitro. Characterization of the clinical S. epidermidis isolates reveals in-host evolution over the 16-week infection period, resulting in increased antibiotic tolerance of the entire population due to a prolonged lag time until growth resumption and a reduced growth rate. Furthermore, we observe adaptation towards an increased biofilm formation capacity and genetic diversification of the S. epidermidis isolates within the patient.

Suggested Citation

  • Vanina Dengler Haunreiter & Mathilde Boumasmoud & Nicola Häffner & Dennis Wipfli & Nadja Leimer & Carole Rachmühl & Denise Kühnert & Yvonne Achermann & Reinhard Zbinden & Stefano Benussi & Clement Vul, 2019. "In-host evolution of Staphylococcus epidermidis in a pacemaker-associated endocarditis resulting in increased antibiotic tolerance," Nature Communications, Nature, vol. 10(1), pages 1-14, December.
    • Handle: RePEc:nat:natcom:v:10:y:2019:i:1:d:10.1038_s41467-019-09053-9
    DOI: 10.1038/s41467-019-09053-9
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    Cited by:

    1. Erica J. Zheng & Ian W. Andrews & Alexandra T. Grote & Abigail L. Manson & Miguel A. Alcantar & Ashlee M. Earl & James J. Collins, 2022. "Modulating the evolutionary trajectory of tolerance using antibiotics with different metabolic dependencies," Nature Communications, Nature, vol. 13(1), pages 1-11, December.

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