Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis

Autor: Hagen Frickmann, Claudia Maletzki, Bernd Kreikemeyer, Merit Krause, Gerhard Stropahl, Andreas E. Zautner, Andreas Podbielski, Silva Holtfreter, Hans Wilhelm Pau
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Adult
Male
Infectious Diseases/Epidemiology and Control of Infectious Diseases
Staphylococcus aureus
Adolescent
medicine.drug_class
Science
Tonsillitis
Antibiotics
Biology
medicine.disease_cause
Peritoneal Diseases
Surgery/Head and Neck Surgery
Microbiology
Infectious Diseases/Bacterial Infections
Antibiotic resistance
Gentamicin protection assay
Pulsed-field gel electrophoresis
medicine
Humans
Typing
Prospective Studies
Child
In Situ Hybridization
Fluorescence
Multidisciplinary
Infectious Diseases/Antimicrobials and Drug Resistance
Infectious Diseases/Respiratory Infections
Middle Aged
medicine.disease
Flow Cytometry
Respiratory Medicine/Respiratory Pediatrics
Immunohistochemistry
Abscess
Electrophoresis
Gel
Pulsed-Field
Treatment Outcome
Child
Preschool
Streptococcus pyogenes
Medicine
Female
Research Article
Zdroj: PLoS ONE, Vol 5, Iss 3, p e9452 (2010)
PLoS ONE
ISSN: 1932-6203
Popis: BackgroundThe two major indications for tonsillectomy are recurrent tonsillitis (RT) and peritonsillar abscess (PTA). Unlike PTAs, which are primarily treated surgically, RT is often cured by tonsillectomy only after a series of failed drug therapy attempts. Although the bacteriological background of RT has been studied, the reason for the lack of success of conservative therapeutic approaches is not well understood.MethodsIn a prospective study, tonsil specimens from 130 RT patients and 124 PTA patients were examined for the presence of extra- and intracellular bacteria using antibiotic protection assays. Staphylococcus aureus isolates from RT patients were characterized by pulsed-field gel electrophoresis (PFGE), spa-typing and MSCRAMM-gene-PCR. Their ability for biofilm formation was tested and their cell invasiveness was confirmed by a flow cytometric invasion assay (FACS), fluorescent in situ hybridization (FISH) and immunohistochemistry.FindingsS. aureus was the predominant species (57.7%) in RT patients, whereas Streptococcus pyogenes was most prevalent (20.2%) in PTA patients. Three different assays (FACS, FISH, antibiotic protection assay) showed that nearly all RT-associated S. aureus strains were located inside tonsillar cells. Correspondingly, the results of the MSCRAMM-gene-PCRs confirmed that 87% of these S. aureus isolates were invasive strains and not mere colonizers. Based upon PFGE analyses of genomic DNA and on spa-gene typing the vast majority of the S. aureus isolates belonged to different clonal lineages.ConclusionsOur results demonstrate that intracellular residing S. aureus is the most common cause of RT and indicate that S. aureus uses this location to survive the effects of antibiotics and the host immune response. A German translation of the Abstract is provided as supplementary material (Abstract S1).
Databáze: OpenAIRE
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