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Efficacy assessment of a novel endolysin PlyAZ3aT for the treatment of ceftriaxone-resistant pneumococcal meningitis in an infant rat model.
Valente, Luca G; Le, Ngoc Dung; Pitton, Melissa; Chiffi, Gabriele; Grandgirard, Denis; Jakob, Stephan M; Cameron, David R; Resch, Grégory; Que, Yok-Ai; Leib, Stephen L.
Afiliação
  • Valente LG; Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
  • Le ND; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Pitton M; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
  • Chiffi G; Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
  • Grandgirard D; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
  • Jakob SM; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Cameron DR; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
  • Resch G; Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
  • Que YA; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.
  • Leib SL; Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
PLoS One ; 17(4): e0266928, 2022.
Article em En | MEDLINE | ID: mdl-35472061
ABSTRACT

BACKGROUND:

Treatment failure in pneumococcal meningitis due to antibiotic resistance is an increasing clinical challenge and alternatives to antibiotics warrant investigation. Phage-derived endolysins efficiently kill gram-positive bacteria including multi-drug resistant strains, making them attractive therapeutic candidates. The current study assessed the therapeutic potential of the novel endolysin PlyAZ3aT in an infant rat model of ceftriaxone-resistant pneumococcal meningitis.

METHODS:

Efficacy of PlyAZ3aT was assessed in a randomized, blinded and controlled experimental study in infant Wistar rats. Meningitis was induced by intracisternal infection with 5 x 107 CFU/ml of a ceftriaxone-resistant clinical strain of S. pneumoniae, serotype 19A. Seventeen hours post infection (hpi), animals were randomized into 3 treatment groups and received either (i) placebo (phosphate buffered saline [PBS], n = 8), (ii) 50 mg/kg vancomycin (n = 10) or (iii) 400 mg/kg PlyAZ3aT (n = 8) via intraperitoneal injection. Treatments were repeated after 12 h. Survival at 42 hpi was the primary outcome; bacterial loads in cerebrospinal fluid (CSF) and blood were secondary outcomes. Additionally, pharmacokinetics of PlyAZ3aT in serum and CSF was assessed.

RESULTS:

PlyAZ3aT did not improve survival compared to PBS, while survival for vancomycin treated animals was 70% which is a significant improvement when compared to PBS or PlyAZ3aT (p<0.05 each). PlyAZ3aT was not able to control the infection, reflected by the inability to reduce bacterial loads in the CSF, whereas Vancomycin sterilized the CSF and within 25 h. Pharmacokinetic studies indicated that PlyAZ3aT did not cross the blood brain barrier (BBB). In support, PlyAZ3aT showed a peak concentration of 785 µg/ml in serum 2 h after intraperitoneal injection but could not be detected in CSF.

CONCLUSION:

In experimental pneumococcal meningitis, PlyAZ3aT failed to cure the infection due to an inability to reach the CSF. Optimization of the galenic formulation e.g. using liposomes might enable crossing of the BBB and improve treatment efficacy.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Meningite Pneumocócica Limite: Animals Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Meningite Pneumocócica Limite: Animals Idioma: En Ano de publicação: 2022 Tipo de documento: Article