Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populations

Treatment of staphylococcal infections is difficult due to multidrug resistance with their persister forms posing an added threat of recalcitrant infections. Antibiotic combinations are widely studied as an alternative strategy to combat them; therefore, they merit further investigation into their e...

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Main Authors: Ekta Kamble, Purva Sanghvi, Karishma Pardesi
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Biofilm
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2590207522000028
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author Ekta Kamble
Purva Sanghvi
Karishma Pardesi
author_facet Ekta Kamble
Purva Sanghvi
Karishma Pardesi
author_sort Ekta Kamble
collection DOAJ
description Treatment of staphylococcal infections is difficult due to multidrug resistance with their persister forms posing an added threat of recalcitrant infections. Antibiotic combinations are widely studied as an alternative strategy to combat them; therefore, they merit further investigation into their effect on the number of persister cells. In the present study, the fractional inhibitory concentrations of antibiotic combinations ciprofloxacin-daptomycin, ciprofloxacin-vancomycin, daptomycin-tobramycin, and tobramycin-vancomycin (checkerboard assay) were determined against two previously studied clinical (S48 and J6) and one standard (NCIM 5021) isolate of Staphylococcus aureus. They showed synergistic effects with a 2 to 256-fold reduction in MICs. All combinations also resulted in inhibition and disruption of biofilms in a concentration-dependent manner. All antibiotic combinations, except ciprofloxacin-daptomycin, showed total biofilm inhibition at 100X MICs. Similarly, antibiotic combination at 100X MIC showed 77–97% disruption of preformed biofilms. Time-kill assays performed at a 100X MIC combination against stationary-phase cells showed a two to six log10 reduction in CFU followed by a plateau indicating the presence of persisters. Significant differences were observed in persister cell fraction remaining after treatment with antibiotic combinations compared to monotherapies (p < 0.05) and therefore merit further investigation in clinical use for treatment against persisters.
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spelling doaj.art-f8da20ccfc0c4157bb45bc98c41f1ed72022-12-22T04:22:26ZengElsevierBiofilm2590-20752022-12-014100068Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populationsEkta Kamble0Purva Sanghvi1Karishma Pardesi2Department of Microbiology, Savitribai Phule Pune University, Ganeshkhind Road, Pune, 411 007, Maharashtra, IndiaDepartment of Microbiology, Savitribai Phule Pune University, Ganeshkhind Road, Pune, 411 007, Maharashtra, IndiaCorresponding author.; Department of Microbiology, Savitribai Phule Pune University, Ganeshkhind Road, Pune, 411 007, Maharashtra, IndiaTreatment of staphylococcal infections is difficult due to multidrug resistance with their persister forms posing an added threat of recalcitrant infections. Antibiotic combinations are widely studied as an alternative strategy to combat them; therefore, they merit further investigation into their effect on the number of persister cells. In the present study, the fractional inhibitory concentrations of antibiotic combinations ciprofloxacin-daptomycin, ciprofloxacin-vancomycin, daptomycin-tobramycin, and tobramycin-vancomycin (checkerboard assay) were determined against two previously studied clinical (S48 and J6) and one standard (NCIM 5021) isolate of Staphylococcus aureus. They showed synergistic effects with a 2 to 256-fold reduction in MICs. All combinations also resulted in inhibition and disruption of biofilms in a concentration-dependent manner. All antibiotic combinations, except ciprofloxacin-daptomycin, showed total biofilm inhibition at 100X MICs. Similarly, antibiotic combination at 100X MIC showed 77–97% disruption of preformed biofilms. Time-kill assays performed at a 100X MIC combination against stationary-phase cells showed a two to six log10 reduction in CFU followed by a plateau indicating the presence of persisters. Significant differences were observed in persister cell fraction remaining after treatment with antibiotic combinations compared to monotherapies (p < 0.05) and therefore merit further investigation in clinical use for treatment against persisters.http://www.sciencedirect.com/science/article/pii/S2590207522000028Drug combinationDrug toleranceBiofilmStaphylococcus aureus
spellingShingle Ekta Kamble
Purva Sanghvi
Karishma Pardesi
Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populations
Biofilm
Drug combination
Drug tolerance
Biofilm
Staphylococcus aureus
title Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populations
title_full Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populations
title_fullStr Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populations
title_full_unstemmed Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populations
title_short Synergistic effect of antibiotic combinations on Staphylococcus aureus biofilms and their persister cell populations
title_sort synergistic effect of antibiotic combinations on staphylococcus aureus biofilms and their persister cell populations
topic Drug combination
Drug tolerance
Biofilm
Staphylococcus aureus
url http://www.sciencedirect.com/science/article/pii/S2590207522000028
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AT karishmapardesi synergisticeffectofantibioticcombinationsonstaphylococcusaureusbiofilmsandtheirpersistercellpopulations