title: Tolerance of staphylococci to bactericidal antibiotics.
abstract: Antibiotic therapy for deep-seated staphylococcal infections, especially when they are associated with artificial devices used for orthopedic surgery is often associated with failure. Standard anti-staphylococcal bactericidal antibiotics, such as semi-synthetic penicillins, cephalosporins, or glycopeptides, are effective when given prophylactically in clinical conditions or experimental trials of implant-related infections. However, the efficacy of all anti-staphylococcal agents is seriously diminished on already established implant-related deep-seated infections, which then frequently require surgical implant removal to obtain a cure. The failure of antibiotic therapy to cure established staphylococcal foreign-body infections may arise in part from a broad-spectrum phenotypic tolerance expressed in vivo to different classes of antimicrobial agents. The molecular and physiological mechanisms of this in vivo tolerance remain poorly understood.
authors.affiliation: Abteilung für Infektionskrankheiten, Universitätsklinikum Genf (HUG), Genf, Switzerland. pierre.vaudaux@hcuge.ch
authors.forename: Pierre
authors.initials: P
authors.lastname: Vaudaux
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Lew
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004195:Disease Models, Animal; D024881:Drug Resistance, Bacterial; D006168:Guinea Pigs; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects; D019736:Prostheses and Implants / Q000009:adverse effects; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D051381:Rats; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013210:Staphylococcus / Q000187:drug effects* / Q000472:pathogenicity; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents