Phenotypic antibiotic tolerance of Staphylococcus aureus in implant-related infections: relationship with in vitro colonization of artificial surfaces.
Antibiotic therapy of deep-seated staphylococcal infections, especially when they are associated with foreign implants, such as orthopedic prostheses and permanently inserted catheters, is a difficult challenge. Semi-synthetic penicillins, glycopeptides and quinolones are found effective when given prophylactically in clinical and experimental trials of implant-related infections, but are frequently poorly effective after implant-related infections are established. Thus, removal of the medical devices is often required to obtain cure. The failure of antibiotic therapy to cure staphylococcal foreign body infections may arise from a broad-spectrum phenotypic tolerance to different classes of antimicrobial agents, whose molecular basis and physiological mechanisms are poorly understood.
Vaudaux
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P
Division of Infectious Diseases, Department of Medicine, University Hospitals of Geneva, CH-1211 Geneva 14, Switzerland. vaudaux@dminovl.heuge.ch