title: Effect of daptomycin on local interleukin-6, matrix metalloproteinase-9, and metallopeptidase inhibitor 1 in patients with MRSA-infected diabetic foot.
abstract: Infection is a major cause of the diabetic foot syndrome being aggravating by the increased burden of multiresistant germs like methicillin-resistant Staphylococcus aureus (MRSA). Maximizing positive outcome for serious MRSA infections requires an aggressive treatment approach and a careful monitoring of the healing process. Therefore, we examined 8 patients with MRSA-infected diabetic foot syndrome Wagner classification grades 2 or 3 (corresponding to the Texas classification stage 2 and 3) during antibiotic treatment with daptomycin. We documented the wound size and obtained samples of wound secretion for analyses of pro-inflammatory interleukin-6 (IL-6), protease (matrix metalloproteinase-9 [MMP-9]), and antiprotease activity (metallopeptidase inhibitor 1 [TIMP-1]). During the course of anti-MRSA therapy, a decrease in the concentration of local IL-6 within the first 3 days followed by a drop of MMP-9 and an increase of TIMP-1 was observed. Finally, a reduction of wound size could be documented. The present data show that efficient antimicrobial treatment with daptomycin leads to a number of beneficial processes at the molecular level of wound healing in MRSA-infected diabetic foot ulcers.
authors.affiliation: Institute of Laboratory Medicine, Microbiology and Hygiene, Regensburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ambrosch
authors.forename: Daniel
authors.initials: D
authors.lastname: Halevy
authors.forename: Boushra
authors.initials: B
authors.lastname: Fwity
authors.forename: Thomas
authors.initials: T
authors.lastname: Brin
authors.forename: Ralf
authors.initials: R
authors.lastname: Lobmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D017576:Daptomycin / Q000494:pharmacology* / Q000627:therapeutic use; D017719:Diabetic Foot / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000187:drug effects; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010865:Pilot Projects; D013203:Staphylococcal Infections / Q000188:drug therapy*; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D015850:Interleukin-6; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; D020780:Matrix Metalloproteinase 9; D017576:Daptomycin
keywords: MMP-9; MRSA; TIMP-1; daptomycin; diabetic foot