Dalbavancin reduces biofilms of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE)

Knafl, Daniela; Tobudic, Selma; Cheng, Serena; Bellamy, D. R.; Thalhammer, Florian

doi:10.1007/s10096-016-2845-z

Cited by 51 publications

(24 citation statements)

References 11 publications

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“…The management of bone and joint infection or of patients with chronic SSTI is very complex due to the biofilm life of bacteria and clinical success can only be achieved by source control in most cases [22]. Recently, high in vitro activity of dalbavancin against MRSA, MRSE and enterococcal biofilms was reported [23,24]. However, in the present study, treatment success was particularly low in MRSA infections.…”

Section: Discussionmentioning

confidence: 55%

Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection

et al. 2019

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Purpose Dalbavancin is a novel lipoglycopeptide with potent activity against several gram-positive pathogens, an excellent safety profile and a long elimination half-life. Methods In this case series observed at the University Hospital of Vienna between 2015 and 2017, all adult patients with gram-positive infections who received at least one dosage of dalbavancin were screened (n = 118). A total of 72 patients were included in the final analysis. The number of included patients stratified by the source of infection was: skin and soft tissue infection (SSTI) (n = 26), osteomyelitis (n = 20), spondylodiscitis (n = 14), acute septic arthritis (n = 4) and prosthetic joint infection (n = 8).Results In 46 patients (64%), clinical cure was detected at the end of dalbavancin therapy without additional antibiotic therapy. Of the 26 patients who received additional antibiotic therapy other than dalbavancin, 15 patients (21%) showed no clinical improvement under dalbavancin therapy, four patients (5%) had side effects (nausea n = 1, exanthema n = 2, hyperglycemia n = 1), and in seven patients (10%) clinical improvement under dalbavancin therapy was detected but antibiotic therapy was de-escalated to an oral drug. Conclusion We demonstrated high clinical effectiveness of dalbavancin for acute gram-positive infections primarily acute SSTI, acute septic arthritis, acute osteomyelitis and spondylodiscitis. In patients with biofilm-associated infection (chronic infection or joint prosthesis), source control was absolutely necessary for treatment success.

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Section: Discussionmentioning

confidence: 55%

Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection

et al. 2019

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“… Both dalbavancin and oritavancin have shown promising in vitro activity against stationary‐phase and biofilm‐producing S. aureus isolates, including many isolates from prosthetic joint infections, highlighting a potential role in the treatment of hardware‐related infections, which in the case of oritavancin include VRE 57–60 . Although, other antibiotics (e.g., daptomycin, ceftaroline, and telavancin) with similar activity may have more potent biofilm activity 60 …”

Section: Considerations For Selection Of Dalbavancin Versus Oritavancinmentioning

confidence: 99%

Advantages of Outpatient Treatment with Long‐Acting Lipoglycopeptides for Serious Gram‐Positive Infections: A Review

et al. 2020

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Treatment of serious gram-positive infections presents multiple challenges. Treatment often results in prolonged hospitalization for administration of intravenous antimicrobials and presents an inefficient use of hospital resources. Prolonged hospitalization is typically also unfavorable to patient preferences and potentially subjects patients to additional health care-associated complications. Current strategies of transition to outpatient settings-outpatient parenteral antimicrobial therapy and use of oral antibiotics-often do not adequately serve vulnerable populations for whom there is often no alternative to inpatient therapy. Specifically, people who use drugs, those who cannot reliably adhere to unsupervised treatment (poor mental or physical health), people with complicating life circumstances (e.g., homelessness, incarceration, rural location), and those with inadequate health insurance remain hospitalized for weeks longer than persons without such conditions. We suspected that long-acting lipoglycopeptides (laLGP), such as dalbavancin and oritavancin, may be useful in patient transitions to outpatient settings. Thus, we conducted a search of the peer-reviewed literature using the PubMed, Google Scholar, and MEDLINE databases. Based on accumulating literature, it appears that laLGPs offer a reliable alternative therapeutic strategy that addresses many of the personal and systemic barriers to the traditional transitioning approaches. Current evidence also suggests that these agents may be cost-effective from patient, payer, and hospital perspectives. Barriers to broader use of laLGPs include, among others, a relative lack of prospective data regarding efficacy in serious infections, a narrow United States Food and Drug Administration-approved indication restricted to only acute bacterial skin and skin structure infections, and lack of reimbursement infrastructure for inpatient settings.

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“…Dalbavancin has already been described as an antibiotic with a potent in vitro bactericidal activity against many gram-positive pathogens, including MRSA and MRSE, in a planktonic mode of growth (Chen et al, 2007). However, the effect of dalbavancin on bacterial biofilms remains unclear as it has only been tested in a few occasions by using standard methods such as CV staining or MIC determinations (Fernández et al, 2016;Knafl et al, 2017). The impedance-based method performed in the current manuscript allows studying of the dynamics of biofilm formation and therefore the extent of biofilm reduction at different time points, obviating the need to select for a specific endpoint (Ferrer et al, 2017b).…”

Section: Discussionmentioning

confidence: 99%

“…Although dalbavancin has been proposed as a promising agent in biofilm-mediated infections, susceptibility to this antibiotic has mainly been tested using traditional microbiological tests such as microdilution or agar-based tests. However, it is well established that bacteria behave differently in a planktonic state or when forming biofilms, and there is currently limited information on its efficacy on biofilm-embedded bacteria, with only a few studies available (Meeker et al, 2016;Knafl et al, 2017;Di Pilato et al, 2020), some of them in animal models (Darouiche and Mansouri, 2005;Baldoni et al, 2013). In some cases, the efficacy of dalbavancin or vancomycin has been shown to be low, with less than an order-of-magnitude decrease in viable counts of staphylococci (Kussmann et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Effect of Dalbavancin on Staphylococcal Biofilms When Administered Alone or in Combination With Biofilm-Detaching Compounds

et al. 2020

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Microorganisms grown in biofilms are more resistant to antimicrobial treatment and immune system attacks compared to their planktonic forms. In fact, infections caused by biofilm-forming Staphylococcus aureus and Staphylococcus epidermidis are a large threat for public health, including patients with medical devices. The aim of the current manuscript was to test the effect of dalbavancin, a recently developed lipoglycopeptide antibiotic, alone or in combination with compounds contributing to bacterial cell disaggregation, on staphylococcal biofilm formation and elimination. We used realtime impedance measurements in microtiter plates to study biofilm growth dynamics of S. aureus and S. epidermidis strains, in the absence or presence of dalbavancin, linezolid, vancomycin, cloxacillin, and rifampicin. Further experiments were undertaken to check whether biofilm-detaching compounds such as N-acetylcysteine (NAC) and ficin could enhance dalbavancin efficiency. Real-time dose-response experiments showed that dalbavancin is a highly effective antimicrobial, preventing staphylococcal biofilm formation at low concentrations. Minimum biofilm inhibitory concentrations were up to 22 higher compared to standard E-test values. Dalbavancin was the only antimicrobial that could halt new biofilm formation on established biofilms compared to the other four antibiotics. The addition of NAC decreased dalbavancin efficacy while the combination of dalbavancin with ficin was more efficient than antibiotic alone in preventing growth once the biofilm was established. Results were confirmed by classical biofilm quantification methods such as crystal violet (CV) staining and viable colony counting. Thus, our data support the use of dalbavancin as a promising antimicrobial to treat biofilm-related infections. Our data also highlight that synergistic and antagonistic effects between antibiotics and biofilm-detaching compounds should be carefully tested in order to achieve an efficient treatment that could prevent both biofilm formation and disruption.

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Dalbavancin reduces biofilms of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE)

Cited by 51 publications

References 11 publications

Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection

Real-world experience with dalbavancin therapy in gram-positive skin and soft tissue infection, bone and joint infection

Advantages of Outpatient Treatment with Long‐Acting Lipoglycopeptides for Serious Gram‐Positive Infections: A Review

Effect of Dalbavancin on Staphylococcal Biofilms When Administered Alone or in Combination With Biofilm-Detaching Compounds

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