Staphylococcal bacteria are a prevalent cause of infections associated with foreign bodies and indwelling medical devices. Bacteria are capable of escaping antibiotic treatment through encapsulation into biofilms. RNA III-inhibiting peptide (RIP) is a heptapeptide that inhibits staphylococcal biofilm formation by obstructing quorum-sensing mechanisms. K 4 -S4(1-13) a is a 13-residue dermaseptin derivative (DD 13 ) believed to kill bacteria via membrane disruption. We tested each of these peptides as well as a hybrid construct, DD 13 -RIP, for their ability to inhibit bacterial proliferation and suppress quorum sensing in vitro and for their efficacy in preventing staphylococcal infection in a rat graft infection model with methicillin-resistant Staphylococcus aureus (MRSA) or S. epidermidis (MRSE). In vitro, proliferation assays demonstrated that RIP had no inhibitory effect, while DD 13 -RIP and DD 13 were equally effective, and that the chimeric peptide but not DD 13 was slightly more effective than RIP in inhibiting RNA III synthesis, a regulatory RNA molecule important for staphylococcal pathogenesis. In vivo, the three peptides reduced graft-associated bacterial load in a dosedependent manner, but the hybrid peptide was most potent in totally preventing staphylococcal infections at the lowest dose. In addition, each of the peptides acted synergistically with antibiotics. The data indicate that RIP and DD 13 act in synergy by attacking bacteria simultaneously by two different mechanisms. Such a chimeric peptide may be useful for coating medical devices to prevent drug-resistant staphylococcal infections.
Nosocomial infections due to Staphylococcus aureus andStaphylococcus epidermidis have increased over the last decades (36, 41, 42). These common skin bacteria are also known to be a frequent cause of infections related to prosthetic and indwelling medical devices (16,46), where these infections are related to bacterial biofilm formation on material surfaces, such as venous or urinary catheters, prosthetic heart valves, orthopedic devices, and contact lenses (16,40,46,63). In particular, the late-appearing vascular graft infections are one of the most feared complications that the vascular surgeon treats, frequently resulting in prolonged hospitalization, organ failure, amputation, and death (7, 34).Effective strategies for the prevention of prosthetic infections vary and include the use of antimicrobials bound in high concentrations to prosthetic grafts (11,44,63,69,71). Because of the increase in resistance to antibiotics, several studies have focused on developing new prosthetic materials that reduce biofilm formation (28,71). One of the most interesting studies was based on the fact that the resistance of a biofilm to antimicrobial agents is acquired as a multicellular strategy that relies on exchange of chemical signals between cells in a process known as quorum sensing (48). Thus, interfering with this mechanism of bacterial cell-cell communication could provide a novel approach to prevent biofilm forma...