Antibiotic modulation of the plasminogen binding ability of viridans group streptococci

Antimicrob Agents Chemother. 2012 Jan;56(1):458-63. doi: 10.1128/AAC.00452-11. Epub 2011 Oct 28.

Abstract

The ability of viridans group streptococci to bind human plasminogen and its subsequent activation into plasmin may contribute to the pathogenesis of infective endocarditis (IE) by leading to a decreased stability of the streptococcal vegetation and facilitating dehiscence of emboli. At levels greater than or equal to their MICs, penicillin, vancomycin, and linezolid are efficacious in the treatment of streptococcal endocarditis. However, at sub-MICs, antibiotics can modulate the expression of bacterial genes, including virulence-associated genes, which can have counterproductive effects on the treatment of endocarditis. The effects of 1/8× and 1/4× MICs of penicillin, vancomycin, and linezolid on the plasminogen binding ability of IE isolates Streptococcus mitis 881/956, Streptococcus oralis 12601, and Streptococcus sanguinis 12403 were assessed phenotypically and the expression of plasminogen receptors α-enolase and glyceraldehyde 3-phosphate dehydrogenase of S. oralis 12601 when exposed to 1/4× MIC of penicillin, was analyzed through quantitative reverse transcription (qRT)-PCR. The plasminogen binding ability of S. mitis 881/956 and S. sanguinis 12403 remained unaffected by exposure to sub-MICs of all of the antibiotics tested, while that of S. oralis 12601 was significantly enhanced by all of the antibiotics tested at sub-MICs. qRT-PCR analysis of S. oralis 12601 demonstrated an upregulation of the eno and gapdh genes, indicating an overexpression of plasminogen receptors. These findings suggest that for some endocarditis isolates, the effect of antibiotic sub-MICs, in addition to a reduced antibacterial effect, may influence the clinical response to nonsurgical therapy. It remains difficult to accurately predict isolate responses to sub-MIC antimicrobials since there appears to be interspecies variation.

MeSH terms

  • Acetamides / administration & dosage
  • Acetamides / adverse effects
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Bacterial Proteins / genetics
  • Bacterial Proteins / metabolism
  • Endocarditis, Bacterial / complications
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / microbiology
  • Fibrinolysin / biosynthesis
  • Gene Expression Regulation, Bacterial / drug effects*
  • Gene Expression Regulation, Bacterial / genetics
  • Glyceraldehyde 3-Phosphate Dehydrogenase (NADP+) / genetics
  • Glyceraldehyde 3-Phosphate Dehydrogenase (NADP+) / metabolism
  • Humans
  • Linezolid
  • Microbial Sensitivity Tests
  • Oxazolidinones / administration & dosage
  • Oxazolidinones / adverse effects
  • Penicillins / administration & dosage
  • Penicillins / adverse effects
  • Phosphopyruvate Hydratase / genetics
  • Phosphopyruvate Hydratase / metabolism
  • Plasminogen / metabolism
  • Protein Binding / drug effects
  • Reverse Transcriptase Polymerase Chain Reaction
  • Species Specificity
  • Streptococcal Infections / complications
  • Streptococcal Infections / drug therapy*
  • Streptococcal Infections / microbiology
  • Streptococcus mitis / drug effects
  • Streptococcus mitis / genetics*
  • Streptococcus mitis / metabolism
  • Streptococcus oralis / drug effects
  • Streptococcus oralis / genetics*
  • Streptococcus oralis / metabolism
  • Streptococcus sanguis / drug effects
  • Streptococcus sanguis / genetics*
  • Streptococcus sanguis / metabolism
  • Vancomycin / administration & dosage
  • Vancomycin / adverse effects

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Oxazolidinones
  • Penicillins
  • Vancomycin
  • Plasminogen
  • Glyceraldehyde 3-Phosphate Dehydrogenase (NADP+)
  • Fibrinolysin
  • Phosphopyruvate Hydratase
  • Linezolid