Efficacy assessment of a novel endolysin PlyAZ3aT for the treatment of ceftriaxone-resistant pneumococcal meningitis in an infant rat model.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_A33C7C8026C9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Efficacy assessment of a novel endolysin PlyAZ3aT for the treatment of ceftriaxone-resistant pneumococcal meningitis in an infant rat model.
Journal
PloS one
Author(s)
Valente L.G., Le N.D., Pitton M., Chiffi G., Grandgirard D., Jakob S.M., Cameron D.R., Resch G., Que Y.A., Leib S.L.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
17
Number
4
Pages
e0266928
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Treatment failure in pneumococcal meningitis due to antibiotic resistance is an increasing clinical challenge and alternatives to antibiotics warrant investigation. Phage-derived endolysins efficiently kill gram-positive bacteria including multi-drug resistant strains, making them attractive therapeutic candidates. The current study assessed the therapeutic potential of the novel endolysin PlyAZ3aT in an infant rat model of ceftriaxone-resistant pneumococcal meningitis.
Efficacy of PlyAZ3aT was assessed in a randomized, blinded and controlled experimental study in infant Wistar rats. Meningitis was induced by intracisternal infection with 5 x 107 CFU/ml of a ceftriaxone-resistant clinical strain of S. pneumoniae, serotype 19A. Seventeen hours post infection (hpi), animals were randomized into 3 treatment groups and received either (i) placebo (phosphate buffered saline [PBS], n = 8), (ii) 50 mg/kg vancomycin (n = 10) or (iii) 400 mg/kg PlyAZ3aT (n = 8) via intraperitoneal injection. Treatments were repeated after 12 h. Survival at 42 hpi was the primary outcome; bacterial loads in cerebrospinal fluid (CSF) and blood were secondary outcomes. Additionally, pharmacokinetics of PlyAZ3aT in serum and CSF was assessed.
PlyAZ3aT did not improve survival compared to PBS, while survival for vancomycin treated animals was 70% which is a significant improvement when compared to PBS or PlyAZ3aT (p<0.05 each). PlyAZ3aT was not able to control the infection, reflected by the inability to reduce bacterial loads in the CSF, whereas Vancomycin sterilized the CSF and within 25 h. Pharmacokinetic studies indicated that PlyAZ3aT did not cross the blood brain barrier (BBB). In support, PlyAZ3aT showed a peak concentration of 785 μg/ml in serum 2 h after intraperitoneal injection but could not be detected in CSF.
In experimental pneumococcal meningitis, PlyAZ3aT failed to cure the infection due to an inability to reach the CSF. Optimization of the galenic formulation e.g. using liposomes might enable crossing of the BBB and improve treatment efficacy.
Keywords
Animals, Anti-Bacterial Agents/pharmacology, Anti-Bacterial Agents/therapeutic use, Ceftriaxone/pharmacology, Ceftriaxone/therapeutic use, Endopeptidases, Meningitis, Pneumococcal/microbiology, Random Allocation, Rats, Rats, Wistar, Streptococcus pneumoniae, Vancomycin/pharmacology
Pubmed
Open Access
Yes
Create date
16/05/2022 10:35
Last modification date
23/11/2022 7:13
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