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Staphylococcus-aureus-Adhärenz, Wirtszellinvasion und Persistenz

Bakterielle Strategien zur Etablierung destruktiver und chronischer Infektionen

Staphylococcus aureus adherence, host cell invasion, and persistence

Bacterial strategies for the establishment of destructive and chronic infections

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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Staphylococcus aureus ist einer der häufigsten Verursacher endovaskulärer Infektionen, die zum Teil schwierig zu behandeln sind und eine hohe Mortalitätsrate aufweisen. Die Ursache dafür liegt nicht nur an der zunehmenden Ausbreitung von Methicillin-resistenten S.-aureus(MRSA)-Stämmen, sondern ist durch die Vielzahl von S.-aureus-Virulenzfaktoren und Infektionsstrategien begründet. Dazu gehört die Fähigkeit von S.  aureus, an Wirtsstrukturen zu adhärieren, einen Biofilm zu bilden und in Wirtszellen einzudringen. Nach Wirtszellinvasion können die Bakterien einerseits proinflammatorische und gewebezerstörende Wirkungen verursachen, andererseits können sie sich auch so verändern, dass sie eine Art Schlafzustand („small-colony variants“, SCVs), annehmen, um über lange Zeit in den Wirtszellen zu persistieren. Bei Verlassen der intrazellulären Lokalisation werden die Bakterien meist sehr schnell wieder hochvirulent, wodurch sie erneut eine Infektion auslösen können. Für eine erfolgreiche Diagnose und Therapie sollte daher gerade bei chronischen Infektionen die SCV-Bildung bedacht und solche Antibiotika zur Therapie gewählt werden, die in Biofilm und intrazellulär penetrieren können.

Abstract

Staphylococcus aureus is a frequent cause of endovascular infections, which are often difficult to treat and still have a high mortality rate. The reason for this is not only the increasing spread of methicillin-resistant S. aureus (MRSA) strains, but is also based in the multiplicity of virulence factors and infection strategies of the bacteria. S. aureus can adhere to host structures, can form biofilms, and can invade host cells. After host cell invasion, the bacteria can induce pro-inflammatory and tissue-destructive effects. On the other hand, the bacteria can also change their phenotypes to small colony variants (SCVs), a state of dormancy, to survive within the host cells for long periods of time. However, when the bacteria leave the intracellular location, they often rapidly revert to their fully aggressive phenotype, which can induce a new episode of acute infection. Thus, to diagnose and treat S. aureus infections successfully, the formation of SCVs should not be overlooked and antimicrobial compounds that penetrate the biofilm and also act intracellularly should be selected.

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  1. Institut für Medizinische Mikrobiologie, Domagkstr. 10, 48149, Münster, Deutschland

    B. Löffler

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Löffler, B. Staphylococcus-aureus-Adhärenz, Wirtszellinvasion und Persistenz. Z Herz- Thorax- Gefäßchir 26, 253–258 (2012). https://doi.org/10.1007/s00398-012-0943-5

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