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Open AccessArticle

Modeling of Effective Antimicrobials to Reduce Staphylococcus aureus Virulence Gene Expression Using a Two-Compartment Hollow Fiber Infection Model

1
Center for Precision Medicine Research, Marshfield Clinic Research Institute, Marshfield, WI 54449, USA
2
Pharmacy Practice Division, School of Pharmacy, University of Wisconsin, Madison, WI 53705, USA
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(2), 69; https://doi.org/10.3390/toxins12020069 (registering DOI)
Received: 18 December 2019 / Accepted: 20 January 2020 / Published: 22 January 2020
(This article belongs to the Special Issue Staphylococcus aureus Toxins: Promoter or Handicap during Infection)
Toxins produced by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) contribute to virulence. We developed a statistical approach to determine an optimum sequence of antimicrobials to treat CA-MRSA infections based on an antimicrobial’s ability to reduce virulence. In an in vitro pharmacodynamic hollow fiber model, expression of six virulence genes (lukSF-PV, sek, seq, ssl8, ear, and lpl10) in CA-MRSA USA300 was measured by RT-PCR at six time points with or without human-simulated, pharmacokinetic dosing of five antimicrobials (clindamycin, minocycline, vancomycin, linezolid, and trimethoprim/sulfamethoxazole (SXT)). Statistical modeling identified the antimicrobial causing the greatest decrease in virulence gene expression at each time-point. The optimum sequence was SXT at T0 and T4, linezolid at T8, and clindamycin at T24–T72 when lukSF-PV was weighted as the most important gene or when all six genes were weighted equally. This changed to SXT at T0–T24, linezolid at T48, and clindamycin at T72 when lukSF-PV was weighted as unimportant. The empirical p-value for each optimum sequence according to the different weights was 0.001, 0.0009, and 0.0018 with 10,000 permutations, respectively, indicating statistical significance. A statistical method integrating data on change in gene expression upon multiple antimicrobial exposures is a promising tool for identifying a sequence of antimicrobials that is effective in sustaining reduced CA-MRSA virulence. View Full-Text
Keywords: mathematical modeling; Staphylococcus aureus; antimicrobials; virulence; hollow fiber model mathematical modeling; Staphylococcus aureus; antimicrobials; virulence; hollow fiber model
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Shukla, S.K.; Carter, T.C.; Ye, Z.; Pantrangi, M.; Rose, W.E. Modeling of Effective Antimicrobials to Reduce Staphylococcus aureus Virulence Gene Expression Using a Two-Compartment Hollow Fiber Infection Model. Toxins 2020, 12, 69.

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