TY - JOUR
T1 - Anti-biofilm Approach in Infective Endocarditis Exposes New Treatment Strategies for Improved Outcome
AU - Lerche, Christian Johann
AU - Schwartz, Franziska
AU - Theut, Marie
AU - Fosbøl, Emil Loldrup
AU - Iversen, Kasper
AU - Bundgaard, Henning
AU - Høiby, Niels
AU - Moser, Claus
N1 - Funding Information:
CM was supported by the Novo Nordisk Foundation-“Borregaard Clinical Scientist Grant” (grant no. NNF17OC0025074).
Publisher Copyright:
© Copyright © 2021 Lerche, Schwartz, Theut, Fosbøl, Iversen, Bundgaard, Høiby and Moser.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6/18
Y1 - 2021/6/18
N2 - Infective endocarditis (IE) is a life-threatening infective disease with increasing incidence worldwide. From early on, in the antibiotic era, it was recognized that high-dose and long-term antibiotic therapy was correlated to improved outcome. In addition, for several of the common microbial IE etiologies, the use of combination antibiotic therapy further improves outcome. IE vegetations on affected heart valves from patients and experimental animal models resemble biofilm infections. Besides the recalcitrant nature of IE, the microorganisms often present in an aggregated form, and gradients of bacterial activity in the vegetations can be observed. Even after appropriate antibiotic therapy, such microbial formations can often be identified in surgically removed, infected heart valves. Therefore, persistent or recurrent cases of IE, after apparent initial infection control, can be related to biofilm formation in the heart valve vegetations. On this background, the present review will describe potentially novel non-antibiotic, antimicrobial approaches in IE, with special focus on anti-thrombotic strategies and hyperbaric oxygen therapy targeting the biofilm formation of the infected heart valves caused by Staphylococcus aureus. The format is translational from preclinical models to actual clinical treatment strategies.
AB - Infective endocarditis (IE) is a life-threatening infective disease with increasing incidence worldwide. From early on, in the antibiotic era, it was recognized that high-dose and long-term antibiotic therapy was correlated to improved outcome. In addition, for several of the common microbial IE etiologies, the use of combination antibiotic therapy further improves outcome. IE vegetations on affected heart valves from patients and experimental animal models resemble biofilm infections. Besides the recalcitrant nature of IE, the microorganisms often present in an aggregated form, and gradients of bacterial activity in the vegetations can be observed. Even after appropriate antibiotic therapy, such microbial formations can often be identified in surgically removed, infected heart valves. Therefore, persistent or recurrent cases of IE, after apparent initial infection control, can be related to biofilm formation in the heart valve vegetations. On this background, the present review will describe potentially novel non-antibiotic, antimicrobial approaches in IE, with special focus on anti-thrombotic strategies and hyperbaric oxygen therapy targeting the biofilm formation of the infected heart valves caused by Staphylococcus aureus. The format is translational from preclinical models to actual clinical treatment strategies.
KW - biofilm
KW - dabigatran
KW - hyperbaric oxygen therapy
KW - in vitro
KW - in vivo
KW - infective endocarditis
KW - innate immunity
KW - Staphylococcus aureus
UR - http://www.scopus.com/inward/record.url?scp=85109103402&partnerID=8YFLogxK
U2 - 10.3389/fcell.2021.643335
DO - 10.3389/fcell.2021.643335
M3 - Review
C2 - 34222225
AN - SCOPUS:85109103402
SN - 2296-634X
VL - 9
JO - Frontiers in Cell and Developmental Biology
JF - Frontiers in Cell and Developmental Biology
M1 - 643335
ER -