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Evaluation of the effect of oritavancin on Clostridium difficile spore germination, outgrowth and recovery.
J Antimicrob Chemother. 2013 Sep; 68(9):2078-82.JA

Abstract

OBJECTIVES

Previous work suggests oritavancin may be inhibitory to Clostridium difficile spores. We have evaluated the effects of oritavancin exposure on C. difficile spore germination, outgrowth and recovery.

METHODS

Germination and outgrowth of C. difficile spores exposed to different concentrations of oritavancin, vancomycin, or metronidazole (0.1-10 mg/L) were monitored at 0, 2, 4, 6, 24 and 48 h using phase-contrast microscopy. Recovery of antimicrobial-exposed spores was determined by viable counting on Brazier's modified CCEYL agar. Persistence of oritavancin activity on spores after washing was determined by measuring activity against a Staphylococcus aureus lawn.

RESULTS

Oritavancin, vancomycin and metronidazole exposure did not prevent germination of phase-bright spores to phase-dark spores, but did inhibit further outgrowth into vegetative cells. The inhibitory effect of oritavancin persisted after washing, whereas the inhibitory effects of vancomycin and metronidazole did not. Oritavancin exposure affected spore recovery; fewer spores were recovered after washing following oritavancin exposure than vancomycin exposure. The extent of this effect was dependent on PCR ribotype, with recovery of ribotype 078 spores completely prevented, but recovery of ribotype 001 spores only slightly affected. Spores exposed to oritavancin, but not vancomycin, retained antimicrobial activity after washing, indicating adherence of oritavancin, but not vancomycin, to the spore surface

CONCLUSIONS

Oritavancin may adhere to spores, potentially causing early inhibition of germinated cells, preventing subsequent vegetative outgrowth and spore recovery. This may prevent some recurrences of symptomatic C. difficile infection that are due to germination of residual spores following antibiotic therapy.

Authors+Show Affiliations

Leeds Institute for Molecular Medicine, University of Leeds, Leeds LS2 9JT, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23759507

Citation

Chilton, C H., et al. "Evaluation of the Effect of Oritavancin On Clostridium Difficile Spore Germination, Outgrowth and Recovery." The Journal of Antimicrobial Chemotherapy, vol. 68, no. 9, 2013, pp. 2078-82.
Chilton CH, Freeman J, Baines SD, et al. Evaluation of the effect of oritavancin on Clostridium difficile spore germination, outgrowth and recovery. J Antimicrob Chemother. 2013;68(9):2078-82.
Chilton, C. H., Freeman, J., Baines, S. D., Crowther, G. S., Nicholson, S., & Wilcox, M. H. (2013). Evaluation of the effect of oritavancin on Clostridium difficile spore germination, outgrowth and recovery. The Journal of Antimicrobial Chemotherapy, 68(9), 2078-82. https://doi.org/10.1093/jac/dkt160
Chilton CH, et al. Evaluation of the Effect of Oritavancin On Clostridium Difficile Spore Germination, Outgrowth and Recovery. J Antimicrob Chemother. 2013;68(9):2078-82. PubMed PMID: 23759507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the effect of oritavancin on Clostridium difficile spore germination, outgrowth and recovery. AU - Chilton,C H, AU - Freeman,J, AU - Baines,S D, AU - Crowther,G S, AU - Nicholson,S, AU - Wilcox,M H, Y1 - 2013/06/11/ PY - 2013/6/14/entrez PY - 2013/6/14/pubmed PY - 2014/4/1/medline KW - adherence KW - outgrowth inhibition KW - recurrence SP - 2078 EP - 82 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 68 IS - 9 N2 - OBJECTIVES: Previous work suggests oritavancin may be inhibitory to Clostridium difficile spores. We have evaluated the effects of oritavancin exposure on C. difficile spore germination, outgrowth and recovery. METHODS: Germination and outgrowth of C. difficile spores exposed to different concentrations of oritavancin, vancomycin, or metronidazole (0.1-10 mg/L) were monitored at 0, 2, 4, 6, 24 and 48 h using phase-contrast microscopy. Recovery of antimicrobial-exposed spores was determined by viable counting on Brazier's modified CCEYL agar. Persistence of oritavancin activity on spores after washing was determined by measuring activity against a Staphylococcus aureus lawn. RESULTS: Oritavancin, vancomycin and metronidazole exposure did not prevent germination of phase-bright spores to phase-dark spores, but did inhibit further outgrowth into vegetative cells. The inhibitory effect of oritavancin persisted after washing, whereas the inhibitory effects of vancomycin and metronidazole did not. Oritavancin exposure affected spore recovery; fewer spores were recovered after washing following oritavancin exposure than vancomycin exposure. The extent of this effect was dependent on PCR ribotype, with recovery of ribotype 078 spores completely prevented, but recovery of ribotype 001 spores only slightly affected. Spores exposed to oritavancin, but not vancomycin, retained antimicrobial activity after washing, indicating adherence of oritavancin, but not vancomycin, to the spore surface CONCLUSIONS: Oritavancin may adhere to spores, potentially causing early inhibition of germinated cells, preventing subsequent vegetative outgrowth and spore recovery. This may prevent some recurrences of symptomatic C. difficile infection that are due to germination of residual spores following antibiotic therapy. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/23759507/Evaluation_of_the_effect_of_oritavancin_on_Clostridium_difficile_spore_germination_outgrowth_and_recovery_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkt160 DB - PRIME DP - Unbound Medicine ER -