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Development and Assessment of Intracellular Infection Models for Staphylococcus aureus
Published on: January 17, 2025
Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis
Andreas E Zautner1, Merit Krause, Gerhard Stropahl
1Institute of Medical Microbiology, Virology and Hygiene, Rostock, Germany. azautne@gwdg.de
Plos One
|March 9, 2010
Summary
Intracellular Staphylococcus aureus causes recurrent tonsillitis (RT), evading antibiotics. This study found invasive S. aureus strains inside tonsil cells, explaining treatment failures in RT patients.
Area of Science:
- Otorhinolaryngology
- Infectious Diseases
- Microbiology
Background:
- Recurrent tonsillitis (RT) and peritonsillar abscess (PTA) are primary tonsillectomy indications.
- RT treatment often fails with antibiotics before surgery, with unclear reasons.
- Bacteriology of RT is studied, but conservative therapy failures remain unexplained.
Purpose of the Study:
- Investigate the bacteriological reasons for recurrent tonsillitis (RT) treatment failures.
- Determine the prevalence and characteristics of bacteria within tonsil tissues of RT and PTA patients.
- Identify bacterial factors contributing to antibiotic resistance in recurrent tonsillitis.
Main Methods:
- Prospective study of 130 RT and 124 PTA patients.
- Tonsil specimens analyzed for extra- and intracellular bacteria using antibiotic protection assays.
- Staphylococcus aureus isolates characterized by PFGE, spa-typing, MSCRAMM-gene-PCR, biofilm assays, and cell invasiveness assays (FACS, FISH, immunohistochemistry).
Main Results:
- Staphylococcus aureus was the predominant species in RT (57.7%), while Streptococcus pyogenes was most prevalent in PTA (20.2%).
- RT-associated S. aureus strains were predominantly intracellular (FACS, FISH, antibiotic protection assay).
- 87% of S. aureus isolates were invasive strains, not mere colonizers, indicating intracellular survival to evade antibiotics and host immunity.
Conclusions:
- Intracellular S. aureus is the most common cause of recurrent tonsillitis.
- S. aureus utilizes intracellular locations to survive antibiotic treatments and host immune responses.
- Understanding bacterial location is crucial for developing effective recurrent tonsillitis therapies.
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