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Sequestration of staphylococci at an inaccessible focus
Abstract:
The persistence of staphylococcal arthritis in a patient treated with nafcillin was attributed to intracellular sequestration of staphylococci. These intraphagocytic organisms were protected against bactericidal activity. The infection was cleared by rifampin--an agent which can penetrate leucocyte membranes. When clinical infections do not respond to seemingly adequate antimicrobial treatment, intracellular persistence of bacteria should be considered.
Insights
Staphylococcal arthritis persisted due to bacteria hiding inside white blood cells, unaffected by nafcillin. Rifampin, which enters these cells, successfully cleared the infection, highlighting intracellular bacterial persistence.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Staphylococcal arthritis is a serious joint infection.
- Nafcillin is a common antibiotic used to treat staphylococcal infections.
Observation:
- A patient with staphylococcal arthritis did not respond to nafcillin treatment.
- Staphylococci were found sequestered within the patient's leukocytes (white blood cells).
Findings:
- Intracellular staphylococci were protected from the bactericidal effects of nafcillin.
- Rifampin, an antibiotic capable of penetrating leukocyte membranes, successfully eradicated the infection.
Implications:
- Intracellular bacterial persistence can cause treatment failure in infections.
- Considering intracellular sequestration is crucial for managing refractory bacterial infections.