Anti-clumping factor A immunoglobulin reduces the duration of methicillin-resistant Staphylococcus aureus bacteremia in an experimental model of infective endocarditis

Antimicrob Agents Chemother. 2003 Nov;47(11):3400-6. doi: 10.1128/AAC.47.11.3400-3406.2003.

Abstract

SA-IGIV is a human polyclonal immunoglobulin containing elevated levels of antibodies specific for the fibrinogen-binding MSCRAMM protein clumping factor A (ClfA). In vitro, SA-IGIV specifically recognized ClfA that was expressed on the surface of Staphylococcus aureus and inhibited bacterial adherence to immobilized human fibrinogen by >95%. Moreover, SA-IGIV efficiently opsonized ClfA-coated fluorescent beads and facilitated phagocytosis by human polymorphonuclear leukocytes. To determine its potential therapeutic efficacy, SA-IGIV was evaluated in combination with vancomycin in a rabbit model of catheter-induced aortic valve infective endocarditis (IE) caused by methicillin-resistant S. aureus (MRSA). The combination therapy was more effective than vancomycin alone in sterilizing all valvular vegetations when used therapeutically during early (12-h) IE. The combination therapy resulted in clearance of bacteremia that was significantly faster than that of vancomycin alone in animals with well-established (24-h) IE. Therefore, in both early and well-established MRSA IE, the addition of SA-IGIV to a standard antibiotic regimen (vancomycin) increased bacterial clearance from the bloodstream and/or vegetations.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology*
  • Endocarditis, Bacterial / drug therapy*
  • Endocarditis, Bacterial / microbiology*
  • Female
  • Fibrinogen / metabolism
  • Flow Cytometry
  • Humans
  • Immunoglobulin G / immunology
  • Immunoglobulins / therapeutic use*
  • Immunotherapy
  • Methicillin Resistance*
  • Opsonin Proteins / pharmacology
  • Rabbits
  • Recombinant Proteins / pharmacology
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology*
  • Vancomycin / pharmacology

Substances

  • Anti-Bacterial Agents
  • Immunoglobulin G
  • Immunoglobulins
  • Opsonin Proteins
  • Recombinant Proteins
  • Vancomycin
  • Fibrinogen