Evidence of an Intracellular Reservoir in the Nasal Mucosa of Patients with Recurrent Staphylococcus aureus Rhinosinusitis

Severe infections due to Staphylococcus aureus require prolonged therapy for cure, and relapse may occur even years after the first episode. Persistence of S. aureus may be explained, in part, by nasal carriage of S. aureus which occurs in a large percentage of healthy humans and represents a major...

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Bibliographic Details
Published in:The Journal of infectious diseases 2005-09, Vol.192 (6), p.1023-1028
Main Authors: Clement, Sophie, Vaudaux, Pierre, Francois, Patrice, Schrenzel, Jacques, Huggler, Elzbieta, Kampf, Sandy, Chaponnier, Christine, Lew, Daniel, Lacroix, Jean-Silvain
Format: Article
Language:English
Subjects:
Antibodies
Bacteria
Bacteriology
Biological and medical sciences
Biopsies
Biopsy
Carrier State
Cell lines
Endocytosis
Endothelial cells
Epithelial cells
Epithelium - microbiology
Fibroblasts - microbiology
Fundamental and applied biological sciences. Psychology
Humans
Infections
Infectious diseases
Medical sciences
Microbiology
Microscopy, Confocal
Microscopy, Electron
Miscellaneous
Nasal Mucosa - microbiology
Nasal Mucosa - pathology
Phagocytes
Recurrence
Rhinitis - microbiology
Rhinitis - pathology
Sinusitis - microbiology
Sinusitis - pathology
Staphylococcal Infections - microbiology
Staphylococcal Infections - pathology
Staphylococcus aureus
Staphylococcus aureus - isolation & purification
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Summary:Severe infections due to Staphylococcus aureus require prolonged therapy for cure, and relapse may occur even years after the first episode. Persistence of S. aureus may be explained, in part, by nasal carriage of S. aureus which occurs in a large percentage of healthy humans and represents a major source of systemic infection. However, the persistence of internalized S. aureus within mucosal cells has not been evaluated in humans. Here, we provide the first in vivo evidence of intracellular reservoirs of S. aureus in humans, which were assessed in endonasal mucosa specimens from patients suffering from recurrent S. aureus rhinosinusitis due to unique, patient-specific bacterial clonotypes. Heavily infected foci of intracellular bacteria located in nasal epithelium, glandular, and myofibroblastic cells were revealed by inverted confocal laser scan fluorescence and electron microscopic examination of posttherapy intranasal biopsy specimens from symptom-free patients undergoing surgery on the sinuses. Intracellular residence may provide a sanctuary for pathogenic bacteria by protecting them from host defense mechanisms and antibiotic treatment during acute, recurrent S. aureus rhinosinusitis
ISSN:0022-1899
1537-6613
DOI:10.1086/432735