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Ongoing resistance developments against antibiotics that also affect last-resort antibiotics require novel antibacterial compounds. Strategies to discover such novel structures have been dimerization or hybridization of known antibacterial agents. We found novel antibacterial agents by dimerization of indols and hybridization with carbazoles. They were obtained in a simple one-pot reaction as bisindole tetrahydrocarbazoles. Further oxidation led to bisindole carbazoles with varied substitutions of both the indole and the carbazole scaffold. Both the tetrahydrocarbazoles and the carbazoles have been evaluated in various S. aureus strains, including MRSA strains. Those 5-cyano substituted derivatives showed best activities as determined by MIC values. The tetrahydrocarbazoles partly exceed the activity of the carbazole compounds and thus the activity of the used standard antibiotics. Thus, promising lead compounds could be identified for further studies.

Staphylococcus aureus is a major human pathogen, which can invade and survive in non-professional and professional phagocytes. Uptake by host cells is thought to contribute to pathogenicity and persistence of the bacterium. Upon internalization by epithelial cells, cytotoxic S. aureus strains can escape from the phagosome, replicate in the cytosol and induce host cell death. Here, we identified a staphylococcal cysteine protease to induce cell death after translocation of intracellular S. aureus into the host cell cytoplasm. We demonstrated that loss of staphopain A function leads to delayed onset of host cell death and prolonged intracellular replication of S. aureus in epithelial cells. Overexpression of staphopain A in a non-cytotoxic strain facilitated intracellular killing of the host cell even in the absence of detectable intracellular replication. Moreover, staphopain A contributed to efficient colonization of the lung in a mouse pneumonia model. In phagocytic cells, where intracellular S. aureus is exclusively localized in the phagosome, staphopain A did not contribute to cytotoxicity. Our study suggests that staphopain A is utilized by S. aureus to exit the epithelial host cell and thus contributes to tissue destruction and dissemination of infection., Author summary Staphylococcus aureus is an antibiotic-resistant pathogen that emerges in hospital and community settings and can cause a variety of diseases ranging from skin abscesses to lung inflammation and blood poisoning. The bacterium can asymptomatically colonize the upper respiratory tract and skin of humans and take advantage of opportune conditions, like immunodeficiency or breached barriers, to cause infection. Although S. aureus was not regarded as intracellular bacterium, it can be internalized by human cells and subsequently exit the host cells by induction of cell death, which is considered to cause tissue destruction and spread of infection. The bacterial virulence factors and underlying molecular mechanisms involved in the intracellular lifestyle of S. aureus remain largely unknown. We identified a bacterial cysteine protease to contribute to host cell death of epithelial cells mediated by intracellular S. aureus. Staphopain A induced killing of the host cell after translocation of the pathogen into the cell cytosol, while bacterial proliferation was not required. Further, the protease enhanced survival of the pathogen during lung infection. These findings reveal a novel, intracellular role for the bacterial protease staphopain A.

Resistance developments against established antibiotics are an emerging problem for antibacterial therapies. Infections with Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) have become more difficult to treat with standard antibiotics that often fail, especially against MRSA. In consequence, novel antibiotics are urgently needed. Antibiotics from natural sources own complicated structures that cause difficulties for a chemical synthetic production. We developed novel small-molecule antibacterials that are easily accessible in a simple one-pot synthesis. The central indolonaphthalene core is substituted with indole residues at various positions. Both the varied indole substitutions and their positions at the molecular scaffold influence the determined antibacterial activity against the evaluated Staphylococcus strains. Best activities have been found for 5-chloro, -cyano, and -hydroxyl indole substitutions. Therefore, first promising lead compounds could be identified that are nontoxic in human HEK and SH-SY5Y cells and exceed the activity of used standard antibiotics, especially against MRSA.

Rhodomyrtone (Rom) is an acylphloroglucinol antibiotic originally isolated from leaves of Rhodomyrtus tomentosa. Rom targets the bacterial membrane and is active against a wide range of Gram-positive bacteria but the exact mode of action remains obscure. Here we isolated and characterized a spontaneous Rom-resistant mutant from the model strain Staphylococcus aureus HG001 (RomR) to learn more about the resistance mechanism. We showed that Rom-resistance is based on a single point mutation in the coding region of farR [regulator of fatty acid (FA) resistance] that causes an amino acid change from Cys to Arg at position 116 in FarR, that affects FarR activity. Comparative transcriptome analysis revealed that mutated farR affects transcription of many genes in distinct pathways. FarR represses for example the expression of its own gene (farR), its flanking gene farE (effector of FA resistance), and other global regulators such as agr and sarA. All these genes were consequently upregulated in the RomR clone. Particularly the upregulation of agr and sarA leads to increased expression of virulence genes rendering the RomR clone more cytotoxic and more pathogenic in a mouse infection model. The Rom-resistance is largely due to the de-repression of farE. FarE is described as an efflux pump for linoleic and arachidonic acids. We observed an increased release of lipids in the RomR clone compared to its parental strain HG001. If farE is deleted in the RomR clone, or, if native farR is expressed in the RomR strain, the corresponding strains become hypersensitive to Rom. Overall, we show here that the high Rom-resistance is mediated by overexpression of farE in the RomR clone, that FarR is an important regulator, and that the point mutation in farR (RomR clone) makes the clone hyper-virulent. Fil: Nguyen, Minh-Thu. Eberhard Karls Universität Tübingen.; Alemania Fil: Saising, Jongkon. Eberhard Karls Universität Tübingen.; Alemania Fil: Tribelli, Paula Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina. Eberhard Karls Universität Tübingen.; Alemania Fil: Nega, Mulugeta. Eberhard Karls Universität Tübingen.; Alemania Fil: Diene, Seydina M.. Geneva University Hospitals; Suiza Fil: François, Patrice. Geneva University Hospitals; Suiza Fil: Schrenzel, Jacques. Geneva University Hospitals; Suiza Fil: Spröer, Cathrin. Leibniz Institute Dsmz-german Collection Of Microorgani; Alemania Fil: Bunk, Boyke. Leibniz-Institut DSMZ-Deutsche Sammlung von Mikroorganismen und Zellkulturen GmbH; Alemania Fil: Ebner, Patrick. Eberhard Karls Universität Tübingen.; Alemania Fil: Hertlein, Tobias. University Of Würzburg; Alemania Fil: Kumari, Nimerta. Eberhard Karls Universität Tübingen.; Alemania Fil: Härtner, Thomas. Eberhard Karls Universität Tübingen.; Alemania Fil: Wistuba, Dorothee. Eberhard Karls Universität Tübingen.; Alemania Fil: Voravuthikunchai, Supayang P.. Prince Of Songkla University; Tailandia Fil: Mäder, Ulrike. University Medicine Greifswald; Alemania Fil: Ohlsen, Knut. University Of Würzburg; Alemania Fil: Götz, Friedrich. Eberhard Karls Universität Tübingen.; Alemania

Meningococcal meningitis is a severe central nervous system infection that occurs when Neisseria meningitidis (Nm) penetrates brain endothelial cells (BECs) of the meningeal blood-cerebrospinal fluid barrier. As a human-specific pathogen, in vivo models are greatly limited and pose a significant challenge. In vitro cell models have been developed, however, most lack critical BEC phenotypes limiting their usefulness. Human BECs generated from induced pluripotent stem cells (iPSCs) retain BEC properties and offer the prospect of modeling the human-specific Nm interaction with BECs. Here, we exploit iPSC-BECs as a novel cellular model to study Nm host-pathogen interactions, and provide an overview of host responses to Nm infection. Using iPSC-BECs, we first confirmed that multiple Nm strains and mutants follow similar phenotypes to previously described models. The recruitment of the recently published pilus adhesin receptor CD147 underneath meningococcal microcolonies could be verified in iPSC-BECs. Nm was also observed to significantly increase the expression of pro-inflammatory and neutrophil-specific chemokines IL6, CXCL1, CXCL2, CXCL8, and CCL20, and the secretion of IFN-g and RANTES. For the first time, we directly observe that Nm disrupts the three tight junction proteins ZO-1, Occludin, and Claudin-5, which become frayed and/or discontinuous in BECs upon Nm challenge. In accordance with tight junction loss, a sharp loss in trans-endothelial electrical resistance, and an increase in sodium fluorescein permeability and in bacterial transmigration, was observed. Finally, we established RNA-Seq of sorted, infected iPSC-BECs, providing expression data of Nm-responsive host genes. Altogether, this model provides novel insights into Nm pathogenesis, including an impact of Nm on barrier properties and tight junction complexes, and suggests that the paracellular route may contribute to Nm traversal of BECs.

Meningococcal meningitis is a severe central nervous system infection that occurs when Neisseria meningitidis (Nm) penetrates brain endothelial cells (BECs) of the meningeal blood-cerebrospinal fluid barrier. As a human-specific pathogen, in vivo models are greatly limited and pose a significant challenge. In vitro cell models have been developed, however, most lack critical BEC phenotypes limiting their usefulness. Human BECs generated from induced pluripotent stem cells (iPSCs) retain BEC properties and offer the prospect of modeling the human-specific Nm interaction with BECs. Here, we exploit iPSC-BECs as a novel cellular model to study Nm host-pathogen interactions, and provide an overview of host responses to Nm infection. Using iPSC-BECs, we first confirmed that multiple Nm strains and mutants follow similar phenotypes to previously described models. The recruitment of the recently published pilus adhesin receptor CD147 underneath meningococcal microcolonies could be verified in iPSC-BECs. Nm was also observed to significantly increase the expression of pro-inflammatory and neutrophil-specific chemokines IL6, CXCL1, CXCL2, CXCL8, and CCL20, and the secretion of IFN-γ and RANTES. For the first time, we directly observe that Nm disrupts the three tight junction proteins ZO-1, Occludin, and Claudin-5, which become frayed and/or discontinuous in BECs upon Nm challenge. In accordance with tight junction loss, a sharp loss in trans-endothelial electrical resistance, and an increase in sodium fluorescein permeability and in bacterial transmigration, was observed. Finally, we established RNA-Seq of sorted, infected iPSC-BECs, providing expression data of Nm-responsive host genes. Altogether, this model provides novel insights into Nm pathogenesis, including an impact of Nm on barrier properties and tight junction complexes, and suggests that the paracellular route may contribute to Nm traversal of BECs.

\(Enterococcus\) species cause increasing numbers of infections in hospitals. They contribute to the increasing mortality rates, mostly in patients with comorbidities, who suffer from severe diseases. \(Enterococcus\) resistances against most antibiotics have been described, including novel antibiotics. Therefore, there is an ongoing demand for novel types of antibiotics that may overcome bacterial resistances. We discovered a novel class of antibiotics resulting from a simple one-pot reaction of indole and \(o\)-phthaldialdehyde. Differently substituted indolyl benzocarbazoles were yielded. Both the indole substitution and the positioning at the molecular scaffold influence the antibacterial activity towards the various strains of \(Enterococcus\) species with the highest relevance to nosocomial infections. Structure-activity relationships are discussed, and the first lead compounds were identified as also being effective in the case of a vancomycin resistance.

Staphylococcus aureus is a major threat to public health systems all over the globe. This second most cause of nosocomial infections is able to provoke a wide variety of different types of infection in humans and animals, ranging from superficial skin and skin structure infections to invasive disease like sepsis or pneumonia. But not enough, this pathogen is also notorious in acquiring and/or developing resistance to antimicrobial compounds, thus limiting available treatment options severely. Therefore, development of new compounds and strategies to fight S. aureus is of paramount importance. But since only 1 out of 5 compounds, which entered clinical trials, becomes a drug, the preclinical evaluation of promising compounds has to be reconsidered, too. The aim of this thesis was to address both sides of this problem: first, to improve preclinical testing by incorporating in vivo imaging technologies to the preclinical testing procedure in order to acquire additional and clearer data about efficacy of promising compounds and second, by evaluating lysostaphin, which is a promising, new option to fight S. aureus infections. The first aim of this thesis focused on the establishment of a dual modality in vivo imaging platform, consisting of Bioluminescence Imaging (BLI) and Magnetic Resonance Imaging (MRI), to offer detailed insights into the course and gravity of S. aureus infection in the murine thigh infection model. Since luciferase-expressing S. aureus strains were generated in former studies and enabled thus bioluminescence imaging of bacterial infection, this technology should be implemented into the compound evaluation platform in order to non-invasively track the bacterial burden over time. MRI, in contrast, was only rarely used in earlier studies to visualize and measure the course of infection or efficacy of anti-bacterial therapy. Thus, the first set of experiments was performed to identify benefits and drawbacks of visualizing S. aureus infections in the mouse model by different MR methods. Native, proton-based MR imaging showed in this regard increased T2 relaxation times in the infected thigh muscles, but it was not possible to define a clear border between infected and uninfected tissue. Iron oxide nanoparticles and perfluorocarbon emulsions, two MR contrast agents or tracer, in contrast, offered this distinction. Iron oxide particles were detected in this regard by their distortion of 1H signal in proton-based MRI, while perfluorocarbon emulsion was identified by 19F MRI. Mammals do not harbor sufficient intrinsic amounts of 19F to deliver specific signal and therefore, 19F MR imaging visualizes only the signal of administered perfluorocarbon emulsion. The in vivo accumulation of perfluorocarbon emulsion can be imaged by 19F MRI and overlayed on a simultaneously acquired 1H MR image, which shows the anatomical context in clear detail. Since this is advantageous compared to contrast agent based MR methods like iron oxide particle-based MRI, further experiments were performed with perfluorocarbon emulsions and 19F MRI. Experimental studies to elucidate the accumulation of perfluorocarbon emulsion at the site of infection showed robust 19F MR signals after administration between day 2 and at least day 8 p.i.. Perfluorocarbon emulsion accumulated in all investigated mice in the shape of a ‘hollow sphere’ at the rim of the abscess area and the signal remained stable as long as the infection prevailed. In order to identify the mechanism of accumulation, flow cytometry, cell sorting and histology studies were performed. Flow cytometry and cell sorting analysis of immune cells at the site of infection showed that neutrophils, monocytes, macrophages and dendritic cells carried contrast media at the site of infection with neutrophils accounting for the overwhelming portion of perfluorocarbon signal. In general, most of the signal was associated with immune cells, thus indicating specific immune cell dependent accumulation. Histology supported this observation since perfluorocarbon emulsion related fluorescence could only be visualized in close proximity to immune cell nuclei. After establishing and testing of 19F MRI with perfluorocarbon emulsions as infection imaging modality, the effects of antibiotic therapy upon MR signal was investigated in order to evaluate the capability of this modality for preclinical testing procedure. Thus, the efficacy of vancomycin and linezolid, two clinically highly relevant anti - S. aureus compounds, were tested in the murine thigh infection model. Both of them showed reduction of the colony forming units and bioluminescence signal, but also of perfluorocarbon emulsion accumulation strength and volume at the site of infection, which was visualized and quantified by 19F MRI. The efficacy pattern with linezolid being more efficient in clearing bacterial infection was shown similarly by all three methods. In consequence, 19F MRI with perfluorocarbon emulsion as MR tracer proved to be capable to visualize antibacterial therapy in preclinical testing models. The next step was consequently to evaluate a promising new compound against S. aureus infections. Thus, lysostaphin, an endo-peptidase that cleaves the cell wall of S. aureus, was tested in different concentrations alone or in combination with oxacillin for efficacy in murine thigh and catheter associated infection models. Lysostaphin only in the concentration of 5 mg/kg body weight or combined with oxacillin in the concentration of 2 mg/kg showed strong reduction of bacterial burden by colony forming unit determination and bioluminescence imaging in both models. The perfluorocarbon accumulation was investigated in the thigh infection model by 19F MRI and was strongly reduced in terms of volume and signal strength in both above-mentioned groups. In general, lysostaphin showed comparable or superior efficacy than vancomycin or oxacillin alone. Therefore, further development of lysostaphin for the treatment of S. aureus infections is recommended by these experiments. Overall, the antibiotic efficacy pattern of all applied antibiotic regimens was similar with all three applied methods, demonstrating the usefulness of MRI for antibiotic efficacy testing. Importantly, treatment with oxacillin either alone or in combination with lysostaphin resulted in stronger perfluorocarbon emulsion accumulation at the site of infection than expected compared to the results from bioluminescence imaging and colony forming unit determination. This might be an indication for immunomodulatory properties of oxacillin. Further murine infection experiments demonstrated in this context a differential release of cytokine and chemokines in the infected thigh muscle in dependence of the applied antibacterial therapy. Especially treatment with oxacillin, but to a less degree with minocycline or linezolid, too, exhibited high levels of various cytokines and chemokines, although they reduced the bacterial burden efficiently. In consequence, possible immunomodulatory effects of antibacterial compounds have to be taken into account for future applications of imaging platforms relying on the visualization of the immune response. However, this observation opens a new field for these imaging modalities since it might be extraordinary interesting to study the immunomodulatory effects of compounds or even bacterial factors in vivo. And finally, a two modality imaging platform which combines methods to visualize on the one hand the bacterial burden and on the other hand the immune response offers an innovative, new platform to study host-pathogen interaction in vivo in a non-invasive fashion. In summary, it could be shown that perfluorocarbon emulsions accumulate in immune cells at the site of infection in the murine S. aureus thigh infection model. The accumulation pattern shapes a ‘hollow sphere’ at the rim of the abscess area and its size and perfluorocarbon content is dependent on the severity of disease and/or efficacy of antibiotic therapy. Thus, 19F MRI with perfluorocarbon emulsions is a useful imaging modality to visualize sites and course of infection as well as to evaluate promising antibacterial drug candidates. Furthermore, since the accumulation of tracer depends on immune cells, it might be additionally interesting for studies regarding the immune response to infections, auto-immune diseases or cancer, but also to investigate the efficacy of immunomodulatory compounds and immunization., Staphylococcus aureus ist als zweithäufigste Ursache nosokomialer Infektionen eine ernste Bedrohung für Gesundheitssysteme weltweit. Dieses Pathogen ist in der Lage eine Vielzahl verschiedener Krankheitsformen, von oberflächlichen Wund- und Gewebsinfektionen bis hin zu invasiven Erkrankungen wie Bakteriämie oder Pneumonie, in Mensch und Tier zu verursachen. Zudem erwies sich dieser Krankheitserreger in der Vergangenheit als höchst anpassungsfähig durch den Erwerb oder die Entwicklung von Resistenzen gegenüber antibakterieller Substanzen, wodurch die Verfügbarkeit wirksamer Therapiemöglichkeiten drastisch eingeschränkt wurde. Aus diesem Grund ist die Entwicklung neuer Antibiotika und Behandlungsstrategien gegen S. aureus Infektionen von enormem gesellschaftlichem Interesse. Da aber lediglich eine von fünf Substanzen, die in klinische Studien eintreten, später als Medikament zugelassen wird, sollte die präklinische Evaluierung neuer, vielversprechender Therapeutika ebenso verbessert und überdacht werden. Diese Doktorarbeit addressiert in diesem Zusammenhang beide Facetten: zum einen wurde durch Einbeziehung von in vivo Bildgebungstechnologien ein deutlicheres Bild von der Effizienz neuer Substanzen während der präklinischen Evaluierung ermöglicht, zum anderen wurde mit Lysostaphin eine neuartige Substanzklasse zur Behandlung von S. aureus Infektionen getestet. Primärziel dieser Arbeit war deshalb die Entwicklung und Etablierung einer dualen Bildgebungsplattform bestehend aus Biolumineszenz- (BLI) und Kernspintomografischer (MRI) Bildgebung, um detaillierte Einblicke in Verlauf und Schwere von S. aureus Infektionen im Muskelinfektionsmodell der Maus zu ermöglichen. Die Biolumineszenzbildgebung bakterieller Infektionen wurde durch die Entwicklung von Luziferase-exprimierenden S. aureus Stämmen bereits in früheren Arbeiten ermöglicht und wurde in die Bildgebungsplatform integriert, um die Entwicklung der Bakterienlast nicht-invasiv verfolgen zu können. Kernspintomografie wurde in früheren Arbeiten hingegen kaum zur Darstellung der Effizienz anti-bakterieller Therapien während der Präklinik verwendet. Aus diesem Grund dienten die ersten Experimente zur Erkennung von Vor- und Nachteilen der Darstellung von S. aureus Infektionen im Tiermodell durch verschiedene Kernspintomografische Bildgebungsmethoden. Native, Protonen-basierte Kernspintomografie wies verlängerte T2 Relaxationszeiten im infizierten Muskelgewebe nach, doch eine klare Eingrenzung des infizierten Bereiches war nicht möglich. Die Anwendung von Eisenoxid und Perfluorcarbon Nanopartikeln, zwei Kontrastmittel zur Kernspintomografie, ermöglichte ebendiese. Eisenoxid Nanopartikel wurden durch ihren Signalstöreffekt auf das MR Protonensignal detektiert, während Perfluorcarbon Emulsionen durch 19F basierte Kernspintomografie nachgewiesen wurden. Säugetiere verfügen nicht über ausreichende Mengen von 19F Atomen, um ein spezifisches Signal zu liefern, weshalb 19F Kernspintomografie lediglich applizierte Perfluorcarbon Emulsion in vivo abbilden kann. Dieses Bild kann dann über ein zugleich aufgenommenes Protonen MR Bild gelegt werden, wodurch die Akkumulation des Kontrastmittels im Detail in anatomischer Umgebung dargestellt werden kann. Da es sich hierbei um einen Vorteil gegenüber anderen Kontrastmittel-basierten MR Bildgebungsmethoden wie Eisenoxid Nanopartikel gestützter Kernspintomografie handelt, wurden nachfolgende Experimente mit Perfluorcarbon Emulsionen durchgeführt. Studien zur Bildgebung der Perfluorcarbon Akkumulation am Infektionsherd des Muskelabszessmodels von S. aureus in der Maus zeigten deutliches 19F MR Signal nach Gabe zwischen Tag 2 und Tag 8 p.i.. In allen untersuchten Tieren zeigte sich eine Ansammlung des Kontrastmittels in Form einer Hohlkugel um den Abszessbereich, wobei das Signal während der gesamten Infektion stabil war. Um den Akkumulationsmechanismus zu identifizieren, wurden Durchflusszytometrie-, Zellseparations- und histologische Experimente durchgeführt. In diesem Zusammenhang erwiesen sich Neutrophile, Makrophagen, Monozyten und Dendritische Zellen als Perfluorcarbon-tragende Immunzelltypen, wobei das Gros an Kontrastmittel in Neutrophilen nachgewiesen werden konnte. Im Allgemeinen war der Großteil des Perfluorcarbonsignals mit Immunzellen assoziert, weshalb eine spezifische Immunzell-abhängige Akkumulation wahrscheinlich erscheint. Die histologischen Untersuchungen stützten diese Beobachtung, da die Kontrastmittel assoziierten Fluoreszenzmarker nur in der Nähe von Immunzellnuclei gefunden werden konnten. Die Etablierung von 19F Kernspintomografie mit Perfluorcarbon Emulsionen als Infektionsbildgebungsmethode ermöglichte im nächsten Schritt die Untersuchung von antibakterieller Therapie auf das MR Signal, um die Eignung dieser Methode für die Präklinik zu evaluieren. Deshalb wurden die Wirksamkeit von Vancomycin und Linezolid, zweier klinisch höchst relevanter Antibiotika zur Behandlung von S. aureus Infektionen, im Muskelabszessmodel der Maus untersucht. Beide erwiesen sich als effizient in der Verringerung der bakteriellen Last im infizierten Muskel und des Bakterien-Biolumineszenzsignals, aber auch bei der Reduktion der Stärke und des Volumens der Perfluorcarbon Akkumulation am Infektionsherd, die durch 19F Kernspintomografie dargestellt und vermessen wurde. Alle drei Methoden zeigten dabei das gleiche Effizienzmuster nach dem Linezolid wirksamer bei der Bekämpfung der Infektion war. Folglich erwies sich 19F Kernspintomografie mit Perfluorcarbon Emulsionen als effektiv um den antibakteriellen Effekt von Antibiotika in präklinischen Modellen zu untersuchen. Konsequenterweise wurde im nächsten Schritt eine neuartige Substanz zur Behandlung von S. aureus Infektionen mit Hilfe der Bildgebungsplattform untersucht: Lyostaphin. Diese Endopeptidase schneidet spezifisch die Zellwand von S. aureus und wurde in verschiedenen Konzentrationen oder in Kombination mit Oxacillin im Muskelabszess- oder Katheterinfektionsmodell der Maus gestestet. Lysostaphin in der Konzentration von 5 mg/kg Körpergewicht (Maus) oder Lysostaphin in der Konzentration von 2 mg/kg in Kombination mit Oxacillin führten zu einer starken Verringerung der Bakterienlast und des Biolumineszenzsignals in beiden Modellen. Die Ansammlung von Perfluorcarbon Kontrastmittel war zudem in diesen beiden Gruppen stark reduziert im Vergleich zur Negativkontrolle und den mit Vancomycin und Oxacillin behandelten Tieren. Zusammenfassend kann festgestellt werden, dass Lysostaphin eine vergleichbare oder bessere Wirksamkeit als Vancomycin oder Oxacillin alleine lieferte. Aus diesem Grund scheint eine Weiterentwicklung dieser Substanz zur Behandlung von S. aureus empfohlen. Der Nutzen der Bildgebungsplattform wurde in diesen Experimenten zudem dadurch deutlich, dass alle drei Methoden zur Bestimmung der Schwere der Erkrankung ähnliche Wirksamkeiten der Antibiotika anzeigten. Dennoch muss festgestellt werden, dass die Gruppen, die Oxacillin entweder alleine oder in Kombination mit Lysostaphin erhielten, stärkere Perfluorocarbon Akkumulation am Infektionsherd aufwiesen als von den Bakterienlast- oder Biolumineszenz-Ergebnissen zu erwarten gewesen wäre. Ein Grund hierfür könnten mögliche immunomodulatorischen Effekte von Oxacillin sein. Tatsächlich zeigten weitere Experimente Variationen in den Konzentrationen von Cytokinen und Chemokinen im infizierten Muskel in Abhängigkeit der verwendeten Antibiotikatherapie. Besonders die Behandlung mit Oxacillin, in geringerem Maße aber auch mit Minocyclin oder Linezolid, führte zu erhöhten Konzentrationen, wenngleich die Bakterienlast deutlich reduziert werden konnte. Folglich sollten mögliche immuno-modulatorischen Effekte antibakterieller Substanzen bei zukünftiger Anwendung von Bildgebungsplattform, die auf dem Markieren von Immunzellen basieren, mit ins Kalkül gezogen werden. Auf der anderen Seite eröffnet diese Beobachtung ein neues Anwendungsfeld für diese Bildgebungsmethoden, da es außerordentlich interessant erscheint, damit immuno-modulatorische Substanzen oder bakterielle Faktoren in vivo zu untersuchen. Zu guter Letzt, ermöglicht diese Bildgebungsplattform, die Methoden zur Darstellung der bakteriellen Last auf der einen und des Immunsystems auf der anderen Seite verknüpft, eine innovative, neue Möglichkeit Wirt-Pathogen Interaktionen nicht-invasiv und in vivo studieren zu können. Zusammenfassend konnte gezeigt werden, dass Perfluorcarbon Emulsionen in Immunzellen am Infektionsherd des S. aureus Muskelabszessmodells der Maus akkumulieren. Die Ansammlung formt eine Hohlkugel am Rand des Abszessbereiches, deren Größe und Fluorgehalt von der Schwere der Erkrankung und/oder der Wirksamkeit der angewandten Antibiotikatherapie abhängt. Aus diesem Grund erwies sich 19F Kernspintomografie mit Perfluorcarbon Emulsionen als Kontrastmittel als nützliche Platform zur präklinischen Evaluierung antibakterieller Substanzen. Weiterhin erscheint diese Methode wegen der Akkumulation des Kontrastmittels in Immunzellen, als interessant zum Studium der Immunantwort gegenüber Infektionen, aber auch Krebs oder Autoimmunerkrankungen sowie zur Erforschung von immuno-modulatorischen Substanzen und Impfansätzen.