Effect of subinhibitory concentrations of antimicrobials on meningococcal adherence.

Meningococci adhere to human pharyngeal cells and agglutinate erythrocytes. These events are dependent upon pili and are reduced by encapsulation. The effect of subinhibitory concentrations of seven antimicrobials on meningococcal adherence, antimicrobials on meningococcal adherence, piliation, hemagglutination (HA), and bacterial proteins was studied to determine their potential for modifying virulence. Piliation was reduced by most antibiotics but was most markedly (greater than 70%) reduced by rifampin, tobramycin, and VCN (vancomycin, colistin, and nystatin). Bacterial proteins as determined by sodium dodecyl sulphate--polyacrylamide gel electrophoresis were altered: tetracycline, sulfamethoxazole, rifampin, and VCN caused loss of a 43-45 K protein and a general decrease in all stainable protein bands, while erythromycin, ampicillin, and tobramycin only caused an increase in a 28 K protein. HA was reduced by ampicillin, tobramycin, erythromycin, and VCN but interstrain variability was present. Epithelial cell adherence was diminished by an average of 45% compared to controls. The meningococcal strains lost HA, piliation, and adherence in the same rank order, however, there was no significant rank correlation of antibiotic inhibitory activities on these parameters. These results indicate that subinhibitory antibiotic concentrations reduce meningococcal piliation and alter other bacterial proteins; these changes are associated with diminished adherence and hemagglutination, alterations which may be markers of meningococcal virulence.