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Efficacy of Combined Vancomycin and Fosfomycin against Methicillin-Resistant Staphylococcus aureus in Biofilms In Vivo

Figure 4

Histological changes in the pouch tissues.

A, On Day 4 after infection (HE at 200× magnification), the pouch wall was made up of mostly necrotic tissue with scattered bacteria mass on its surface. B, On Day 8 (HE at 100× magnification), extensive necrotic tissue formed on the pouch surface with continuous bacteria colonies (black arrows), and inflammatory cell infiltration. B′, On Day 8 (Gram staining at 100× magnification), widespread Gram-positive bacterial colonies formed on the pouch surface at the same site showed in B (black arrows). C, On Day 16 (HE at 400× magnification), multilayer colonies formed on the pouch surface with more necrotic tissue in the control animals. A large number of inflammatory cells had infiltrated the necrotic tissues. D, On Day 16 (HE at 200× magnification), scattered colonies (black arrows) were observed in the necrotic tissues treated with either VAN or FOS. E, On Day 16 (HE at 200× magnification), bacterial colonies disappeared from animals receiving the combination therapy; newly formed granular tissues were observed.

Figure 4

doi: https://doi.org/10.1371/journal.pone.0113133.g004