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In vitro bacteriostatic effects of rifampin on Orientia tsutsugamushi.
[scrub typhus]
We
performed
an
in
vitro
cell
culture
experiment
to
ascertain
whether
rifampin
exhibits
bactericidal
effects
against
Orientia
tsutsugamushi
,
the
causative
agent
of
scrub
typhus
.
ECV
304
cells
were
infected
with
the
Boryong
or
AFSC-
4
strain
of
O
.
tsutsugamushi
and
then
,
the
cultures
were
maintained
in
media
with
increasing
concentrations
of
rifampin
,
azithromycin
,
doxycycline
,
or
chloramphenicol
for
4
days
.
On
day
5
,
the
media
were
replaced
with
fresh
antibiotic-free
medium
and
the
cultures
were
maintained
until
day
28
.
On
days
5
,
13
,
and
28
,
immunofluorescence
(
IF
)
staining
of
O
.
tsutsugamushi
was
performed
.
IF
staining
on
days
13
and
28
revealed
increasing
numbers
of
IF-
positive
foci
in
all
cultures
,
even
in
cultures
initially
exposed
to
the
highest
concentration
of
rifampin
(
80
µg
/
mL
)
,
azithromycin
(
80
µg
/
mL
)
,
doxycycline
(
20
µg
/
mL
)
,
or
chloramphenicol
(
100
µg
/
mL
)
.
The
present
study
reveals
that
rifampin
has
no
bactericidal
effect
against
O
.
tsutsugamushi
as
observed
for
azithromycin
,
doxycycline
,
and
chloramphenicol
.
A
subpopulation
of
the
bacteria
that
are
not
killed
by
high
concentrations
of
the
antibiotics
may
explain
the
persistence
of
O
.
tsutsugamushi
in
humans
even
after
complete
recovery
from
scrub
typhus
with
antibiotic
therapy
.
Diseases
Validation
Diseases presenting
"even in cultures initially exposed to the highest concentration of rifampin"
symptom
scrub typhus
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