Targeting Cutibacterium acnes RoxP to decrease morbidity and mortality of indwelling medical devices
William McCoy, M.D., Ph.D.
Human skin is covered by healthy microbes that can cause infection when introduced into the human body. These microbes can gain entry during the insertion of an indwelling medical device like a catheter, pacemaker, heart valve, or replacement joint. When an infection occurs, antibiotics are prescribed for weeks to months and the device is replaced, but this type of infection will still result in disability or death (>25% for mechanical heart valves) for many patients. Prior to a medical procedure, surgeons try to reduce the risk of these infections by (1) cleaning the skin and (2) giving antibiotics. The common skin microbe Cutibacterium acnes can survive these steps and go on to cause infections with significant consequences including death. To grow on human skin, C. acnes must produce the protein RoxP. Only C. acnes and one other bacterium make RoxP. I propose a study to develop (1) antibodies and (2) chemicals that prevent C. acnes growth by blocking RoxP activity. Since these new medicines will only affect C. acnes, their use should not carry the risks of traditional antibiotics (Clostridium difficile infections, antibiotic resistance). Medicines developed from this work will reduce healthcare costs and poor patient outcomes (including death) from the insertion of an indwelling medical device.