Phage typing of the untypable strains of Staphylococcus aureus by the experimental phages and the heat shock method.
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Prevalence of exfoliatin production has been investigated in 100 strains of Staphylococcus aureus, bacteriophage group II, by inoculation into newborn mice. Serotyping, detection of protein A and antibiotic susceptibility tests have also been performed. Thirty-one strains (31%) were toxin producers; they all produced a yellow pigment; there was no difference in phage attacks between toxinogenic and non-toxinogenic strains; but exfoliatin production was significantly associated to the presence of agglutinogens h2 and 263-2; rate of protein-A presence and of antibiotic susceptibility did not differ between the two groups of strains. In addition, toxin production has been investigated in 31 isolates from various skin lesions; 9 were found toxinogenic (8 amongst them had been cultivated from bullous lesions); most of them belonged to phage group II and possessed agglutinogens h2 and 263-2. So, in order to carry out the diagnosis of some bacterial skin infections, clinical symptoms, pathological and bacteriological data must be compared; the latter must include phage-typing, serotyping and exfoliatin detection.
The heat shock technique (heating a culture at 55 degrees C for 3 min immediately before phage typing) has been used in our laboratory as an adjunct to routine phage typing for 2 years. This has enabled phage typing patterns to be determined on isolates otherwise recorded as untypable. The method is easily performed and standardized. Phage patterns were found to be reproducible and adequate discrimination was achieved. We found the technique provided significant information which was not available by conventional typing.
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A phage-induced cell wall solubilizing enzyme isolated from phage-infected Staphylococcus aureus phage type 80 was purified 588-fold. The pH optimal activity was 6.8 to 7.3, and pH optimal stability, 6.5 to 7.5. It was inhibited by p-hydroxymercuribenzoate, ethylenediaminetetraacetic acid, and specific rabbit antisera. The cell wall lytic reaction is a peptidase resulting in cleavage of the cell wall peptide at N-terminal alanine, glutamic acid, and glycine. Electron micrographs are shown of cell wall "ghosts" remaining after the enzymatic digestion of cell walls.
Sixty percent of Staphylococcus aureus isolates from patients in Israeli hospitals proved to be non typable by the conventional phage typing method. Heat pretreatment improved typability only to 54% while reverse typing increased typability to 75%. In general isolates typable by conventional phages belonged to group V, II, III, I, or to mixed groups. While isolates typable only by reverse typing belonged to group III, II, the extended group III + IIIa, or to mixed groups, but seldom to group I. Although most isolates were resistant to penicillin G, only one half were resistant to other antibiotics as well. While one third of these isolates could by typed by conventional phage typing, typability was significantly improved to over 80%, by the use of reverse typing as the additional typing method. Two main groups of oxacillin resistant isolates were identified. The partial resistant group consisting of isolates resistant to penicillin G and oxacillin with no or few other resistances. These isolates were mostly typable by conventional phage typing (group V) and dominated in the first study period (1989-1990) but were only seldom isolated in the second one (1991-1992). The multiresistant group consisted of isolates resistant to penicillin G and oxacillin accompanied by resistances to 3-5 other antibiotics (chloramphenicol, clindamycin, erythromycin, gentamicin and tetracycline). These isolates were mostly typable by reverse typing (the extended group III + IIIa) and showed no change in isolation frequencies during the entire study period. Reverse typing is proposed by us as a typing tool for these multiresistant S. aureus isolates.
Of 2,144 isolates of Staphylococcus aureus (from human beings in New York State) received in the authors' laboratory during 1975, 992 (46.,%) were nontypable with the use of the international basic set of bacteriophages. These 2,144 isolates were retested with the use of the recently added phages 94, 95, and 96. Nearly 60% of the isolates were lysed with one or more of these three phages, including 64% of those previously nontypable, thus reducing the percentage of nontypables to 16.5%. One hundred randomly selected isolates that remained nontypable were heat-shocked and retested with the revised basic set of phages, which includes the three new phages. Forty-three isolates were typable with the use of this procedure; all but one of these produced the exact same phage pattern in at least three of five trials.
Enterotoxin was detected in 22 (61.1%) of the 36 S. aureus strains isolated from clinical materials and in 3 (13%) of the 23 S. aureus strains from food samples (P < 0.05). On the basis of individual types of enterotoxin, staphylococcal enterotoxin A (SEA) was produced by 11.1%, SEB by 38.9% and SEC by 22.2% of SS. aureus strains from clinical material. Of the food S. aureus strains, SEC and SED produced by 8.7% and 4.3% respectively. Of the clinical and food S. aureus strains, 52.8% and 39.1%, respectively, were typeable by the 23 phages of International Phage Set. The majority of the typeable S. aureus strains from clinical and food sources belonged to group II being at 22.2% and 17.4% respectively. Furthermore, of the 14 SEB-producing S. aureus, 42.9% were of phage group II. In conclusion, the results obtained indicate that enterotoxin-producing S. aureus strains from clinical materials in Libya are not uncommon; however, certain foods appear not to be the source of such strains. Because of the low susceptibility to bacteriophages shown by S. aureus isolated in Libya, compared to reports from several countries, other methods of typing should be used in conjunction with phage typing in epidemiological investigations concerning this organism.
øg1e is a temperate phage of the Lactobacillus strain G1e. The phage-host junctions attR and attL cloned from the lysogen have a 24-bp common (core) sequence implicated in recombination. DNA sequencing analysis of a 5.2-kbp SacI fragment of the øg1e phage genome (42.5 kbp) revealed two possible open reading frames (ORF), xis and int, and the phage attachment (recombination) site (attP), whose 24-bp sequence is identical to the core sequence detected in attR and attL. The deduced int product (Int) is a basic protein of 391 amino acids with an estimated pI of 9.70, and significantly resembles other presumed integrases encoded by the Lactobacillus and Lactococcus phages including øadh and øLC3, as well as the Escherichia coli phages such as lambda. The predicted øg1e xis protein (Xis) is small and very acidic (66 amino acids; pI 4.55), and shows a resemblance (32% overall identity) with a putative excisionase encoded by the Staphylococcus phage ø11. The øg1e Int with a deduced molecular mass of 45.5 kDa was overproduced in E. coli cells, and electrophoretically analyzed.
Strains of Staphylococcus aureus were isolated from 360 patients with angular cheilitis. Of these 24 per cent were sensitive to penicillin G, 74 per cent to tetracycline, 93 per cent to fusidic acid and 96 per cent to erythromycin. Twenty per cent belonged to bacteriophage Group I, 9 per cent to Group II, 13 per cent to Group III, 39 percent miscellaneous and 19 per cent were untypable. A number of phage typing patterns which have been reported for strains associated with specific forms of staphylococcal disease were present in the 360 isolates. In investigations involving cross infection of Staph. aureus, both patients and staff should be examined for evidence of infection at the angles of the mouth.
Examination of milk from goats yielded 41 strains from 40 clinically affected halves; 15 were Staphylococcus aureus, 6 Staph. epidermis, 1 Streptococcus agalactiae, 2 Strept. dysgalactiae, 5 Strept. uberis, 2 Corynebacterium pyogenes, 3 Escherichia coli, 3 Pasteurella spp. and 4 Mycoplasma spp. One half had dual infection of Staph. aureus and Strept. dysgalactiae. Twenty two of the 297 milk samples from apparently normal halves also harboured pathogens comprising of 9 Staph. aureus, 1 Strept. agalactiae, 2 E. coli, 2 Pasteurella spp., 2 Candida albicans and 6 Mycoplasma spp. Most of the bacterial isolates were sensitive to many broad spectrum antibiotics. Twenty of the 24 Staph. aureus isolates were phase typable by a set of 23 human Staphylococcal International Phages suggesting the utility of these phages for the typing of goat strains. The isolates were grouped into 15 phage-types, many of which have been reported from human infections in Iraq. This indicates the possibility of association of human strains of Staph. aureus in caprine mastitis. No definite correlation could be noted between antibiogram and phage types of Staph. aureus strains.
Bacteriophage typing was performed on 285 strains of Staphylococcus hyicus subsp. hyicus isolated from pigs, chickens, and cattle, using the 5 S. hyicus subsp. hyicus phages, S9, S13, S39, S188 and CH11. One hundred and twenty-eight (64.3%) of the 199 swine strains, 62 (100%) of the 62 chicken strains, and 24 (100%) of the 24 cattle strains were typable at either routine test dilution (RTD) or 100 X RTD. Most (124/128) of the typable swine strains showed phage patterns consisting of lytic reactions with one or more of the phages S9, S13, S39 and S188. Phage patterns including phage CH11 were detected in only 4 swine strains. All of the typable chicken strains showed phage patterns consisting of lytic reactions with phage CH11. Cattle strains had the phage patterns that were found most frequently in swine and chicken strains. This study suggested that phage typing might be a useful marker for distinguishing ecovars within S. hyicus subsp. hyicus.
A group of 596 Staphylococcus aureus strains isolated from various clinical sources or implicated in food poisoning was investigated for enterotoxins A and B (SEA and SEB) production. The conventional ELISA techniques (competitive and sandwich ELISA) were compared with a newly developed avidin-biotin ELISA in their ability to detect the enterotoxins. The avidin-biotin system was not remarkably influenced by SPA up to 10 micrograms/ml. A semi-quantitative competitive ELISA for the detection of staphylococcal protein A (SPA) in culture supernatants was carried out in parallel. The strains isolated in cases of food poisoning showed different antibiotic resistance patterns, whereas the strains from clinical sources were selected for either methicillin or penicillin resistance only. The strains isolated in food poisoning outbreaks (FP strains) were enterotoxin A positive in 22%, enterotoxin B positive in 11%, and SEA + SEB positive in 9% of cases. The strains with resistance to penicillin only (PER strains) produced SEB in 26%, SEA in 14%, and both toxins in 7% of the cases. The methicillin-resistant strains (MCR strains) produced SEA in 59% of cases, whereas SEB was produced in 6% only (SEA + SEB: 20%). 37% of the SEA producers belonged to phage group III (SEB: 30%; SEA + SEB: 25%) and 12% (SEB: 11%; SEA + SEB: 9%) to phage group I. 26% of the SEA-producing and 37% of the SEB-producing strains (SEA + SEB: 23%) were non-typable.
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Staphylococcus felis is a coagulase-negative Staphylococcus (CoNS) primarily associated with the feline microbiota and only rarely reported in human disease. Here, we report its implication in diabetic foot osteomyelitis, and provide the first comprehensive characterization of its pathogenic potential. Two isolates (NSF001 and NSF002), recovered 5 months apart from bone biopsies of the same patient, were analyzed for growth kinetics, biofilm formation, and intracellular persistence in macrophages and osteoblasts. Both isolates proliferated efficiently, produced robust biofilm, and persisted within host cells, most markedly in osteoblasts. In a zebrafish embryo infection model, both isolates caused significant mortality, confirming their pathogenic potential in vivo. Whole-genome sequencing revealed conserved virulence determinants, a narrow resistome, and strain-specific genomic variations affecting genes involved in virulence regulation, phage defense, and iron acquisition. The lytic phage SAVM02, previously characterized for activity against other Staphylococcus species, effectively inhibited S. felis growth in vitro and conferred protection in vivo against lethal infection. Notably, the two sequential isolates differed in their in vivo virulence and phage susceptibility, paralleling these within-host microevolutionary changes and illustrating bacterial adaptation during chronic infection. Altogether, this study establishes S. felis as a CoNS capable of intracellular persistence, biofilm formation, and in vivo virulence in chronic human infection. Our findings also highlight the therapeutic potential of lytic phages against virulent CoNS species and support further investigation of phage therapy for chronic staphylococcal infections.IMPORTANCECoagulase-negative staphylococci (CoNS) are increasingly recognized as genuine agents of chronic infection, yet the pathogenic capacity of most individual species remains undefined. Staphylococcus felis, a commensal of cats only exceptionally reported in humans, had never been implicated in a chronic human infection. Here, we describe two sequential S. felis isolates recovered from bone biopsies of a patient with diabetic foot osteomyelitis and show that this species combines biofilm formation, intracellular persistence in macrophages and osteoblasts, and lethality in a zebrafish embryo model. Whole-genome comparison of the two isolates uncovered microevolutionary changes, most notably in iron-acquisition and genome-defense loci, that paralleled differences in virulence and phage susceptibility. These findings extend the list of CoNS capable of causing invasive human disease and provide a rationale for lytic phage therapy against emerging, difficult-to-treat staphylococcal pathogens.