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Species identification, antibiotic sensitivity and slime production of coagulase-negative staphylococci isolated from clinical specimens.

Two hundred and seventy-five consecutive clinical isolates of coagulase-negative staphylococci, including strains associated with disease, contaminants and skin colonizers, were speciated, tested for slime production and for their sensitivity to a range of antibiotics. Staphylococcus epidermidis was the most commonly identified species, comprising 63% of all isolates. Slime production was detected in half the strains of Staph. epidermidis, Staph. haemolyticus and Staph. saprophyticus but was rare in other species. Most Staph. haemolyticus strains and approximately half of the Staph. epidermidis strains were resistant to five or more antibiotics. A significant association was found between slime production and multiple antibiotic resistance. For catheter-associated strains, clinical relevance was predictable by species i.e. Staph. epidermidis. Multi-resistant slime-positive Staph. haemolyticus strains, although infrequently associated with disease, were common skin colonizers, presumably acquired from the hospital environment. We describe a practical and inexpensive scheme for the speciation of human coagulase-negative staphylococcal isolates.

Coagulase↗

In vitro activity of levofloxacin against coagulase-positive and -negative staphylococci.

The in vitro activity of levofloxacin compared with that of ciprofloxacin, ofloxacin and norfloxacin were examined by conventional in vitro tests against 150 clinical isolates of staphylococci, subdivided according to species and susceptibility to methicillin. Although the minimum inhibitory concentrations (MICs) of all quinolones were highest in methicillin-resistant Staphylococcus aureus strains, the activity of levofloxacin was almost complete in methicillin-resistant S. epidermidis and methicillin-resistant S. haemolyticus when compared with ciprofloxacin and ofloxacin, which showed more than 30% resistance. Methicillin-susceptible S. aureus and S. epidermidis strains were susceptible to all quinolones with few differences between the antibiotics tested. The minimal bactericidal activity of levofloxacin was within the double dilution range of MIC values for all strains tested, demonstrating its potent role against staphylococci. In time-kill studies, levofloxacin exerted bactericidal activity within 3 h against all staphylococci. These in vitro results suggest that levofloxacin is a potent fluoroquinolone against coagulase-negative staphylococci and that it is both methicillin-susceptible and resistant. Further studies are necessary to determine the role of this drug in the treatment of infections sustained by these microorganisms.

Anti-Infective Agents↗

Identification of coagulase-negative staphylococci with the API STAPH-IDENT system.

A group of 300 clinically derived isolates of coagulase-negative staphylococci were tested in parallel with the API STAPH-IDENT system (Analytab Products) and 14 conventional biochemical tests contained in Kloos and Schleifer's simplified scheme for identification of human Staphylococcus species. STAPH-IDENT is a miniaturized biochemical test strip that incorporates four synthetic chromogenic substrates, urea, arginine, and four carbohydrates and that requires only a 5-h test period. Use of the STAPH-IDENT system alone allowed correct or partly correct classification of 67% (201 of 300) of the study isolates. However, if a supplemental test was performed (most often novobiocin susceptibility), correct classification of an additional 25.7% (77) was possible, for a total of 92.7% of isolates identified to the species level. Species correctly identified included 94% (116 of 123) of Staphylococcus epidermidis isolates, 98% (63 of 64) of S. saprophyticus, 71% (34 of 48) of S. hominis, 100% (22) of S. simulans, 100% (18) of S. haemolyticus, 100% (17) of S. warneri, and 100% (8) of S. capitis. Fourteen percent (42 of 300) of profile codes encountered in this study were not included in the STAPH-IDENT profile register, but were included in Analytab Products' expanded computer data base.

Bacteriological Techniques↗

Vitronectin and type-I collagen binding by Staphylococcus aureus and coagulase-negative staphylococci.

Binding of 125I-labelled type-I collagen and 125I-labelled vitronectin (human serum spreading factor or S-protein) was studied using Staphylococcus aureus and coagulase-negative staphylococci of different species. Binding of collagen and vitronectin was time dependent for S. aureus ISP 546, and S. haemolyticus E 2498/86. Co-operative binding of vitronectin and collagen by staphylococcal cells was demonstrated. Binding to S. haemolyticus E 2498/86 was more rapid and was enhanced in vitronectin/collagen mixtures than for either protein separately. Furthermore, pre-incubation of staphylococcal cells with unlabelled collagen enhanced vitronectin binding. When cells of S. haemolyticus E 2498/86 were treated with pronase E, proteinase K, subtilopeptidase A or trypsin, vitronectin-binding was decreased by 50% or more, whereas collagen-binding was protease resistant. For the strains of S. aureus tested, both vitronectin and collagen binding were found to be protease sensitive. Type-I collagen peptides inhibited collagen-binding to S. haemolyticus E 2498/86, whereas vitronectin-binding was not affected perhaps indicating different receptors for these proteins. The binding of both collagen and vitronectin was shown to be reversible, since bound 125I-collagen and 125I-vitronectin were displaced after adding excess of the homologous protein.

Binding, Competitive↗

[Modern scheme for the diagnosis of staphylococci].

A simplified scheme for the subdivision of coagulase-positive staphylococci and another simplified scheme for the diagnostics of coagulase-negative species were worked out. On the basis of the production of staphylokinase, coagulation of human and bovine plasma, acetoin production from glucose, and growth on agar with crystal violet, it is possible to identify S. aureus with its biovars A, B, C1, C2, D, as well as S. intermedius. The coagulase-negative species can be diagnosed according to their sensitivity to novobiocin, nitrate reduction, fermentation of maltose, sucrose, salicin, xylose, trehalose, mannitol and mannose, and haemolytic activity. The proposed diagnostic schemes were verified with success on the collection strains and on the 1305 staphylococci strains isolated largely from the bovine mammary gland, from dogs, man and domestic fowl. In S. aureus strains a close correlation was demonstrated between their biotype characteristics and the host species. A similar correlation was determined for S. intermedius. As to the coagulase-negative species, S. epidermidis, S. hominis and S. haemolyticus were diagnosed most frequently. Both schemes represent a reliable, prompt and technically simple method of the diagnostics of the Staphylococcus microorganisms.

Animals↗

Different susceptibilities of Staphylococcus and Gram-negative rods to epigallocatechin gallate.

We examined the antibacterial effects of epigallocatechin gallate (EGCg, the main constituent of tea catechins) against various strains of Staphylococcus and Gram-negative rods. Compared to the minimum inhibitory concentrations (MICs) of EGCg against S. aureus, S. epidermidis, S. hominis, and S. haemolyticus (50-100 micro g/ml), higher MICs (>or=800 micro g/ml) were observed against Gram-negative rods, including Escherichia coli, Klebsiella pneumoniae, Salmonella typhi, Proteus mirabilis, Pseudomonas aeruginosa, and Serratia marcescens. And difference was observed between the binding abilities of EGCg with viable S. aureus and with E. coli. The bactericidal activity of EGCg for S. aureus was blocked dose-dependently by purified peptidoglycan but not by lipopolysaccharide or dextran. It was also found that peptone and protein, but not amino acids, in the culture medium greatly affected the antibacterial activity of EGCg. These results indicate that the structure of the bacterial cell wall and the different affinities of EGCg with the various cell wall components are responsible for the different susceptibilities of Staphylococcus and Gram-negative rods to EGCg.

Anti-Bacterial Agents↗

Selection of resistance to glycopeptide antibiotics in staphylococci.

Clinical strains belonging to ten Staphylococcus species were investigated for their abilities to develop single-step resistance in vitro to vancomycin and teicoplanin. Surviving clones were only recovered from strains of three species, namely S. aureus, S. epidermidis, and S. haemolyticus. A similar ratio of grown to plated cells (approximately 1 x 10(-8)) was mostly obtained from strains of S. aureus and S. epidermidis. Higher ratios (1 x 10(-6) to 1 x 10(-7)) were obtained from strains of S. haemolyticus, especially when exposed to teicoplanin. When tested for susceptibility, many survivors exhibited vancomycin and teicoplanin minimum inhibitory concentrations (MICs) below the drug concentration used for in vitro selection, probably due to an inoculum effect in the plating procedure. However, MICs were particularly high in many clones of S. haemolyticus (up to 12.8 microg/ml for vancomycin, and > or = 102.4 microg/ml for teicoplanin).

Anti-Bacterial Agents↗

Hemagglutination by Staphylococcus saprophyticus and other coagulase-negative staphylococci.

Hemagglutination tests were performed to specify surface lectins (hemagglutinins) of four coagulase-negative staphylococcal species: S. saprophyticus (31 strains), S. epidermidis (5 strains), S. haemolyticus (3 strains), and S. warneri (3 strains). All strains of S. saprophyticus agglutinated sheep red blood cells (RBC) and the hemagglutination was inhibited by N-acetylglucosamine (GlcNAc) plus either N-acetylgalactosamine (GalNAc, 15 strains) or N-acetylneuraminic acid (NANA, 16 strains). Those strains showing inhibition by GalNAc also agglutinated horse RBC while those inhibited by NANA agglutinated rabbit RBC. The former type was more common among urinary tract isolates (10/15) and the second one among respiratory isolates (9/14). The eleven strains of other staphylococci agglutinated rabbit (and not sheep or horse) RBC; this hemagglutination was never inhibited by GlcNAc but instead by NANA alone or together with another sugar (7 strains) or by other sugars (4 strains, 3 different patterns of inhibition).

Animals↗

Deoxyribonucleic acid relatedness amongst Staphylococcus epidermidis and Staphylococcus saprophyticus strains.

The degree of binding was determined between DNA preparations from 65 staphylococci representing cluster defined in a numerical phenetic survey and 3H-labelled DNA from reference strains of S. epidermidis, S. haemolyticus, S. hominis, S. saprophyticus and S. warneri. The congruence between the DNA pairing and numerical phenetic data was good with S. epidermidis and S. saprophyticus being shown to be genomic species. However, some strains identified as S. epidermidis using recommended diagnostic procedures were found to belong to other taxa, notably S. simulans and S. warneri. The moles percent guanine plus cytosine content of the DNA of the test strains was within the range 27 to 34.

Base Composition↗

The production of fatty acid modifying enzyme (FAME) and lipase by various staphylococcal species.

Eighty-six strains encompassing 11 species of coagulase-negative staphylococci were examined for the production of fatty acid modifying enzyme (FAME) and lipase. Staphylococcus schleiferi and S. saprophyticus most closely resembled S. aureus in that 80% of the strains produced both enzymes. In contrast, no strains of S. lugdunensis and S. haemolyticus tested produced these enzymes. S. simulans was unusual in that eight of 10 strains produced FAME, but only one produced lipase. Among the other species the proportion of strains producing both enzymes ranged from 10 to 60%. Generally there was a strong correlation between FAME and lipase production.

Acyltransferases↗

Cross protection between a strain of Staphylococcus epidermidis and eight other species of coagulase-negative staphylococci.

Passive protective activity of rabbit antiserum prepared by a representative capsular type II strain of Staphylococcus epidermidis in mice was absorbed out with homologous capsular type strains of S. simulans, S. cohnii, S. xylosus, S. hominis, S. capitis, S. hyicus, S. haemolyticus, and S. saprophyticus in addition to the homologous strain. The minimum amount of the strains required for absorption differed greatly, depending upon the strain. No absorption of the activity was shown with a strain of capsular type I and III of S. epidermidis, S. simulans, and S. cohnii, and a strain of capsular type III of S. hominis. These results suggest a possible capsular type specificity in the cross protection between strains of S. epidermidis and other species of coagulase-negative staphylococci.

Animals↗

Antimicrobial susceptibility of Staphylococcus saprophyticus and urethral staphylococci.

The activity of eight antimicrobial agents was determined against 115 isolates of Staphylococcus saprophyticus. All were susceptible to ampicillin, cephalexin, and trimethoprim-sulfamethoxazole and resistant to nalidixic acid and novobiocin. A bimodal pattern of susceptibility to erythromycin was observed: 80% were inhibited by 0.25 microgram/ml, whereas 13% required greater than or equal to 128 micrograms/ml. The following urethral staphylococci were susceptible to ampicillin, cephalexin, and nitrofurantoin but resistant to nalidixic acid: S. epidermidis, S. hominis, S. haemolyticus, S. warneri, S. simulans, and S. cohnii.

Anti-Bacterial Agents↗

Bactericidal activity of teicoplanin in an in-vitro two-compartment kinetic model.

The bactericidal activity of teicoplanin was studied in a model system in which antibiotic concentration is continuously varied. A two-compartment open model was used to reproduce, in vitro serum pharmacokinetics of teicoplanin in humans during 24 h after iv administration. Staphylococcal and streptococcal strains of various species were tested. Teicoplanin showed rapid killing of Staphylococcus epidermidis and Staph. hominis. All strains of Staph. epidermidis were rapidly killed in spite of the high MIC values (4-16 mg/l). The killing effect against Staph. haemolyticus was less rapid and marked than against Staph. epidermidis, with strain to strain variation. A 99.9% kill was achieved for most strains within 22 h, but with other isolates regrowth occurred which was due to the presence of highly resistant cells in the original population. Other staphylococci (Staph. aureus, Staph. saprophyticus) and Streptococcus pyogenes, Str. bovis and Str. salivarius were reduced by 99.9% within 22 h. Bactericidal activity against other streptococci (Str. mutans, Str. agalactiae, Str. faecalis, Str. faecium) was less marked; against Str. sanguis teicoplanin was bacteriostatic.

Anti-Bacterial Agents↗

The effectiveness of lysostaphin therapy for experimental coagulase-negative Staphylococcus endophthalmitis.

PURPOSE: To quantitatively determine the effectiveness of lysostaphin therapy for experimental endophthalmitis mediated by coagulase-negative Staphylococcus species, the leading cause of postsurgical endophthalmitis. METHODS: Minimal inhibitory concentrations (MIC) of lysostaphin were determined for 54 isolates representing the following species: S. epidermidis, S. warneri, S. haemolyticus, S. cohnii, S. simulans, and S. capitis. The effectiveness of lysostaphin therapy was tested in an experimental model of endophthalmitis by intravitreally injecting log phase bacteria (100 colony-forming units; cfu) into rabbit eyes (n = 3 eyes per group). At 8 hr postinfection (PI), lysostaphin (250 microg) was injected intravitreally, and the number of cfu/ml of vitreous was determined at 24 hr PI. RESULTS: Average MIC for S. epidermidis was 0.7 microg/ml for 90% of the 33 strains tested. Six methicillin-resistant strains of S. epidermidis (MRSE) had an average MIC of 0.74 micro g/ml. All other species had MIC values of =1.1 microg/ml, except for one strain of S. capitis (MIC = 15.6 microg/ml) and one S. haemolyticus (MIC = 1.41 microg/ml). At 24 hr PI, all untreated eyes had between 5.7 and 8.08 log cfu/ml vitreous humor. Treatment with lysostaphin significantly reduced the cfu/ml as compared with untreated eyes for 13 strains tested in vivo (p = 0.020), but not for two S. haemolyticus strains (p = 0.13), two MRSE strains (p = 0.544), or one S. cohnii strain (p = 0.1366). Treatment with lysostaphin reduced the cfu/ml of methicillin-sensitive S. epidermidis strains by 6 logs; for S. warneri, there was a 2 log reduction; and for the other species a 4 log reduction in cfu/ml relative to untreated eyes. CONCLUSIONS: Lysostaphin was mostly effective in treating coagulase-negative staphylococcal experimental endophthalmitis.

Animals↗

[Incidence of methicillin-resistant and methicillin-susceptible Staphylococcus strains in clinical materials].

365 S. aureus and 165 CNS were evaluated for susceptibility to methicillin. They were received from various clinic of Clinical Hospital in Bydgoszcz. The bacterial cells that grew in the presence of 25 mg methicillin/L were evaluated as methicillin-resistant. It was found that the 129 MRSA and MRCNS. Incidence depended on the kind of clinic and material. Most often they were isolated from clinic: Surgery, Neurosurgery, Intensive Care Unit, Neurology and Ortopedics. They were from: intubation tube, catheters and vascular grafts. The methicillin-resistant S. epidermidis and S. haemolyticus showed above 50% resistance to methicillin.

Blood Vessel Prosthesis↗

Polar lipids of Staphylococcus strains analysed by fast atom bombardment mass spectrometry.

This study used fast atom bombardment mass spectrometry (FAB MS) to obtain detailed information on polar lipids of Staphylococcus by examining 23 isolates. Eighteen major anions were found in the range m/z 199-297, consistent with the presence of carboxylate anions. A further 21 major anions were found in the higher mass regions of m/z 609-805, consistent with the presence of phospholipid anions. In Staph. aureus, Staph. epidermidis, Staph. haemolyticus and Staph. hominis, the most intense peaks putatively assigned as carboxylate ions were consistent with presence of C15:0, followed by C17:0 except in the case of Staph. epidermidis. The major phospholipid anions were consistent with the presence of PG(30:0), PG(32:0) and PG(33:0). It is concluded that Staphylococcus has a characteristic polar lipid profile and that qualitative and quantitative differences may be seen between Staph. aureus and Staph. epidermidis.

Carboxylic Acids↗

[Dichotomous keys for identifying Staphylococcus isolated from bovine milk].

Many efforts have been done in order to identify species of Gram positive and catalase positive coccus isolated from raw milk. The aim of this epidemiological observation, was to identify different strains isolated from raw milk according to conventional criteria and to recommend a useful and practical methodology for their correct identification. Gram positive and catalase positive coccus were tested for bacitracin resistance, novobiocin susceptibility, coagulase and others tests (e.g. carbohydrate fermentation). Dichotomic keys were designed to typify Staphylococcus' species. They were grouped into: Group I, coagulase positive, novobiocin susceptibility; Group II coagulase negative novobyocin resistance; and Group III coagulase negative novobiocin susceptibility. 62 strains were tested and S. hycus (17.7%) was the most isolated species, S. aureus (14.5%), S. sciuri (12.9%) and S. haemolyticus (11.3%) were also isolated. S. epidermidis was not isolated.

Animals↗

Binding of fibronectin to Staphylococcus strains.

Fibronectin, a major protein component of plasma and loose connective tissue has previously been shown to bind to several strains of Staphylococcus aureus. We examined a large number of strains of different species of Staphylococcus with respect to their ability to bind fibronectin. The relative numbers of strains defined as fibronectin-binders among the different species were as follows: S. aureus (22 of 23), S. haemolyticus (5 of 5), S. warneri (8 of 11), S. hyicus (5 of 6), S. hominis (13 of 17), S. saprophyticus (11 of 20), S. epidermidis (4 of 7), and S. simulans (8 of 10). Only three species showed a predominance of nonbinders over binders: S. capitis (4 of 14), S. xylosus (0 of 4), and S. cohnii (3 of 11). These data indicate that staphylococcal species isolated from soft tissue infections frequently have the ability to bind fibronectin and suggest that the ability to bind to this protein may contribute to the virulence of coagulase-positive and coagulase-negative staphylococci.

Fibronectins↗