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In vitro activity of decaplanin (M86-1410), a new glycopeptide antibiotic.

The in vitro activity of decaplanin (formerly M86-1410), a novel glycopeptide antimicrobial agent, was tested against 169 gram-positive bloodstream isolates from patients at the University of Iowa Hospitals and Clinics and 12 selected vancomycin-resistant strains. Enterococcus faecalis, E. faecium, Staphylococcus aureus, streptococci, bacilli, corynebacteria, and listeria were inhibited by decaplanin (MICs for 90% of the strains tested [MIC90s], 0.12 to 4 micrograms/ml). However, some rarely isolated and selected Enterococcus sp. populations had a MIC90 of 16 micrograms/ml, and S. haemolyticus strains had a MIC90 of 8 micrograms/ml. These in vitro results suggest that decaplanin may be useful against most gram-positive strains, even though some Enterococcus species and coagulase-negative staphylococci were potentially resistant (MICs, greater than or equal to 8 micrograms/ml).

Ampicillin↗

Identification of Staphylococcus species with the API STAPH-IDENT system.

The API STAPH-IDENT system was compared with conventional methods for the identification of 14 Staphylococcus species. Conventional methods included the Kloos and Schleifer simplified scheme and DNA-DNA hybridization. The API STAPH-IDENT strip utilizes a battery of 10 miniaturized biochemical tests, including alkaline phosphatase, urease, beta-glucosidase, beta-glucuronidase, and beta-galactosidase activity, aerobic acid formation from D-(+)-mannose, D-mannitol, D-(+)-trehalose, and salicin, and utilization of arginine. Reactions of cultures were determined after 5 h of incubation at 35 degrees C. Results indicated a high degree of congruence (greater than 90%) between the expedient API system and conventional methods for most species. The addition of a test for novobiocin susceptibility to the API system increased the accuracy of identification of S. saprophyticus, S. cohnii, and S. hominis, significantly. Several strains of S. hominis, S. haemolyticus, and S. warneri which were difficult to separate with the Kloos and Schleifer simplified scheme were accurately resolved by the API system.

Bacteriological Techniques↗

The effect of antiseptic solutions on microorganisms in venous leg ulcers.

The effect on the microbial ulcer flora of wet gauze dressings soaked in antiseptic solutions used for desloughing leg ulcers is not known. Quantitative cultures were therefore performed in 45 venous leg ulcers, before application and after 15 minutes' treatment with gauze dressings with four different antiseptic solutions: aluminium acetotartrate (Alsol) 1%, potassium permanganate 0.015%, acetic acid 0.25% and chloramine 0.25%. The percentage of ulcers with each type of microorganism did not differ before and after application of the antiseptic solutions. Staphylococcus aureus was found in 79% of the ulcers, gram-negative rods in 39%, S. epidermidis in 21%, Proteus spp in 21%, Pseudomonas spp in 14% and fungi in none. Potassium permanganate reduced the mean number of bacteria per ulcer from 4.4 x 10(6) to 0.9 x 10(6) (ns), chloramine from 2.7 x 10(6) to 2.2 x 10(6) (ns), Alsol from 1.2 x 10(7) to 3.5 x 10(6) (ns) and acetic acid from 6.3 x 10(6) to 2.6 x 10(5) (p = 0.007). S. aureus was reduced by acetic acid (p = 0.002), gram-negative rods by both chloramine (p = 0.03) and acetic acid (p = 0.03). The number of Pseudomonas, Proteus, S. epidermidis and Streptococcus haemolyticus group G was not reduced significantly (p > 0.05) by any of the solutions.

Acetates↗

Staphylococcus saprophyticus as a cause of urinary tract infections.

Our objectives in this study were to elucidate various aspects of the epidemiology of Staphylococcus saprophyticus. This organism was isolated from the midstream urine specimens of 7.5% of 145 college women with frequency and urgency of urination and dysuria, but from only 0.07% of 14,835 urine specimens from adult inpatients at the Victoria General Hospital. It was found to be part of the urethral flora of only 2% of healthy women. Other staphylococci which formed part of the urethral flora of 100 healthy women included S. epidermidis (59 women), S. hominis (15 women), S. haemolyticus (13 women), S. warneri (9 women), and S. aureus (6 women). Finally, we determined that resistance to the 5-micrograms novobiocin disk has a 93% positive predictive accuracy as a presumptive test for S. saprophyticus.

Adolescent↗

Molecular epidemiology of Staphylococcus spp. contamination in the ward environment: study on mecA and femA genes in methicillin-resistant strains.

Staphylococcus spp. were isolated from the ward environment and antibiotic susceptibility tests were performed. Twenty-nine strains out of 274 isolates were S. aureus, and 41.4% of the S. aureus strains were methicillin resistant (MRSA). All 12 strains of MRSA were also resistant to oxacillin, ceftizoxime, ampicillin and clindamycin. Among the coagulase-negative staphylococci (CNS), methicillin-resistant (MR) strains of S. epidermidis, S. capitis, S. warneri, S. haemolyticus, S. hominis, S. auricularis, S. saprophyticus and S. cohnii were isolated. Eight of the 10 S. Haemolyticus strains were methicillin resistant. The femA gene was detected in S. aureus (MSSA and MRSA), but not in CNS by polymerase chain reaction (PCR) analysis and Southern blot analysis. The mecA gene was found in all the MRSA and MR-S. epidermidis strains tested, and one of the two MR-S. hominis strains, but not in MSSA, MS-S. epidermidis, MS-S. hominis, or MS-S. haemolyticus. DNA from one strain of MR-S. hominis and 2 strains of MR-S. haemolyticus was not amplified by PCR using the mecA gene primer, or hybridized by Southern blotting. The ambiguity that mecA was detected in some MR-CNS strains, but not in others is discussed.

Base Sequence↗

The activity of metal compounds against aerobic and anaerobic bacteria.

We evaluated the antimicrobial activity of two metal compounds, JM-1397 (OsO2[xylyl]2) and JM-2469 (AuCl[S2CPEt3]). Both inhibited methicillin-susceptible and methicillin-resistant Staphylococcus aureus at concentrations of 0.5-2 micrograms/ml, with a minimum inhibitory concentration (MIC90) of 1 microgram/ml for JM-1397 and 0.5 microgram/ml for JM-2469. Similar concentrations inhibited methicillin-susceptible and -resistant coagulase-negative staphylococci (S. epidermidis, S. haemolyticus, and S. saprophyticus). JM-2469 inhibited group A, B, C, F, and G beta-hemolytic streptococci and viridans group streptococci at 1-8 micrograms/ml (MIC90 4 micrograms/ml) but Enterococcus faecalis and E. faecium had MICs of 8-16 micrograms/ml. JM-1397 had MICs for these organisms of greater than 64 micrograms/ml. Bacteroides fragilis, other Bacteroides, and Clostridium species were inhibited by less than or equal to 0.12-4 micrograms/ml (MIC90, 0.5 microgram/ml). MICs of both compounds for Enterobacteriaceae and Pseudomonas spp. were greater than 64 micrograms/ml. These studies show that osmium and gold compounds have potential as topical agents against Gram-positive and anaerobic species.

Anti-Bacterial Agents↗

Isolation of coagulase-negative staphylococci from the milk and environment of sheep.

Various species of coagulase-negative staphylococci (C-NS) are reported to be common in milk and on the teat skin of domestic ruminants. The commonest C-NS species in mastitic milk of cows varies between reports, with Staphylococcus simulans (Jarp, 1991) in one and Staph. hyicus in another (Watts & Washburn, 1991). The teat skin of heifers may be colonized by Staph. xylosus or Staph. chromogenes, while Staph. chromogenes and Staph. warneri are reported as frequent isolates from teat canals and secretion (Boddie & Nickerson, 1986; White et al. 1989). Staph. haemolyticus was isolated frequently from the nares, the teat skin and the milk of goats (Valle et al. 1991), although others reported Staph. xylosus (Bedidi-Madani et al. 1992) or Staph. epidermidis and Staph. capitis (Kalogridou-Vassiliadou, 1991) as the most predominant C-NS in goats' milk. Staph. simulans has been found experimentally to be pathogenic for the mammary gland of meat ewes (Fthenakis & Jones, 1990), but little is known about the prevalence of this species in ewes' milk collected from cases of naturally occurring subclinical mastitis (SCM). The aim of the present investigation was the identification of the commonest C-NS species in ewes' milk collected from field cases of SCM or predominating in the ewes' environment.

Animals↗

Prevalence of coagulase negative Staphylococcus species among hospital personnel and surgical patients.

Two hundred and fourteen strains of Coagulase negative Staphylococci (CNS) isolated from hospital personnel (114 strains) and patients (100 strains) were identified upto species level. The prevalence rate of CNS in relation to sex, sources and type of specimens were analysed. Most of the CNS strains belonged to S. epidermidis (49.1% among carriers and 39% in clinical isolates) and S. hominis (36% each). Besides, five more CNS species, namely S. saprophyticus, S. capitis, S. haemolyticus, S. cohnii and S. xylosus were also isolated. (0.5 to 10.3% isolation rates). Maximum S. hominis isolated were from hospital personnel and urine from patients (63.4% and 72.2%, respectively), 50.0% and 33.3% of S. hominis were found from urine and blood, respectively. The present study revealed that the leading species S. epidermidis and S. hominis may play an important role in the nosocomial infections, especially among immunocompromised hosts during their hospital stay.

Carrier State↗

[Sensitivity to vancomycin and teicoplanin of coagulase-negative staphylococci isolated from clinical specimens].

The frequency of resistance and elevated resistance to teicoplanin and vancomycin among 689 strains of coagulase-negative staphylococci isolated in one year from clinical specimens was determined. Using ATB.STAPH test, a resistance was shown mainly among strains of S. epidermidis and S. haemolyticus. The elevated resistance to teicoplanin was much more frequently observed than to vancomycin. About 27% of isolated strains of S. haemolyticus and 6.8% of S. epidermidis were classified as resistant. Among other species only single strains were recognised as resistant: one strain of S. xylosus, one of S. cohni and one of S. intermedius. 94.7% of S. epidermidis and 100% of S. haemolyticus strains classified as resistant to teicoplanin in ATB showed MIC values 14 mg/l. Moreover it was shown that 26.3% of these strains of S. epidermidis and 33.3% of S. haemolyticus had MBC of teicoplanin values equal to or higher than 32 mg/l.

Coagulase↗

Prevalence and antimicrobial susceptibility of staphylococci isolated from saliva of clinically normal cats.

Samples were collected from 150 adult cats, processed for isolation of Staphylococcus species and tested for susceptibility to penicillin G, gentamicin, oxacillin, enrofloxin and tetracycline. Methicillin resistance was also determined. One hundred and four isolates were obtained (69.3% of samples). Coagulase-negative species were most common, and the most frequently isolated (33 samples) species was Staph. felis. Other coagulase-negative species, such as Staph. haemolyticus, Staph. simulans, Staph. epidermidis and Staph. saprophyticus were also isolated. Coagulase-positive staphylococci were obtained from 30 cats, and the only species recovered in this group was Staph. intermedius. Resistance to antibiotics was frequently observed, with 68.2% of the isolates showing resistance to at least one drug. Resistance to Penicillin G was observed in 68 of the 104 isolates (65.4%), 23 samples were resistant to oxacillin (22.1%), 33 to tetracycline (31.7%) and 24 to enrofloxin (23.1%). Gentamicin was the most active antimicrobial agent. The role of these microorganisms in the saliva of cats is discussed.

Animals↗

Rapid identification of staphylococcal strains from positive-testing blood culture bottles by internal transcribed spacer PCR followed by microchip gel electrophoresis.

PCR analysis of the 16S-23S rRNA gene internal transcribed spacer (ITS) followed by microchip gel electrophoresis (MGE) was evaluated for its usefulness in identification of staphylococci. Forty ITS PCR patterns were demonstrated among 228 isolated colonies of Staphylococcus aureus: 26 patterns for methicillin-susceptible S. aureus (MSSA; 91 strains), 11 patterns for methicillin-resistant S. aureus (MRSA; 99 strains), and 3 patterns for both MSSA and MRSA (38 strains). Thirty-seven control strains of coagulase-negative staphylococci (CNS) representing 16 species showed unique ITS PCR patterns (24 patterns) at the species and subspecies levels: two patterns for S. caprae, S. cohnii, S. haemolyticus, and S. saprophyticus; three patterns for S. lugdunensis; four patterns for S. capitis; and one pattern for each of the other CNS species. The combined PCR-MGE method was prospectively adapted to the positive blood culture bottles, and this method correctly identified MSSA and MRSA in 102 (89%) of 114 blood cultures positive for S. aureus on the basis of the ITS PCR patterns. Eight ITS PCR patterns were demonstrated from 166 blood culture bottles positive for CNS. The most frequent CNS species isolated from blood cultures were S. epidermidis (76%), S. capitis (11%), and S. hominis (8%). Overall, all 280 blood culture bottles shown to contain a single Staphylococcus species by routine phenotypic methods were correctly identified by the PCR-MGE method at the species level, whereas the organism failed to be identified in 8 culture bottles (3%) with mixed flora. The PCR-MGE method is useful not only for rapid identification ( approximately 1.5 h) of staphylococci in positive blood culture bottles, but also for strain delineation of S. aureus.

Bacteremia↗

Three cases of destructive native valve endocarditis caused by Staphylococcus lugdunensis.

Described here are three cases of acute native valve endocarditis due to the coagulase-negative pathogen Staphylococcus lugdunensis with serious complications. Two of the three patients died despite optimal antibiotic therapy and cardiovascular surgery. These cases demonstrate the aggressive nature of S. lugdunensis and emphasize the importance of identifying coagulase-negative staphylococci to the species level and not considering the isolation of S. lugdunensis from normally sterile body fluids as contamination. On the contrary, when this organism is found in patients with endocarditis, early surgery should be considered. The possibility that this organism could be misidentified as S. aureus because of "autocoagulation" and that commercial identification systems may misidentify it as S. haemolyticus, S. hominis or S. warneri should also be remembered.

Adult↗

Polar lipid and isoprenoid quinone composition in the classification of Staphylococcus.

Representatives of 13 species of Staphylococcus were examined using a small-scale procedure for the sequential extraction of isoprenoid quinones and polar lipids. Menaquinones were the only isoprenoid quinones found in the 77 test strains which were divided into three groups based upon the predominant isoprenologue detected: (i) S. hyicus subsp. hyicus, S. sciuri subsp. lentus and S. sciuri subsp. sciuri contained unsaturated menaquinones with six isoprene units; (ii) S. capitis, S. cohnii, S. epidermidis, S. haemolyticus, S. hominis, S. hyicus subsp. chromogenes, S. intermedius, S. saprophyticus, S. simulans, S. warneri and S. xylosus contained unsaturated menaquinones with seven isoprene units and (iii) S. aureus contained unsaturated menaquinones with eight isoprene units and varying amounts of the corresponding lower isoprenologue. All of the organisms contained very similar polar lipid patterns consisting of diphosphatidylglycerol, phosphatidylglycerol, beta-gentiobiosyl diacylglycerol and a number of glycolipids and phospholipids. One of the glycolipids was chromatographically indistinguishable from beta-gentiotriosyl diacylglycerol. Lysylphosphatidylglycerol was a major component in S. aureus and S. intermedius but was usually present in minor amounts in the coagulase-negative strains. The polar lipid data underline the homogeneity of the genus Staphylococcus and distinguish staphylococci from aerobic, Gram-positive cocci and from the phylogenetically related aerobic, endospore-forming bacteria. Menaquinone composition can also be used to separate staphylococci from other aerobic, Gram-positive cocci.

Chromatography, Thin Layer↗

Enhanced basal and stimulated PMN chemiluminescence activity in children with atopic dermatitis: stimulatory role of colonizing staphylococci?

In adults, intense staphylococcal skin colonization and hyperactivity of polymorphonuclear leukocyte (PMN) oxidative metabolism are characteristic features of atopic dermatitis. Precise data on childhood atopic dermatitis are lacking. In a prospective study we analysed the PMN chemiluminescence activity with special reference to staphylococcal stimuli in 19 children (mean age 6.2 years) with mild to moderate atopic dermatitis. Staphylococcus aureus was isolated from 17/19 (90%) of children with atopic dermatitis and 13/45 (29%) of healthy age-matched controls (p less than 0.001). The mean (SEM) chemiluminescence activity of unstimulated atopic dermatitis-PMN was 0.34 (0.009) (controls: 0.092 (0.003) x 10(6) cpm/10(6) PMN/min (p less than 0.02). Staphylococcal antigens (S. aureus, S. epidermidis, S. haemolyticus) induced a 1.9-3.1-fold higher peak chemiluminescence response in children with atopic dermatitis than in controls (p less than 0.05). The time interval until peak chemiluminescence activity was considerably shorter for all stimuli in atopic dermatitis. We conclude that PMN of children with atopic dermatitis are "primed", showing enhanced release of reactive oxygen metabolites even in the "resting" state, and are easily stimulated by staphylococcal antigens present on the skin of patients with atopic dermatitis from early childhood on. We speculate that PMN hyperreactivity may contribute to chronic skin damage in atopic dermatitis.

Adolescent↗

[Minimal biochemical tests for interspecies identification in the Staphylococcus genus].

A total of 50 different strains from clinical specimens and/or from experimental surgery were typified. The Staphylococcus genus was subdivided according to minimal test results for Staphylococcus genus differentiation into 3 groups: A. the coagulase-positive/novobiocin-susceptible species; B. the coagulase-negative/novobiocin-resistant species and C. the coagulase-negative/novobiocin-susceptible species. Species belonging to the different groups were differentiated by means of minimal biochemical tests readily available to all clinical bacteriology laboratories. To evaluate the predictive value of the procedure employed, the following strains were used as unknown: S. capitis, S. simulans, S. hominis, S. warneci, S. intermedius, S hyicus subsp. hycus, S hyicus subsp. chromogenes and S. haemolyticus. Results indicated that, for the coagulase-positive/novobiocin-susceptible group, the production of pigment and acetoin plus beta-galactosidase were sufficient for interspecies differentiation. For the coagulase-negative/novobiocin-resistant group, urease and phosphatase activity plus production of acid from xylose proved to be sufficient. The coagulase-negative/novobiocin-susceptible group required the greatest number of tests, due to phenotypical variability of species, including: reduction of nitrates; production of acetoin; use of arginine and the production of acid from maltose and/or trehalose. Preliminary findings justify routine application of these minimal tests for Staphylococcus genus differentiation.

Bacterial Typing Techniques↗

Identification of staphylococci from bovine milk in Argentina.

Two hundred and thirty three strains of staphylococci isolated from bovine milk from 17 dairies in Argentina were classified into 16 species. Most of the strains (78%) belonged to 4 species; S. aureus, S. haemolyticus, S. hominis, and S. warneri (38.5, 20.5, 9.4 and 9.0%, respectively). The remaining 12 species appeared with low frequencies. Twenty-one of the strains were isolated from mammary quarters with signs of clinical mastitis. The majority of the milk samples infected with S. aureus or S. haemolyticus showed very high somatic cell counts.

Animals↗

Staphylococci express a receptor for human transferrin: identification of a 42-kilodalton cell wall transferrin-binding protein.

Staphylococcus aureus and the coagulase-negative staphylococci are commonly responsible for peritonitis in renal patients undergoing continuous ambulatory peritoneal dialysis. To simulate growth conditions in vivo, staphylococci isolated from peritoneal infections were cultured in used human peritoneal dialysate (HPD). Immunoblotting experiments using cell wall preparations from these staphylococci revealed the presence of the host iron-binding glycoprotein transferrin bound to S. aureus, S. epidermidis, S. capitis, S. haemolyticus, and S. hominis but not to S. warneri or S. saprophyticus. Similar results were obtained by incubating broth-grown staphylococci with human transferrin, although, in contrast to S. aureus, the coagulase-negative staphylococci bound more transferrin after growth in iron-restricted broth. To determine whether the staphylococci express a saturable specific receptor for human transferrin, the interaction of human 125I-transferrin with the staphylococci was examined. Both S. aureus and S. epidermidis bound the radiolabelled iron-saturated ligand in a time- and concentration-dependent manner. From competition binding assays, the affinity (Kd) and number of receptors were estimated for S. epidermidis (Kd, 0.27 microM; 4,200 receptors per cell) and S. aureus (Kd, 0.28 microM; 4,200 receptors per cell). S. epidermidis but not S. aureus receptor activity was partially iron regulated. Human apotransferrin and iron-saturated transferrin and rabbit and rat transferrins competed equally well for the staphylococcal receptor. Bovine and porcine transferrins and ovotransferrin as well as human and bovine lactoferrins were much less effective at competing with human transferrin. Treatment of whole staphylococci with protease abolished transferrin binding, indicating the involvement of cell surface protein. Western blots (immunoblots) of cell wall preparations probed with human transferrin revealed the presence of a 42-kDa transferrin-binding protein common to both S. aureus and S. epidermidis. On Western strip blots, the binding of human transferrin to this protein was blocked by labelled human transferrin but not by albumin, immunoglobulin G, or bovine transferrin or ovotransferrin. To assess the conservation of the 42-kDa transferrin-binding protein, cell wall proteins of S. epidermidis, S. haemolyticus, S. capitis, S. hominis, S. warneri, and S. saprophyticus were Western blotted and probed with human transferrin. Only S. warneri and S. saprophyticus lacked the 42-kDa wall protein, consistent with their inability to bind transferrin. These data show that the staphylococci express a specific receptor for human transferrin based at least in part on a common 42-kDa cell wall protein.

Animals↗

[Interspecies lysogenization in staphylococci: transfer of bacteriophage converting enterotoxin A from a clinical strain of Staphylococcus aureus to Staphylococcus intermedius].

The ability of lysogenization was examined of 50 S. intermedius strains and of 77 strains belonging to 14 different species of coagulase-negative staphylococci using 8 enterotoxin A converting bacteriophages isolated from S. aureus. All the examined bacteriophages showed lytic activity against at least 1 of 11 susceptible strains of S. intermedius to them. Lytic activity towards coagulase-negative staphylococci was observed for 6 of 8 examined bacteriophages. Two bacteriophages were active against 1 of 9 examined S. capitis strains, one against 1 of 11 examined S. haemolyticus strains, four against 1 of 6 examined S. lugdunensis strains, three against 1 of 6 examined S. warneri strains and one against 1 of 5 examined S. xylosus strains. Lysogenization with bacteriophage f421-1 able to convert positively enterotoxin A and staphylokinase and negatively beta-haemolysin of one S. intermedius strain was successful. S. intermedius lysogenized with phi 421-1 was able to produce both enterotoxin A and staphylokinase and lost ability to produce beta-haemolysin. Our results showed a broad lytic spectrum and interspecies host range of some S. aureus bacteriophages and the ability of interspecies transfer of bacteriophages between S. aureus and S. intermedius.

Enterotoxins↗