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Further characterization of Staphylococcus epidermidis transposon mutants deficient in primary attachment or intercellular adhesion.

Biofilm formation is suggested to be the result of primary attachment of Staphylococcus epidermidis cells to a polymer surface followed by accumulation in multilayered cell clusters. Here we describe the further characterization of transposon (Tn917) mutants of Staphylococcus epidermidis O-47 having been biofilm-negative in a polystyrene microtiter plate adhesion assay. Among 5000 Tn917 insertion strains, we isolated four biofilm-negative mutants, each carrying one copy of Tn917. The mutants could be divided into two phenotypic classes: class A (mut1 and mut1a) and class B (mut2 and mut2a). Mutants of phenotype class A lacked four cell surface proteins and were affected in the primary attachment to polystyrene, but remained able to form multilayered cell clusters and to produce PIA. Mutants of phenotype class B were able to attach to polystyrene, but did not form multilayered cell clusters nor produce PIA. The cell surface protein pattern relative to the wild type was unchanged in class B mutants. On Congo red agar, the wild type and class A mutants formed black colonies (positive reaction on Congo red agar) while class B mutant colonies were red (negative reaction). The initial binding of cells to polystyrene and the ability to form multilayered cell clusters were found to be phenotypically and genetically distinct traits.

Adhesins, Bacterial↗

Structural features of piperazinyl-linked ciprofloxacin dimers required for activity against drug-resistant strains of Staphylococcus aureus.

We previously demonstrated that piperazinyl-linked fluoroquinolone dimers possess potent antibacterial activity against drug-resistant strains of Staphylococcus aureus. In this study, we report the preparation and evaluation of a series of incomplete dimers toward ascertaining structural features of piperazinyl-linked ciprofloxacin dimers that render these agents refractory to fluoroquinolone-resistance mechanisms in Staphylococcus aureus.

Anti-Infective Agents↗

Stress resistance in Staphylococcus aureus.

Staphylococcus aureus is a major human pathogen of increasing importance as a result of the spread of antibiotic resistance. It causes a wide range of diseases and survives outside the host by virtue of its adaptability and resistance to environmental stress. Several cellular components involved in Staphylococcus aureus stress resistance have begun to be characterized.

Adaptation, Physiological↗

Does focal destruction of the thoracic aorta wall by Staphylococcus aureus lead to the development of infected aneurysms? An experimental study.

OBJECTIVE: The infrequency of infected aneurysms suggests that either infection of segments of the aortic wall is uncommon, or that infections do not always lead top infected aneurysm formation. The purpose of the study was to determine whether focal Staphylococcus aureus infection of aortic wall segments leads consistently to the development of infected aneurysms and to evaluate the segments in which infection did not lead to the infected aneurysm formation. METHODS: Twenty pigs were inoculated with 0.1 ml of a Staphylococcus aureus inoculum in three segments of the thoracic aorta wall (study group). In another 10 pigs, 0.1 ml of saline solution was injected in three segments of the thoracic aorta wall (control group). STUDY GROUP: histological abnormalities and bacterial culture of the inoculation sites were evaluated at 10 days (n = 5 pigs), 30 days (n = 5 pigs), and 90 days (n = 10 pigs). CONTROL GROUP: histological abnormalities were evaluated at 10 days (n = 5 pigs) and 90 days (n = 5 pigs). RESULTS STUDY GROUP: infected aneurysms developed in only two animals killed at 30 days. At 90 days, destruction of the elastic tissue, scar tissue and neointima formation were found in all the aortic segments studied. CONTROL GROUP: no significant changes were found in any of the segments evaluated. CONCLUSION: In our experimental model, acute local infection by S. aureus caused the development of infected aortic aneurysm in only 10% of the animals. In the remaining 90%, healing of the site of infection followed resolution of the infection.

Aneurysm, Infected↗

Photosensitization of Staphylococcus aureus with malachite green isothiocyanate: inactivation efficiency and spectroscopic analysis.

The potential of malachite green isothiocyanate as a photosensitizer for the inactivation of bacteria has been evaluated. Samples of Staphylococcus aureus are treated with the dye and exposed to continuous-wave red light from a filtered xenon lamp. Reduction in cell viability is seen to increase with radiation dose, whilst non-photosensitized samples are largely unaffected with exposure. The mechanism of photosensitization and the subsequent inactivation is addressed. UV-Vis and Fourier-transform infrared absorption spectrometry have been applied to this biological system, revealing the rapid hydrolysis of the isothiocyanate group of the dye and the transition to the colourless carbinol base when in solution. On binding to Staphylococcus aureus via a complexation mechanism, the dye is seen to be stabilized in its cationic form. Involvement of the excited triplet state of the photosensitizer is suggested and identification of reduced dye photoproducts is made following irradiation.

Absorption↗

Effect of Staphylococcus aureus bacteria and bacterial toxins on meningeal permeability in vitro.

BACKGROUND AND OBJECTIVES: Epidural catheterization is associated with a significant bacterial colonization rate and occasionally frank infection. During epidural space infection, decreased analgesia despite increased epidural opioid doses has been described. One possible explanation for this observation is that bacterial infection decreases meningeal permeability. The purpose of the study was to determine whether Staphylococcus aureus bacteria, the most common organism causing epidural space infection, or S. aureus toxins alter meningeal permeability. METHODS: Spinal meninges of M. nemestrina monkeys were mounted in a previously established in vitro diffusion cell model and exposed to S. aureus toxins A, B, and F. Simultaneous transmeningeal fluxes of mannitol and sufentanil were measured before and after toxin exposure and compared to controls. In a second series of experiments, diffusion cells were inoculated with live S. aureus bacteria in suspension and the permeability of sufentanil was investigated. RESULTS: Staphylococcus aureus toxin-A increased the transmeningeal flux of mannitol but not sufentanil. Toxins B and F did not alter the meningeal permeability of either drug. Inoculation with live S. aureus bacteria increased the transmeningeal flux of sufentanil by 115+/-21% (P = .032). CONCLUSIONS: These data demonstrate that S. aureus alpha-toxin and live S. aureus bacteria can increase meningeal permeability. Thus, clinical observations of decreased epidural analgesia in the face of bacterial infection cannot be explained by decreased meningeal permeability.

Animals↗

Three-year outcome in a patient with Staphylococcus lugdunensis discitis.

The few reported cases of bone and joint infection by Staphylococcus lugdunensis indicate that the clinical manifestations are severe, the diagnosis elusive, and the treatment difficult. We report a case of lumbar discitis caused by Staphylococcus lugdunensis in a 67-year-old man receiving chemotherapy for stage III IgA lambda multiple myeloma. Treatment was with ofloxacin and pristinamycin for 1 year. Although he started to improve only 5 months after treatment initiation, the outcome was favorable. Follow-up at the time of this writing is 3 years.

Aged↗

Staphylococcus aureus and Streptococcus dysgalactiae in Norwegian herds after introduction of selective dry cow therapy and teat dipping.

The objective was to promote a reduction in the prevalence of Staphylococcus aureus and Streptococcus dysgalactiae after 2 years of selective dry cow therapies and teat dipping/external teat sealant implementation. Three different dry cow treatments, one long-acting and two short-acting penicillin-based products were tested at herd level together with a negative control teat dipping group, an iodine teat dipping group and DryFlextrade mark, an external teat sealant. The regimes were independently randomly allocated to 178 dairy herds. Yearly bacteriological quarter milk samples were collected from all cows at the beginning of the trial, after 1 year and 2 years. At herd level, a total of 15% of the herds showed no Staphylococcus aureus isolates after 2 years, compared with 5% at the beginning. The distribution of Streptococcus dysgalactiae infected herds remained the same after 2 years. At cow level, there were no significant differences in the reduction of Staph. aureus between the different dry cow therapies and teat dipping regimes. But there was a significant reduction of Str. dysgalactiae in the iodine teat dipping group compared with Dryflextrade mark and the negative control group. The proportional rate of Staph. aureus positive quarters was reduced from 65.9% to 54.9% after 2 years. As for Str. dysgalactiae, an increase was observed from 14.2% to 15.2%.

Administration, Topical↗

The impact of methicillin-resistant Staphylococcus aureus on ENT practice.

Antibiotic-resistant bacteria are increasingly common and present a major problem for the modern day ENT surgeon. This article reviews the development of methicillin resistance in Staphylococcus aureus and how it has come to affect ENT practice. We look at the evidence behind measures taken to help deal with methicillin-resistant Staphylococcus aureus (MRSA) and to prevent its spread. We go on to suggest a departmental guideline for infection control, which we hope can be implemented to help deal with the problems created by MRSA.

Cross Infection↗

A comparison of pneumonia caused by gentamicin, methicillin-resistant and gentamicin, methicillin-sensitive Staphylococcus aureus: epidemiologic and clinical studies.

We investigated an outbreak of nosocomial pneumonia due to gentamicin, methicillin-resistant Staphylococcus aureus (GMRSA). We compared the predisposing factors for pneumonia due to GMRSA to those for pneumonia due to gentamicin, methicillin-sensitive Staphylococcus aureus (GMSSA). Seventeen of 29 patients with staphylococcal pneumonia were infected with GMRSA. Risk factors and associated diseases which selected for infection with GMRSA as opposed to GMSSA included prior antibiotic therapy for a prolonged period of time (p = 0.0001), number of risk factors per patient (p = 0.0001), days hospitalized prior to diagnosis of pneumonia (p = 0.002) and number of associated diseases per patient (p = 0.002). Despite the epidemiologic differences between GMSSA and GMRSA pneumonia, there were no differences in the clinical presentation, course of illness, complications, response to appropriate therapy or outcome between the two groups. Survival was adversely affected by age only among the GMSSA patients (p = 0.02) and by the number of associated diseases (p = 0.005).

Anti-Bacterial Agents↗

The analysis of the impact of a mild, low-iodine, lotion soap on the reduction of nosocomial methicillin-resistant Staphylococcus aureus: a new opportunity for surveillance by objectives.

A significant unremitting increase in the incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections in a 500-bed acute care community teaching hospital prompted reevaluation of the efficacy of the infection control measures used. A well-accepted, low-iodine, antimicrobial soap was used to replace a liquid natural handsoap in two areas with the highest incidence of MRSA--the intensive care unit, and a medical division. Over a two-year period, an analysis was made of the effect of soap replacement on nosocomial infections and pathogens. Soap changeover occurred at the midpoint of the two-year period. From year to year, the nosocomial MRSA rate decreased 80% (t test, P = 0.005). Other pathogens that demonstrated a dramatic decrease included methicillin-sensitive Staphylococcus aureus (MSSA), infections where no pathogens were isolated, and various gram-negative infections. Categories of nosocomial infections that decreased included surgical wound infections, primary bacteremias, and respiratory tract infections. The overall nosocomial infection rate of the two combined areas decreased 21.5%, representing a year-to-year savings of $109,500. As a result, the decision was made to install the low-iodine handsoap permanently at all sinks within the hospital.

Costs and Cost Analysis↗

Crystal violet reactions of fresh clinical isolates of Staphylococcus aureus from two British hospitals.

When 168 fresh clinical isolates of Staphylococcus aureus were examined for their reactions on a medium containing 1 part in 100,000 crystal violet 50.6% of strains produced a purple appearance, 39.3% produced a white appearance and 10.1% produced a yellow appearance. Purple-reacting isolates were significantly associated with both invasive infections (P less than 0.01) and hospital origin (P less than 0.001). There were no significant associations between the crystal violet reactions and either animal contact or other properties previously reported to be characteristic of white and yellow-reacting strains (beta haemolysin and bovine coagulase production). The results of phage typing showed associations between susceptibility to group III phages and purple-reacting strains and between phage group II susceptibility and white and yellow-reacting strains. There was also a highly significant association between white reactions on crystal violet agar and susceptibility to lysis by a combination of all three groups (that is, I + II + III) and white-reacting strains were significantly more susceptible to lysis by phages 94 and/or 96, whether as a restricted pattern or as part of a broader pattern. The purple reaction on crystal violet medium may be a reliable marker of the 'hospital staphylococcus'.

Animals↗

Phage typing of Staphylococcus saprophyticus.

This study included 502 staphylococcus strains; Staphylococcus saprophyticus (297 strains) S. cohnii (47), S. xylosus (10), S. epidermidis (67) and S. aureus (81). Mitomycin C induction was performed on 100 isolates of S. saprophyticus and all induced strains were reacted with each other. Twenty-six strains proved to be lysogenic. Phages were propagated and titrated. With 12 of the phages there were three frequent associations, named lytic groups A, B and C, which included 75% of all typable strains. Typability of the system was 45% and reproducibility was between 94.2% and 100%. Phages did not lyse S. aureus and S. epidermidis strains, but they lysed S. saprophyticus and only rare strains of other novobiocin resistant species. Effective S. saprophyticus typing serves ecological purposes and tracing the origin of urinary strains from the skin or mucous membranes. Phage typing in association with plasmid profiling previously described, are anticipated as complementary methods with strong discriminatory power for differentiating among S. saprophyticus strains.

Bacteriophage Typing↗

Application of pulsed-field gel electrophoresis to the epidemiological characterization of Staphylococcus intermedius implicated in a food-related outbreak.

An outbreak of food intoxication involving over 265 cases in western United States occurred in October 1991. Staphylococcus intermedius was implicated as the aetiologic agent. Representative outbreak isolates (five clinical and ten from foods) produced type A enterotoxin. DNA fragments generated by four restriction endonucleases and analysed by pulsed-field gel electrophoresis (PFGE) provided definitive evidence that all isolates from nine different counties in California and Nevada were derived from a single strain. The PFGE pattern of these outbreak isolates was distinct from those of a heterogeneous collection of seven S. intermedius strains of veterinary origin and five unrelated S. aureus laboratory strains. The data show a significant PFGE pattern heterogeneity not only among members of different Staphylococcus species but also within members of the same species and even the same enterotoxin type. The results indicate that PFGE is a valuable strain-specific discriminator for the epidemiological characterization of S. intermedius. To our knowledge, this represents the first documented foodborne outbreak caused by S. intermedius. These findings suggest that the presence of S. intermedius and other species such as S. hyicus in food should be reason for concern.

Butter↗

An additional set of phages to characterize epidemic methicillin-resistant Staphylococcus aureus strains from Spain (1989-92).

In recent years, methicillin-resistant Staphylococcus aureus (MRSA) isolates in Spain have increased dramatically; in 1986 there were only 1.2% MRSA amongst all nosocomial Staphylococcus aureus (SA) isolates, by 1989 this percentage had risen to 44% in some hospital causing a very serious epidemic situation in the country. We have characterized these isolates by direct, reverse and Fisk phage typing and we have also looked for an additional local set of phages to help us to differentiate these strains. We have been able to differentiate an epidemic strain from other MRSA strains which cause sporadic hospital outbreaks, and we have also distinguished between some variants of the epidemic strain.

Bacteriophage Typing↗

Purification and substrate specificity of Staphylococcus hyicus lipase.

The Staphylococcus hyicus lipase gene has been cloned and expressed in Staphylococcus carnosus. From the latter organism the enzyme was secreted into the medium as a protein with an apparent molecular mass of 86 kDa. This protein was purified, and the amino-terminal sequence showed that the primary gene product was indeed cleaved at the proposed signal peptide cleavage site. The protein was purified from large-scale preparations after tryptic digestion. This limited proteolysis reduced the molecular mass to 46 kDa and increased the specific activity about 3-fold. Although the enzyme had a low specific activity in the absence of divalent cations, the activity increased about 40-fold in the presence of Sr2+ or Ca2+ ions. The purified lipase has a broad substrate specificity. The acyl chains were removed from the primary and secondary positions of natural neutral glycerides and from a variety of synthetic glyceride analogues. Thus triglycerides were fully hydrolyzed to free fatty acid and glycerol. The enzyme hydrolyzed naturally occurring phosphatidylcholines, their synthetic short-chain analogues, and lysophospholipids to free fatty acids and water-soluble products. The enzyme had a 2-fold higher activity on micelles of short-chain D-lecithins than on micelles composed of the L-isomers. Thus the enzyme from S. hyicus has lipase activity and also high phospholipase A and lysophospholipase activity.

Amino Acid Sequence↗

Identification of factor XIIIA-reactive glutamine acceptor and lysine donor sites within fibronectin-binding protein (FnbA) from Staphylococcus aureus.

Staphylococcal fibronectin-binding protein (FnbA) is a surface-associated receptor responsible for the reversible binding of bacteria to human fibronectin and fibrin(ogen). Recently we have shown that FnbA serves as a substrate for coagulation factor XIIIa and undergoes covalent cross-linking to its ligands, resulting in the formation of heteropolymers (Matsuka, Y. V., Anderson, E. T., Milner-Fish, T., Ooi, P., and Baker, S. (2003) Staphylococcus aureus fibronectin-binding protein serves as a substrate for coagulation factor XIIIa: Evidence for factor XIIIa-catalyzed covalent cross-linking to fibronectin and fibrin, Biochemistry 42, 14643-14652). Factor XIIIa also catalyzes the incorporation in FnbA of fluorescent probes dansylcadaverine and glutamine-containing synthetic peptide patterned on the NH(2)-terminal segment of fibronectin. In this study, the above probes were utilized for site-specific labeling and identification of reactive Gln and Lys residues targeted by factor XIIIa in rFnbA. Probe-decorated rFnbA samples were subjected to trypsin or Glu-C digestion, followed by separation of labeled peptides using reversed phase HPLC. Sequencing and mass spectral analyses of isolated probe-modified peptides have been employed for the identification of factor XIIIa-reactive Gln and Lys residues. Analysis of dansylcadaverine-labeled peptides resulted in the identification of one major, Gln103, and three minor, Gln105, Gln783, and Gln830, amine acceptor sites. The labeling procedure with dansyl-PGGQQIV probe revealed that Lys157, Lys503, Lys620, and Lys762 serve as amine donor sites. The identified reactive glutamine acceptor and lysine donor sites of FnbA may participate in transglutaminase-mediated cross-linking reactions resulting in the covalent attachment of pathogenic Staphylococcus aureus to human host proteins.

Adhesins, Bacterial↗

Adhesion of Staphylococcus aureus to implants with different physicochemical characteristics.

Adhesion of pathogenic Staphylococcus aureus (strain 209) to BT1-0 titanium disks (12 mm in diameter) with different coatings and noncoated was studied in vitro by photocolorimetry. Transparency of bacterial suspension in normal saline was evaluated after 2-h culturing with the implants at 37 degrees C. The decrease of S. aureus content in the suspension due to its adsorption on implants was negligible and increased by 0.9-5.5% in comparison with the control (adhesion to glass). When the specimens were placed into bacterial suspension, the density of staphylococcal adsorption on the surface considerably increased (by 9-53%) in comparison with the control, which attested to active participation of the implants in bacterial adsorption. The degree of bacterial adhesion to the implants decreased in the following order: disk with calcium phosphate ceramic coating-disk with calcium phosphate X-ray amorphous coating-disk without coating-disk with cermet coating. The adhesion of Staphylococcus is a stochastic process depending on the sum of implant characteristics, in particular, on the phase composition of the coating, electric conductivity, and Ca/P ionic ratio. The authors conclude that the formation of antibacterial properties of coating by saturating them with antibiotics or impregnation with metals, specifically silver ion implantation, is justified, because it reduces the postimplantation infection risk.

Adsorption↗