Staphylococcus epidermidis BV: Antibiotic Resistance Patterns, Physiological Characteristics, and Bacteriophage Susceptibility

Staphylococcus epidermidis BV is a group of mannitol-fermenting coagulase-negative staphylococci characterized by multiple antibiotic resistance, very similar biochemical characteristics, and phage susceptibility. Clinical isolates belonging to this group are resistant to most antibiotics tested, including oxacillin, lincomycin, and novobiocin. The only antibiotic to which all tested strains are sensitive is vancomycin. Common biochemical traits of the tested S. epidermidis BV strains include fermentation of trehalose and ribose, phospho-β-glucosidase activity, growth on synthetic medium with amino acids as carbon source, and lack of deoxyribonuclease, phosphatase, lipase, and gelatinase activity. Some of these characteristics appear more frequently in mannitol-positive control strains than in mannitol-negative strains. S. epidermidis BV strains carry lysogenic phages with a host range restricted to this group. These phages allow the differentiation of individual strains.     

Drug Resistance of Staphylococci

According to an epidemiological survey of drug resistance in Staphylococcus aureus, it was found that there are three types of cross-resistance to macrolide antibiotics (EM, erythromycin: OM, oleandomycin: LM, leucomycin: SP, spiramycin), i.e., resistance to EM, OM, LM, and SP, to EM and OM, and inducible resistance to “EM, OM”. In the inducible strains of S. aureus, EM and OM are active inducers, and the optimal concentrations of the inducers are 0.1 μg/ml and 1.0 μg/ml, respectively. The induction of high resistance (800 μg/ml or more) to both EM and OM occurred within 10 min exposure to 0.1 μg/ml of EM, and the resistance of induced cells was lost after overnight growth in the absence of inducer. After 1 to 3 hr exposure to 1.0 μg/ml of OM, the inducible strains acquired high resistance (100 μg/ml or more) to EM and to a lesser extent, resistance to OM, and the acquired resistance was lost when grown in antibiotic free media. When a known concentration of EM was mixed with the induced cells or with a crude extract from induced cells which had acquired high resistance to EM and OM, the antibiotic activity of EM was still retained in the mixture, indicating that the induced mixture or the extract from the induced cells was incapable of antibiotic (EM) inactivation under the test conditions.     

Staphylococci Isolated from Carriage Sites and Infected Sites of Dogs as a Reservoir of Multidrug Resistance and Methicillin Resistance

The aim of this study was to compare the spread of multidrug-resistant (MDR) and methicillin-resistant (MR) staphylococci in healthy dogs and in dogs with evident symptoms of infection. The samples from 172 healthy and 197 infected dogs were examined. The staphylococci were identified with conventional methods and by means of the polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) method (MboI). Susceptibility to 15 antibiotics from 10 different antimicrobial classes was tested. Resistance to methicillin was confirmed by the presence of Staphylococcus aureus mecA and S. sciuri mecA genes. Multidrug resistance was defined as resistance to three or more antimicrobial classes. The oral mucosa to be the most frequent site of staphylococcal colonization (55.8 %), followed by nasal cavity (44.2 %), and anus (32.6 %). The prevalence of MDR staphylococci in infected dogs was significantly higher than in the healthy animals (74/137 vs. 34/95, P = 0.006). The MR strains of S. pseudintermedius (2.9 %) originated solely from infected dogs. In contrast, the MR coagulase-negative strains (7.4 %) were isolated solely from healthy dogs. S. aureus strains originated from nasal swabs, MRSA strains were not isolated. MDR staphylococci and MR S. pseudintermedius are more common among infected dogs, but coagulase-negative staphylococci (mostly S. sciuri) seem to be a reservoir of methicillin resistance in healthy dogs.     

Drug Resistance as Influenced by Inactivated Sensitivity Discs

Reports of staphylococci resistant to the semisynthetic penicillins stimulated a study of the factors influencing the stability of the drugs in discs. The behavior of penicillin G, methicillin, oxacillin, cloxacillin, and cephalothin discs under different humidity and temperature conditions is described. Humidity was found to be the most significant factor in drug inactivation. Storage of discs in a vacuum desiccator at -20 C provides maximal antibiotic stability.     

New Type of R Factors Incapable of Inactivating Chloramphenicol

Four R factors conferring chloramphenicol (CM) resistance were isolated from Escherichia coli strains of clinical origin. Strains carrying the factors were found to be incapable of inactivating the drug in the presence of acetyl coenzyme A. E. coli W3630 carrying R(70), one of these factors, became sensitive to CM after treatment with glycine, indicating that the spheroplasts of W3630 R(70) (+) were sensitive to the drug and suggesting that the cell membrane is important for CM resistance. The observation that cell-free protein synthesis in W3630 R(70) (+) was inhibited by CM is also compatible with a decrease in permeability. CM resistance in W3630 R(70) (+) appeared to be inducible, because (i) preincubation with subinhibitory concentrations of CM prevented the prolonged lag noted for growth in the presence of 25 mug of CM per ml, and (ii) the preincubation effect was lost after overnight growth in CM-free medium. By contrast, E. coli W3630 cml(+), in which the resistance determinant is integrated into the chromosome, was capable of rapid inactivation of CM. E. coli W3630 cml(+) R(70) (+), which contains the proposed permeability determinant (episomal) as well as levels of the inactivating enzyme (chromosomal) that are comparable with W3630 cml(+), was capable of brief inactivation of CM when inoculated into drug-containing medium. The absence of continued inactivation on more prolonged incubation favors the hypothesis that the R(70) factor inhibited further penetration of CM and that this property possesses the characteristics of induction.     

Class 1 integron in staphylococci

As a major concern in public health, methicillin-resistant staphylococci (MRS) still remains one of the most prevalent pathogens that cause nosocomial infections throughout the world and has been recently labeled as a “super bug” in antibiotic resistance. Thus, surveillance and investigation on antibiotic resistance mechanisms involved in clinical MRS strains may raise urgent necessity and utmost significance. As a novel antibiotic resistance mechanism, class 1 integron has been identified as a primary source of antimicrobial resistance genes in Gram-negative organisms. However, most available studies on integrons had been limited within Gram-negative microbes, little is known for clinical Gram-positive bacteria. Based on series studies of systematic integrons investigation in hundreds of staphylococci strains during 2001–2006, this review concentrated on the latest development of class 1 integron in MRS isolates, including summary of prevalence and occurrence of class 1 integron, analysis of correlation between integron and antibiotic resistance, further demonstration of the role integrons play as antibiotic determinants, as well as origin and evolution of integron-associated gene cassettes during this study period.     

Proposed virulence factors among coagulase-negative staphylococci isolated from two healthy populations

Proposed virulence factors, including multiple antibiotic resistance and slime-mediated adherence, among coagulase-negative staphylococci colonizing healthy individuals from two different study populations were examined. Resistance to methicillin was more commonly seen than initially anticipated. In addition, adherence characteristics, as quantitated by a microtiter plate method, were very similar to those of strains of coagulase-negative staphylococci causing nosocomial infections.     

Safety-related properties of staphylococci isolated from food and food environments

Aims: To test some safety‐related properties within 321 staphylococci strains isolated from food and food environments. Methods and Results: The isolates were identified as Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Staphylococcus pasteuri, Staphylococcus sciuri, Staphylococcus warneri and Staphylococcus xylosus. Decarboxylase activity was quite common for the various Staphylococcus spp., and tyrosine was the most frequently decarboxylated amino acid. The frequency of antibiotic resistance was highest in Staph. pasteuri and Staph. xylosus. Several of the isolates were tolerant to QAC compounds, and in some cases, QAC tolerance was present in antibiotic‐resistant strains. Most of the strains displayed moderate to high adhesion rates to stainless steel and Teflon^®. The strains that readily formed biofilms belonged to the species Staph. aureus, Staph. epidermidis and Staph. pasteuri. Conclusions: An high incidence of some safety hazards was found within the staphylococcal strains of food origin tested in this study. In particular, amino acid decarboxylase activity and biofilm‐forming ability were common within strains, and antibiotic resistance and tolerance to QAC‐based compounds occurred frequently as well. These characteristics are an important safety concern for food industry. Significance and Impact of the Study: This work gives a first picture of safety hazards within staphylococcal species isolated from food environments. The presence of disinfectant‐resistant staphylococci is a concern because resistance can be genetically transferred between the various Staphylococcus species. This could lead an increase and spread of resistant enterotoxic staphylococci and/or pathogenic staphylococci.     

Desoxyribonuclease and lecithinase activity in antibiotic-resistant and -sensitive staphylococci]

Staphylococcus aureus, a laboratory strain 209-P and strain I isolated freshly from infected wounds, as well as lincomycin hydrochloride, ampicillin, oxacillin and methicillin manufactured in the USSR and cephaloridin manufactured by "PLIVA" in Yugoslavia were used. Various activity levels of desoxyribonuclease and lecitinase of the staphylococci depending on sensitivity or resistance of the test-microbe to the antibiotics were shown. The activity of the above microbial enzymes characterizing the pathogenic properties decreased with development of the antibiotic resistance, sometimes to complete inactivation of the enzymes synthesized by the staphylococci. In spite of closeness of their modes of action the semisynthetic penicillins had a differentiating effect on the above enzymes.     

医院感染葡萄球菌的耐药性及D-试验研究分析

目的了解医院感染葡萄球菌的耐药性及克林霉素诱导试验（D-试验）临床意义。方法从住院患者标本中分离到的539株葡萄球菌进行药敏试验和D-试验,所得结果进行统计分析。结果葡萄球菌中耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MPSE）的检出率高,分别为65．1％和83．6％,各种葡萄球菌对万古霉素敏感率为100％,对阿奠西林头孢菌素在内的各种β-内酰胺酶类抗生素敏感率低于35％,对红霉素耐克林霉素敏感的D-试验阳性率为57．O％。结论葡萄球菌耐甲氧西林检出率,呈多重耐药,在选用大环内酯类,克林霉素类抗生素时要注意D试验,合理用药,提高疗效。     

Study of beta-lactamase activity of staphylococci from different sources

The beta-lactamase activity of staphylococci isolated from the nasopharynx and skin of children with destructive affections of the lungs and from blood of patients with cardiovascular diseases subjected to surgical operations was determined with acidometric and microbiological procedures. Interrelation between synthesis of beta-lactamase by the staphylococcal strains and their resistance to beta-lactam antibiotics was demonstrated. No correlation of the antibiotic resistance and the taxonomic position of the staphylococcal strains was observed.     

Drug Resistance of Enteric Bacteria

Drug resistance of 3,000 Shigella strains isolated in 1965 were investigated. These strains originated from 10 City Hospitals and 4 Prefectural Health Centers, which are located in different parts of Japan. One hundred and seventy strains which were resistant to 4 drugs, chloramphenicol (CM), tetracycline (TC), dihydrostreptomycin (SM), and sulfanilamide (SA), were selected at random from these stock cultures in this laboratory and the distribution of R factors in these isolates was examined. It was found that the strains all harbored R factors which were capable of transferring drug resistance by usual conjugal process. Among the strains carrying R factors, 85 per cent harbored a single type of R factor and 15 per cent carried two types of R factor in a cell. The latter is called the hetero-R state. Among the strains in the hetero-R state, isolation of strains harboring both R (SM.SA) and R (TC.CM.SM.SA) factors was most frequent. It was found that 25 R (SM.SA) factors isolated from strains in hetero-R had the genetic determinant iR^?, while most of the R (TC.CM.SM.SA) factors isolated from natural sources were iR⁺. When two types of R factor, R (SM.SA) and R (TC.CM.SM.SA) derived from the same host cells, were brought together in a host cell by superinfection with both factors, they were found to exist stably in a host bacterium. These results confirmed the stable existence of both factors in Shigella strains isolated from dysenteric patients.     

Resistance of different strains of pathogenic staphylococcus to unfavorable environmental factors]

A study was made of the resistance to drying the UV-irradiation, the action of furacillin and chloramine displayed by 60 stains of S. aureus differing by origin (hospital and extrahospital), by the source of discharge (the upper respiratory tracts of carriers and the discharge of the purulent-inflammatory foci of surgical patients), relation to the antibiotics (polyresistant and sensitive) and phage-group reference. It was found that the resistance of staphylococci to the unfavourable factors was not always associated with the listed signs of the strains. In respect to drying a marked resistance was expressed by the hospital strains in comparison with the extrahospital ones, polyresistant in comparison with the sensitive ones, staphylococci of III and I+III phage groups in comparison with the strains of other bacteriophage groups. Strains of the III phage group proved to be the most resistant to the UV-irradiation. Strains isolated from carriers were more resistant to furacillin than staphylococci isolated from the purulent-inflammatory foci. Strains of the III phage group and nontyping had analogous advantages over the cultures of other phage groups.     

Donor activity of methicillin resistant staphylococci in transduction experiments]

Antibiotic resistance gene transmission from methicillin resistant strains of Staphylococcus aureus (MRSA), isolated in a burn care unit, was studied in transduction experiments with type phages 29, 52, 52A and in experiments with prophage induction. The results of the experiments demonstrated high donor activity of MRSA. Recombinants with different antibiotic resistance phenotypes were revealed, but there were no methicillin resistant staphylococci among them. Stability of cloramphenicol resistance gene transmission in the experiments on specific transduction with the prophage induction could be indicative of the prophage localization near the chloramphenicol resistance genes. Variety of the antibiotic resistance combinations in the transductants from the clinical strains of MRSA could prove heterogeneity of the strains even under conditions of one hospital.     

Quantitative disk diffusion as a convenient method for determining minimum inhibitory concentrations of oxacillin for staphylococci strains

In this study the susceptibility of 58 coagulase-negative staphylococci (CoNS) strains and 58 Staphylococcus aureus strains to oxacillin was evaluated by a novel method called quantitative disk diffusion (DD) method. The results obtained were compared to phenotypic methods as agar dilution (AD) for oxacillin, disk diffusion (DD) for cefoxitin, and related to the presence of the mecA gene detected by PCR. Minimum inhibitory concentrations (MIC) determined by the quantitative DD method were equivalent to MICs determined in the AD method for S. aureus (Student's t test, p=0.99) and CoNS (Student's t test, p=0.97). Incongruent results between PCR mecA gene determinations and the quantitative DD method were obtained in 8 strains (5 S. aureus and 3 CoNS) where the mecA gene expression was blocked. However, oxacillin resistance was detected by the proposed method even in staphylococci strains showing low-level or heterogeneous resistance to the antibiotic while other phenotypic methods failed. The single quantitative DD method is not expensive, it can be performed in any laboratory and permits accurate identification of oxacillin resistant staphylococci.     

Antimicrobial susceptibility of intestinal bacteria from Swiss poultry flocks before the ban of antimicrobial growth promoters

From the crop and the caecum of Swiss broilers slaughtered between November 1997 and January 1998, Escherichia coli, enterococci, staphylococci, lactobacilli and Campylobacter species were isolated. After identification to the genus or species level, their minimal inhibitory concentrations (MIC's) for several clinically used antimicrobial agents were determined with the E-Test stripes and compared to those from studies in other European countries. All strains of Enterococcus faecalis (n = 38), E. faecium (27), staphylococci (n = 39) and lactobacilli (n = 14) showed a hundred percent resistance against bacitracin which was included in the feed of the mother animals, but not in the feed of the investigated animals. E.coli strains (n = 60) showed higher resistance incidences than in comparable studies from Finland and Denmark, but lower than those in studies from Italy and Germany. In staphylococci, low resistance rates were observed. A high susceptibility of the 13 Campylobacter jejuni strains was found against therapeutically used antimicrobials. These data can be used as a baseline to determine antibiotic resistance rates after implementation of the growth promotor ban in 1999 in Switzerland.     

Occurrence of high-level mupirocin resistant coagulase-negative staphylococci in hospitals and their characterization

Occurrence of high-level mupirocin resistant coagulase-negative staphylococci in 5 hospitals in the region of Gdansk was determined. The study was carried out on 192 staphylococcal strains isolated from patients and medical staff. The mupirocin resistant strains were detected by 5 microgram mupirocin disc. The minimal inhibitory concentration (MIC) for mupirocin was estimated by E-tests. The mupirocin resistant strains were characterised by antibiotic sensitivity, including MIC for glycopeptides and oxacillin. Biotypes of resistant strains were also determined. Eight high-level mupirocin resistant strains (4.7%) were found. Only one strain expressed low-level resistance. All but one of high-level mupirocin resistant strains were resistant to methicillin. Six of them belonged to the S. epidermidis species but differences in the biotypes and antibiotic resistance patterns of these strains suggest they did not have a common origin.     

Circadian rhythms of antibacterial resistance, coagulase and antilysozyme activity of Staphylococcus aureus

AIM: To determine daily dynamics of antibacterial resistance as well as antilysozyme and coagulase activity of S. aureus strains. MATERIALS AND METHODS: On an example of clinical strains of S.aureus isolated from patients with surgical infections daily dynamics of biological characteristics of staphylococci was studied. After 12 hours of incubation strains were tested for coagulase activity by standard method (test tube method), antilysozyme activity by photometric method, and antibacterial resistance by method of serial dilutions in agar. Tests were repeated each 3-hours during a day. RESULTS: Variation of levels of studied biological characteristics of staphylococci during a day was revealed. Structures of coagulase and antilysozyme circadian rhythms had some differences in different S. aureus strains. Alongside with it, similarity in temporal expression of such biological characteristics of staphylococci as antibacterial resistance and antilysozyme activity was noted. CONCLUSION: Obtained data open prospect to use biorhythmological approach in study of biological characteristics of microorganisms during evaluation of their mechanisms of adaptation to changing environmental conditions. Chronobiological approach allows to reveal periods of maximal expression of S. aureus characteristics that could be used for increasing of effectiveness of antibacterial treatment by the choice of optimal time for administration of antibiotic.     

Strain Identification in Rhizobium Using Intrinsic Antibiotic Resistance

The variation in intrinsic resistance to low levels of eight antibiotics was used as an identifying characteristic for 26 Rhizobium leguminosarum strains. The pattern of antibiotic resistance of each strain was a stable property by which rhizobia isolated from root nodules of inoculated Pisum sativum could be recognized. The antibiotic tests for strain identification with R. leguminosarum were applied to R. phaseoli . It was necessary to include reference cultures in tests with this species, as the tests most suitable for the R. leguminosarum strains showed some variability with R. phaseoli .     

Resistance to chlorine of freshwater bacterial strains

The disinfectant properties of chlorine have been known for centuries but in the last few years water chlorination has attracted some criticism due to its secondary effects and the increased resistance of bacterial strains to chlorine inactivation. In this paper the kinetics of inactivation by chlorine of different Gram-positive and Gram-negative bacterial strains isolated from chlorinated water is studied. The Gram-positive strains were more resistant to chlorine and the behaviour of some of them in the presence of chloramphenicol suggests either the synthesis of unique proteins or aggregation of the bacteria as mechanisms of resistance to inactivation. The concept of K _i, the inactivation rate constant, by comparison with K _s in Michaelis-Menten enzyme kinetics (considering enzymic saturation), or with K _s in Monod growth kinetics (considering limiting rates of transport and metabolism of substrates), may be an interesting parameter to define microbial resistance to disinfectants and toxics.