Mini-review: Staphylococcus epidermidis as the most frequent cause of nosocomial infections: old and new fighting strategies

Staphylococcus epidermidis is nowadays regarded as the most frequent cause of nosocomial infections and indwelling medical device-associated infections. One of the features that contributes to the success of this microorganism and which is elemental to the onset of pathogenesis is its ability to form biofilms. Cells in this mode of growth are inherently more resistant to antimicrobials. Seeking to treat staphylococcal-related infections and to prevent their side effects, such as the significant morbidity and health care costs, many efforts are being made to develop of new and effective antistaphylococcal drugs. Indeed, due to its frequency and extreme resistance to treatment, staphylococcal-associated infections represent a serious burden for the public health system. This review will provide an overview of some conventional and emerging anti-biofilm approaches in the management of medical device-associated infections related to this important nosocomial pathogen.     

In vitro activity of the antimicrobial peptide AP7121 against the human methicillin-resistant biofilm producers Staphylococcus aureus and Staphylococcus epidermidis

Abstract

In vitro activity against methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis biofilm producers from blood cultures of patients with prosthetic hip infections was evaluated. The Minimum Inhibitory Concentration (MIC) for AP7121 was determined and the bactericidal activity of AP7121 (MICx1, MICx4) against planktonic cells was studied at 4, 8 and 24?h. The biofilms formed were incubated with AP7121 (MICx1, MICx4) for 1 and 24?h. The anti-adhesion effect of an AP7121-treated inert surface over the highest MIC isolate was studied with scanning electron microscopy (SEM). The bactericidal activity of AP7121 against all the planktonic staphylococcal cells was observed at 4?h at both peptide concentrations. Dose-dependent anti-biofilm activity was detected. AP7121 (MICx4) showed bactericidal activity at 24?h in all isolates. SEM confirmed prevention of biofilm formation. This research showed the in vitro anti-biofilm activity of AP7121 against MRSA and S. epidermidis and the prevention of biofilm formation by them on an abiotic surface.     

Prevention of Staphylococcus aureus biofilm formation and reduction in established biofilm density using a combination of phage K and modified derivatives

Aims: To investigate the ability of a mixture of phage K and six of its modified derivatives to prevent biofilm formation by Staphylococcus aureus and also to reduce the established biofilm density. Methods and Results: The bioluminescence‐producing Staph. aureus Xen29 strain was used in the study, and incubation of this strain in static microtitre plates at 37°C for 48 h confirmed its strong biofilm‐forming capacity. Subsequently, removal of established biofilms of Staph. aureus Xen29 with the high‐titre phage combination was investigated over time periods of 24 h, 48 h and 72 h. Results suggested that these biofilms were eliminated in a time‐dependant manner, with biofilm biomass reduction significantly greater after 72 h than after 24–48 h. In addition, initial challenge of Staph. aureus Xen29 with the phage cocktail resulted in the complete inhibition of biofilm formation over a 48‐h period with no appearance of phage resistance. Conclusions: In general, our findings demonstrate the potential use of a modified phage combination for the prevention and successful treatment of Staph. aureus biofilms, which are implicated in several antibiotic‐resistant infections. Significance and Impact of the Study: This study highlights the first use of phage K for the successful removal and prevention of biofilms of Staph. aureus.     

Aureolysin of Staphylococcus warneri M accelerates its proteolytic cascade,and participates in biofilm formation

The aureolysin (Aur) gene of S. warneri M (aurWM) was cloned and sequenced. Analyses of the aurWM-inactivated mutant (S. warneri Mau) suggested that AurWM was probably associated with efficient processing of the PROM protease (homolog of V8/SspA serine protease), whereas considerable amount of mature-PROC protease (homolog of SspB cysteine protease) accumulated without AurWM. Additionally, AurWM appeared to affect biofilm formation in an uncertain suppressive way.     

Various biofilm matrices of the emerging pathogen Staphylococcus lugdunensis: exopolysaccharides,proteins, eDNA and their correlation with biofilm mass

Abstract

Staphylococcus lugdunensis is an emerging high-virulent pathogen causative of hospital-acquired infections. Biofilm formation is a complex pathogenic process that leads to well-established bacterial communities. There is a paucity of data on the composition of the biofilm matrix among S. lugdunensis strains. Here, twenty-two S. lugdunensis clinical isolates, mainly from orthopaedic infections but also from other clinical sources, were sub-grouped by ribotyping and dendrogram analysis. Biofilms were analysed by fluorimetric methods based on FITC-Wheat Germ Agglutinin, SYPRO Ruby and TOTO-1 dyes to detect exopolysaccharides, proteins and extracellular DNA (eDNA), respectively. Biofilm morphology was investigated under confocal laser scanning microscopy (CLSM). Isolates displayed intriguing diversities in biofilm mass and matrix composition. The content of exopolysaccharides was found to be to be strongly associated with the biofilm mass (R² = 0.882), while the content of proteins turned out to be weakly (R² = 0.465) and that of eDNA very weakly associated (R² = 0.202) to the biofilm mass.     

Effects of adaptation to carvacrol on Staphylococcus aureus in the planktonic and biofilm phases

The effect of exposure to sub-minimum inhibitory concentrations of carvacrol, for either 3–10 days, on direct (carvacrol) or cross-protection (cinnamaldehyde, eugenol, antibiotics) and the influence on planktonic and biofilm growth of four Staphylococcus aureus strains were reported. The sequential exposure to carvacrol resulted in a direct protection that was more evident in two of the four strains after 10 days. No significant cross-protection against cinnamaldehyde, eugenol and antibiotics was detected. An adaptive response was associated with a prolonged lag phase, a lower yield of bacteria, a colony phenotype likely to be associated to small colony variants and an increase in biofilm production. Generally, the biofilm of the adapted strains was less susceptible to subMICs of carvacrol compared to the biofilms of non-adapted strains. In contrast, it was demonstrated that in the case of mature biofilms the susceptibility was similar. The exposure of S. aureus to carvacrol at concentrations above the MIC resulted in a very low mutation frequency.     

Liposome as a delivery system for the treatment of biofilm-mediated infections

Biofilm formation by pathogenic microorganisms has been a tremendous challenge for antimicrobial therapies due to various factors. The biofilm matrix sequesters bacterial cells from the exterior environment and therefore prevents antimicrobial agents from reaching the interior. In addition, biofilm surface extracellular polymeric substances can absorb antimicrobial agents and thus reduce their bioavailability. To conquer these protection mechanisms, liposomes have been developed into a drug delivery system for antimicrobial agents against biofilm-mediated infections. The unique characteristics of liposomes, including versatility for cargoes, target-specificity, nonimmunogenicity, low toxicity, and biofilm matrix-/cell membrane-fusogenicity, remarkably improve the effectiveness of antimicrobial agents and minimize recurrence of infections. This review summarizes current development of liposomal carriers for biofilm therapeutics, presents evidence in their practical applications and discusses their potential limitations.     

The use of functionalized nanoparticles to treat Staphylococcus aureus-based surgical-site infections: a systematic review

Staphylococcus aureus-based surgical site infections have become the leading cause of failure for total joint arthroplasty operations and remain a major issue across surgical specialties. Moreover, S. aureus-based infections are becoming drastically more difficult to treat due to the development of antibiotic resistant strains and due to the bacteria's propensity to produce biofilms. The emergence of highly resistant S. aureus infections has created the need for a novel antimicrobial treatment. Functionalized nanoparticles have recently been suggested as being a viable option to fill this void due to their strong antimicrobial and antibiofilm properties. However, said research remains a novel and developing field. The presented systematic review aimed to synthesize the best and most recent evidence available to accurately direct new research towards a viable treatment mechanism. In doing so, the authors performed a comprehensive literature search as directed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The results showed that nanoparticles—particularly those including an iron-oxide component or acidic capping agent—are a viable treatment for S. aureus infections both in vivo and in vitro, and show even greater efficacy when combined with exposure to a magnetic field and irradiation.     

药用植物微生物组及其与药用植物次生代谢产物的关系

药用植物是中药的原料,是中药产业的源头,其生长发育受遗传和环境等诸多因素的影响。以往研究强调植物基因型及生态因子对药用植物产量和品质的影响。近几年,随着人类微生物组研究的推进,植物微生物组作为植物整体的重要组成部分在药用植物的生长发育、品质形成甚至药效等方面的作用也日益受到重视,有关植物微生物组的多样性,微生物组在植物生长发育中的作用已有较详细的综述,而有关药用植物微生物组及其与药用植物次生代谢产物间关系的综述较少。本文重点总结了自2010年以来药用植物微生物组的研究进展,包括药用植物微生物组物种组成、功能及其与药用植物次生代谢产物产生的关系等,并对其在药用植物提质增效及其生态种植中的潜在应用进行了展望。     

Antimicrobial efficacy of the alkaloid harmaline alone and in combination with chlorhexidine digluconate against clinical isolates of Staphylococcus aureus grown in planktonic and biofilm cultures

Aims: To investigate the antimicrobial efficacy of an alkaloid, harmaline alone and in combination with chlorhexidine digluconate (CHG) against clinical isolates of Staphylococcus aureus (S. aureus) grown in planktonic and biofilm cultures. Methods: Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were determined for each micro‐organism grown in suspension and in biofilm using microbroth dilution method. Chequerboard assays were used to determine synergistic, indifferent or antagonistic interactions between harmaline and CHG, and the some of results were verified by confocal laser scanning microscopy. Results: Harmaline and CHG showed effective antimicrobial activity against suspensions and biofilm cultures of S. aureus, respectively. As determined by fractional inhibitory concentration index (FICI), synergistic antimicrobial effects between harmaline and CHG were observed in nine and 11 of the 13 S. aureus strains when in suspension and in biofilm, respectively. FICI values were from 0·375 to 1·25 when in suspension and from 0·25 to 1·25 when in biofilm. Conclusions: Synergistic activity of harmaline and CHG against clinical isolates of S. aureus (in suspension and in biofilm) was observed in vitro. Significance and Impact of the Study: This study might provide alternative methods to overcome the problem of drug‐resistance of S. aureus both in suspension and in biofilm.     

Comparative studies of the immunogenicity and protective potential of biofilm vs planktonic Staphylococcus aureus vaccine against bovine mastitis using non-invasive mouse mastitis as a model system

This study was undertaken to compare the immunogenicity and protective potential of biofilm vs planktonic Staphylococcus aureus vaccine for the prevention of mastitis using the mouse as a model system. Mice immunized with formalin-killed whole cell vaccine of S. aureus residing in a biofilm when delivered via an intramammary route produced a cell mediated immune response. Mice immunized with this biofilm vaccine showed significant reductions in colonization by S. aureus in mammary glands, severity of clinical symptoms and tissue damage in mammary glands in comparison with the mice immunized with formalin-killed whole cells of planktonic S. aureus. The planktonic vaccine administered by a subcutaneous route produced a significantly higher humoral immune response (IgG₁ and IgG) than the biofilm vaccine. However, considering the host response, tissue damage, the clinical severity and colonization of S. aureus in mammary glands, the biofilm vaccine performed better in immunogenicity and protective potential when administered by the intramammary route.     

SrrAB在葡萄球菌生长代谢及存活中的作用研究进展

双组分信号转导系统SrrAB能够感应外界环境中氧浓度的变化,通过磷酸化水平的改变来调控靶基因的转录,进而影响葡萄球菌的多种生物学特性.研究发现SrrAB与葡萄球菌的毒力、生物膜的形成密切相关,而且有氧及厌氧条件下的调控机制不尽相同.然而,SrrAB与葡萄球菌的生长、代谢及其在病原体-宿主互作中的机制尚不清楚.结合课题组...     

Anti-biofilm properties of the antimicrobial peptide temporin 1Tb and its ability,in combination with EDTA,to eradicate Staphylococcus epidermidis biofilms on silicone catheters

In search of new antimicrobials with anti-biofilm potential, in the present study activity of the frog-skin derived antimicrobial peptide temporin 1Tb (TB) against Staphylococcus epidermidis biofilms was investigated. A striking ability of TB to kill both forming and mature S. epidermidis biofilms was observed, especially when the peptide was combined with cysteine or EDTA, respectively. Kinetics studies demonstrated that the combination TB/EDTA was active against mature biofilms already after 2–4-h exposure. A double 4-h exposure of biofilms to TB/EDTA further increased the therapeutic potential of the same combination. Of note, TB/EDTA was able to eradicate S. epidermidis biofilms formed in vitro on silicone catheters. At eradicating concentrations, TB/EDTA did not cause hemolysis of human erythrocytes. The results shed light on the anti-biofilm properties of TB and suggest a possible application of the peptide in the lock therapy of catheters infected with S. epidermidis.     

Epidemiology and Pathogenesis of Staphylococcus Bloodstream Infections in Humans: a Review

Staphylococci are among the most frequent human microbiota components associated with the high level of bloodstream infection (BSI) episodes. In predisposed patients, there is a high risk of transformation of BSI episodes to sepsis. Both bacterial and host factors are crucial for the outcomes of BSI and sepsis. The highest rates of BSI episodes were reported in Africa, where these infections were up to twice as high as the European rates. However, there remains a great need to analyze African data for comprehensive quantification of staphylococcal BSI prevalence. The lowest rates of BSI exist in Australia. Asian, European, and North American data showed similar frequency values. Worldwide analysis indicated that both Staphylococcus aureus and coagulase-negative staphylococci (CoNS) are the most frequent BSI agents. In the second group, the most prevalent species was Staphylococcus epidermidis, although CoNS were not identified at the species level in many studies. The lack of a significant worldwide decrease in BSI episodes indicates a great need to implement standardized diagnostic methods and research etiological factors using advanced genetic methods.     

亚抑菌浓度的穿心莲内酯及与红霉素联用影响表皮葡萄球菌生物膜形成的初步研究

目的 观察亚抑菌浓度(亚-MIC)穿心莲内酯及其与红霉素联用对表皮葡萄球菌生物膜形成的影响.方法 连续稀释法测定穿心莲内酯和红霉素对表皮葡萄球菌的MIC;棋盘格法测定穿心莲内酯和红霉素联用对表皮葡萄球菌悬浮菌的作用;体外构建表皮葡萄球菌生物膜,XTT减低法评价亚-MIC穿心莲内酯及与红霉素联用对表皮葡萄球菌生物膜内细菌代谢及初始黏附能力的影响,扫描电镜观察用药后表皮葡萄球菌形态和生物膜结构改变.结果 穿心莲内酯对表皮葡萄球菌悬浮菌的MIC大于1000 mg/L,穿心莲内酯和红霉素联用对表皮葡萄球菌悬浮菌的FIC指数(联合抑菌分数)＞2;亚抑菌浓度穿心莲内酯对表皮葡萄球菌生物膜黏附及膜内菌代谢均有抑制作用;穿心莲内酯和红霉素联用对表皮葡萄球菌的黏附能力的影响表现为协同作用,对悬浮菌和膜内菌代谢作用表现为拮抗.结论 亚抑菌浓度穿心莲内酯对表皮葡萄球菌生物膜黏附及膜内菌代谢均有抑制作用;穿心莲内酯和红霉素联用对表皮葡萄球菌悬浮菌及膜内菌代谢存在拮抗,提示临床治疗表皮葡萄球菌感染时应避免同时使用这两种药物.     

Evaluation of biofilm production and prevalence of the icaD gene in methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains isolated from patients with nosocomial infections and carriers

Staphylococcus aureus is one of the most important etiological agents responsible for healthcare-associated infections and is capable of producing many virulence factors including biofilm. The aim of the present study was to analyze the correlation between the presence of the icaD and icaA genes and the ability to produce biofilm in vitro in 302 methicillin-resistant (MRSA) and 268 methicillin-sensitive S. aureus (MSSA) strains isolated in the Provincial Hospital in Gdansk. Presence of the icaD and icaA genes was detected by PCR and the ability to produce biofilm in vitro was measured both spectrophotometrically and via Congo Red Agar plate culture methods. We found that 91% of MRSA strains harbored the icaD gene. Moreover, all icaD-negative strains were icaA-positive. Of MRSA and MSSA strains, 47% and 69%, respectively, produced biofilm in vitro. The level of consistency between the two applied phenotypic methods was 96%. Additionally, we found that strains with the same biofilm status may be present in asymptomatic carriers and cause infections.