Pulsed-field gel electrophoresis of genomic restriction fragments as a tool for the epidemiological analysis of Staphylococcus aureus and coagulase-negative staphylococci

Thirteen Staphylococcus aureus and S. epidermidis strains obtained from nose and hand of two employees and one patient of a medical ward as well as two S. hemolyticus strains were analysed according to their restriction fragment length patterns (RFLP) by pulsed-field gel electrophoresis (PFGE) using the restriction enzymes SmaI and SstII. Species identification of the isolates was performed by a system which includes 20 biochemical reactions. Furthermore, the antibiotic resistance patterns of the strains were determined. While several isolates exhibited identical antibiotic susceptibilities and biochemical profiles, differences in the RFLP were obtained. In three cases, S. epidermidis strains colonizing the skin showed an identical restriction profile as isolates from the mucous membranes of the same person. We concluded that the analysis of staphylococcal strains by PFGE is an important epidemiological tool with high discrimination power.     

Identification of Staphylococcus epidermidis using a 16S rRNA-directed oligonucleotide probe

Staphylococcus epidermidis is the most medically significant of the coagulase-negative staphylococci. An oligonucleotide probe (pSe) for identification of S. epidermidis was defined by comparing the sequences of the 16S rRNA variable region V6 from numerous coagulase-negative staphylococci. In order to increase the sensitivity of the detection, polymerase chain reaction amplification of the variable region with primers based on the conserved flanking sequences was applied. The detection limit of the polymerase chain reaction assay combined with pSe probe was shown to be 1 fg which corresponds to about one single bacterium. Additionally, a sensitive, non-radioisotopic system with chemiluminescence detection was tested.     

The investigation of Staphylococcus aureus and coagulase-negative staphylococci nasal carriage among patients undergoing haemodialysis

The frequency of nasal staphylococcal colonization among haemodialysed patients was investigated. The swabs were collected in 1998 and 2004 from 28 and 43 patients, respectively.

Staphylococcus aureus colonization rates were 57.1% and 27.9% in 1998 and 2004, respectively. Twenty-six coagulase-negative staphylococci (CNS) isolates were cultured: S. epidermidis (21), S. lugdunensis (2), single S. haemolyticus, S. warneri, and S. capitits isolates. One S. aureus and 10 CNS isolates were methicillin resistant. The methicillin-resistant S. aureus (MRSA) was resistant to β-lactams, tetracycline, and harbored the pvl gene encoding the Panton-Valentine leukocidin.

The decrease in S. aureus colonization at 6-year interval was observed. The presence of the pvl gene and a favorable antibiotic susceptibility pattern of the MRSA suggest that the isolate was a member of community-acquired MRSA (CA-MRSA). Concluding, screening of haemodialysed patients for staphylococcal colonization accompanied by characterization of cultured isolates is important to understand its epidemiology and to develop infection prevention measures and treatment strategies.     

Dependence of Staphylococcus epidermidis on non-transferrin-bound iron for growth

The ability of Staphylococcus epidermidis strains to grow in the presence of human transferrin and varying amounts of ferric iron was studied. At initial bacterial densities up to 10(4) cfu ml(-1), none of the three strains grew when transferrin iron saturation was below the full saturation point, whereas the bacteria grew consistently when transferrin was fully iron-saturated and there was non-transferrin-bound iron in the medium. Precultivation of the bacteria under iron-restricted conditions to induce siderophore production did not abolish the growth dependence on non-transferrin-bound iron. At initial bacterial densities of 10(6) cfu ml(-1), the bacteria proliferated consistently also in the presence of partially saturated transferrin. The results indicate that at low bacterial densities, S. epidermidis cannot utilise transferrin-bound iron for growth and that its proliferation is dependent on non-transferrin-bound iron.     

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.     

Transformation of Staphylococcus epidermidis and other staphylococcal species with plasmid DNA by electroporation

In this paper, the influence of various parameters on plasmid transformation by electroporation of Staphylococcus epidermidis Tü3298 was investigated. Cell growth conditions, various concentrations and forms of plasmid DNA, field strength, pulse duration and media for electroporation and regeneration were tested. In order to obtain optimal transformation efficiency, the cells were incubated for 30 min with DNA before pulsing. With the optimized procedure, other staphylococcal species such as S. aureus, S. staphylolyticus and S. carnosus were transformed with an efficiency up to 3 X 10(5) transformants per micrograms pC194 plasmid DNA.     

The effects of extracellular slime from Staphylococcus epidermidis on phagocytic ingestion and killing

Abstract Extracellular slime (Ecs) from three strains of Staphylococcus epidermidis was prepared and added to fresh suspensions of polymorphonuclear neutrophils. Phagocytic ingestion and killing of opsonised and unopsonised S. epidermidis strains was assessed over time using slide preparations stained by the Gram's method and microbiological culture. Both phagocytic ingestion and killing were inhibited. Investigation as to one possible mechanism of action of Ecs on phagocytes was performed using 1 μ polystyrene spheres which were incubated overnight with Ecs. It was found that the surface tension was altered with Ecs making the beads more hydrophilic, a factor which may interfere with the phagocytic response to infection.     

Anomalous growth of Staphylococcus epidermidis in the presence of Silastic and glycopeptide antibiotics

Abstract In the presence of supra-inhibitory concentrations of the glycopeptide antibiotics vancomycin and teicoplanin, biofilms of Staphylococcus epidermidis on a Silastic surface produce anomalous growwth. This takes the form of macroscopic, cohesive aggregates of cocci bound together with slime. This phenomenon was intermittent, independent of antibiotic concentrations between 20 and 50 μg ml⁻¹, occured more often with teicoplanin, and was found both with slime-negative strains.     

Apotransferrin administration prevents growth of Staphylococcus epidermidis in serum of stem cell transplant patients by binding of free iron

We investigated the effect of free, non-transferrin-bound iron occurring in haematological stem cell transplant patients on growth of Staphylococcus epidermidis in serum in vitro, and prevention of bacterial growth by exogenous apotransferrin. S. epidermidis did not grow in normal serum at inoculated bacterial densities up to 10(3) cfu ml(-1) but slow growth could be detected at higher initial inocula. Addition of free iron abolished the growth-inhibitory effect of serum, whereas addition of apotransferrin again restored it. Appearance of free iron and loss of growth inhibition coincided in patient serum samples taken daily during myeloablative therapy. Intravenously administered apotransferrin effectively bound free iron and restored the growth inhibition in patient sera. The results suggest that exogenous apotransferrin might protect stem cell transplant patients against infections by S. epidermidis and possibly other opportunistic pathogens.     

Lack of biofilm contribution to bacterial colonisation in an experimental model of foreign body infection by Staphylococcus aureus and Staphylococcus epidermidis

The contribution of in vivo biofilm-forming potential of Staphylococcus aureus and Staphylococcus epidermidis was studied in an experimental model of foreign body infections. Increasing inocula (from 10(2) to 10(7) organisms) of ica-positive strains of S. aureus and S. epidermidis and their ica-negative isogenic mutants (the ica locus codes for a major polysaccharide component of biofilm) were injected into subcutaneously implanted tissue cages in guinea pigs. Surprisingly, bacterial counts and time-course of tissue cage infection by ica-positive strains of S. aureus or S. epidermidis were equivalent to those of their respective ica-negative mutants, in the locally infected fluids and on tissue-cage-inserted plastic coverslips.     

Macrolide resistance genotypes and phenotypes among erythromycin-resistant clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci, Italy

One hundred macrolide-resistant staphylococcal isolates from clinically relevant infections in Italy during a 19-month period were studied. Four distinct resistance phenotypes were observed using the triple-disk induction test (erythromycin, clindamycin, telithromycin): the cMLS_B phenotype (24 isolates); the iMLS_B phenotype (41 isolates); the MS phenotype (three isolates); and the iMTS phenotype (erythromycin-induced telithromycin resistance) (32 isolates). ermC and ermA genes predominated within erythromycin-resistant Staphylococcus aureus isolates with iMLS_B phenotype and cMLS_B phenotype, respectively. Among erythromycin-resistant CoNS isolates, half of the strains showed the iMTS or MS/ msrA association, and ermC gene predominated among isolates with MLS_B phenotype. By pulsed-field gel electrophoresis, high genetic heterogeneity was observed among the isolates studied. Both independent acquisition of macrolide resistance genes and spread of specific resistant clones were observed. Association between certain clonal types and specific types of infection could be detected. To our knowledge, this is the first report on characterization of erythromycin-resistant staphylococci in Italy.     

Comparative analysis of a biofilm-forming Staphylococcus epidermidis strain and its adhesion-positive, accumulation-negative mutant M7

Abstract We have isolated a stable slime-negative mutant, M7, from the wild-type Staphylococcus epidermidis RP62A by mitomycin mutagenesis. Besides its inability to produce slime in the test tube this mutant differed also in two other properties from its parent strain: it lacked the ability to accumulate on a surface, and it did not produce a 115 kDa and a 18 kDa extracellular protein. In all other tested properties such as initial adherence, growth rate, cell-wall composition, surface characteristics, DNA restriction profile, the presence of a 29 kb antibiotic resistance plasmid, and antimicrobial susceptibility profile, M7 was indistinguishable from its wild-type. The mutant is an important basis for further study of the pathogenesis of polymer-associated S. epidermidis infections.     

Cloning and restriction analysis of DNA conferring new quinolone antimicrobial agent resistance from Staphylococcus aureus and other coagulase-negative Staphylococcus species

DNA conferring resistance to new quinolone antimicrobial agents (NQR) in clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci (CNS), S. epidermidis and S. haemolyticus, was analyzed after cloning in Escherichia coli. The NQR phenotypes were expressed in E. coli at lower levels. NQR gene(s)-carring HindIII fragments were very similar to each other among S. aureus or CNS, although the S. aureus fragments differed from the CNS fragments in terms of the NQR phenotypes and restriction endonuclease maps. The data suggest the possibility that the NQR genes have disseminated in evolutionarily distinct routes among S. aureus and CNS.     

重症监护病房凝固酶阴性葡萄球菌分布及耐药性分析

目的了解重症监护病房(ICU)凝固酶阴性葡萄球菌(CNS)临床分布及耐药情况,以期指导临床合理使用抗菌药物。方法采用VITEK-2细菌鉴定及药敏分析系统,对2009年10月至2010年9月重症监护病房的患者各类标本分离的凝固酶阴性葡萄球菌进行鉴定和药敏试验。结果共检出CNS 189株,以表皮葡萄球菌和溶血葡萄球菌为主,占71.42%。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)122株,分离率为61.5%,β-内酰胺酶检出率达100%,MRCNS对青霉素、红霉素、苯唑西林耐药率最高,分别达100%、93.44%、91.80%,对复方新诺明、喹诺酮类药的耐药率次之,对利福平、呋西地酸、替考拉宁、喹奴普汀/达福普汀等耐药率均较低;甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)67株,分离率为38.5%,β-内酰胺酶检出率为61.1%,MSCNS对大多数抗生素敏感;189株CNS中未检测到万古霉素耐药株。结论 ICU分离的CNS以表皮葡萄球菌和溶血葡萄球菌为主,MRCNS检出率高且呈多重耐药,万古霉素、呋西地酸、替考拉宁、喹奴普汀/达福普汀是治疗MRCNS感染的首选药物。     

穿心莲内酯等中药有效成分对表皮葡萄球菌生物膜渗透性的比较

目的比较穿心莲内酯、大黄素、盐酸小檗碱等对表皮葡萄球菌生物膜的渗透性,为中药治疗表皮葡萄球菌引起的相关感染提供相关研究的依据。方法在体外建立SE—BF（表皮葡萄球菌生物膜模型）和PB（生物膜渗透模型）,观察穿心莲内酯、大黄素、盐酸小檗碱等中药有效成分对PB的渗透率。结果大黄素、穿心莲内酯36h渗透率分别达到88．00％、82．89％,而盐酸小檗碱渗透率在几种药物中相对较差。结论中药有效成分对表皮葡萄球菌生物膜有较强的渗透性。     

Erratum to "Apotransferrin administration prevents growth of Staphylococcus epidermidis in serum of stem cell transplant patients by binding of free iron". [FEMS Immunol. Med Microbiol. 37 (2003) 45-51

We investigated the effect of free, non-transferrin-bound iron occurring in haematological stem cell transplant patients on growth of Staphylococcus epidermidis in serum in vitro, and prevention of bacterial growth by exogenous apotransferrin. S. epidermidis did not grow in normal serum at inoculated bacterial densities up to 10(3) cfu ml(-1) but slow growth could be detected at higher initial inocula. Addition of free iron abolished the growth-inhibitory effect of serum, whereas addition of apotransferrin again restored it. Appearance of free iron and loss of growth inhibition coincided in patient serum samples taken daily during myeloablative therapy. Intravenously administered apotransferrin effectively bound free iron and restored the growth inhibition in patient sera. The results suggest that exogenous apotransferrin might protect stem cell transplant patients against infections by S. epidermidis and possibly other opportunistic pathogens.     

Comparative proteome profiling of bovine and human Staphylococcus epidermidis strains for screening specifically expressed virulence and adaptation proteins

The present study reports a comparative proteome cataloging of a bovine mastitis and a human‐associated Staphylococcus epidermidis strain with a specific focus on surfome (cell‐wall bound and extracellular) proteins. Protein identification by 1DE coupled with LC‐MS/MS analyses resulted in 1400 and 1287 proteins from the bovine (PM221) and human (ATCC12228) strains, respectively, covering over 50% of all predicted and more than 30% of all predicted surfome proteins in both strains. Comparison of the identification results suggests elevated levels of proteins involved in adherence, biofilm formation, signal transduction, house‐keeping functions, and immune evasion in PM221, whereas ATCC12228 was more effective in expressing host defense evasion proteases, skin adaptation lipases, hemagglutination, and heavy‐metal resistance proteins. Phenotypic analyses showed that only PM221 displays protein‐ and DNA‐mediated adherent growth, and that PM221 was more efficient in cleaving tributyrin, a natural compound of milk fat under low CO₂ conditions. These findings are in line with the identification data and suggest that distinct expression of lipases and adhesive surfome proteins could lead to the observed phenotypes. This study is the first extensive survey of S. epidermidis proteomes to date, providing several protein candidates to be examined for their roles in adaptation and virulence in vivo. All MS data have been deposited in the ProteomeXchange with identifier PXD000404 ( http://proteomecentral.proteomexchange.org/dataset/PXD000404 ).