Comparison of coagulase-negative staphylococci by pulsed-field gel electrophoresis

Five pathogenic strains each of Staphylococcus epidermidis, S. haemolyticus, S. lugdunensis and S. schleiferi were analysed by conventional electrophoresis and field inversion gel electrophoresis. For these coagulase-negative staphylococci, the restriction endonuclease SmaI emerged as the most suitable enzyme for pulsed-field electrophoresis by providing an adequate number of clearly separated DNA fragments. Field inversion gel electrophoresis confirmed the differences among strains already discriminated by conventional electrophoresis, and furthermore, differentiated strains which had previously appeared identical. Among the species that were studied, S. epidermidis showed great genomic diversity with a few common bands. On the contrary, S. haemolyticus, S. lugdunensis and S. schleiferi showed less diversity. Although these minor variations may be epidemiologically significant, this question has to be investigated on a larger number of strains.     

Vitronectin and type-I collagen binding by Staphylococcus aureus and coagulase-negative staphylococci

Abstract Binding of ¹²⁵I-labelled type-I collagen and ¹²⁵I-labelled vitronectin (human serum spreading factor or S-protein) was studied using Staphylococcus aureus and coagulase-negative staphylococci of different species. Binding of collagen and vitronectin was time dependent for S. aureus ISP 546, and S. haemolyticus E 2498/86. Co-operative binding of vitronectin and collagen by staphylococcal cells was demonstrated. Binding to S. haemolyticus E 2498/86 was more rapid and was enhanced in vitronectin/collagen mixtures than for either protein separately. Furthermore, pre-incubation of staphylococcal cells with unlabelled collagen enhanced vitronectin binding. When cells of S. haemolyticus E 2498/86 were treated with pronase E, proteinase K, subtilopeptidase A or trypsin, vitronectin-binding was decreased by 50% or more, whereas collagen-binding was protease resistant. For the strains of S. aureus tested, both vitronectin and collagen binding were found to be protease sensitive. Type-I collagen peptides inhibited collagen-binding to S. haemolyticus E 2498/86, whereas vitronectin-binding was not affected perhaps indicating different receptors for these proteins. The binding of both collagen and vitronectin was shown to be reversible, since bound ¹²⁵I-collagen and ¹²⁵I-vitronectin were displaced after adding excess of the homologous protein.     

The slime of coagulase-negative staphylococci: Biochemistry and relation to adherence

Abstract In recent years, infections of implanted plastic devices by coagulase-negative staphylococci have become a major cause of septicaemia in human patients. The causal bacterial species is usually Staphylococcus epidermidis and these organisms grow as a biofilm adherent to a solid surface. Several methods have been introduced to assess the mass of adherent bacteria and the slimy matrix in which they are embedded. Some methods measure total biofilm, others measure the organisms or the slime alone. In vitro , the type of medium, the atmosphere during incubation, and the nature of the solid surface, affect the quantity of biofilm that is formed. In most studies on the chemistry of the slime, the material used was formed on complex media solidified with agar. Contamination by ingredients of the media or by agar may not always have been recognised. Recent work with chemically defined medium (liquid or solidified with silica gel) shows that the slime is a mixture of about 80% (w/w) teichoic acid and 20% protein. Growth as a biofilm may protect the staphylococci from antibiotics. At present, the greatest success in preventing infection has come from improved surgical techniques during the insertion of implants.     

Role of bacteriophages in genomic variability of related coagulase-negative staphylococci

Abstract DNA analysis using pulsed-field gel electrophoresis (PFGE) has emerged as one of the most sensitive epidemiological tools for the characterization of coagulase-negative staphylococci (CNST). The significance of some minor differences observed between the DNA restriction pulsed patterns of two CNST strains are difficult to interpret since they can theoretically be due to minor chromosomal rearrangements or to phage DNA integration. The latter possibility was investigated by comparing DNA restriction patterns of Staphylococcus epidermidis strains with those of their lysogenized derivatives. In vitro lysogenisation was obtained by exposing the strains to phage 118II. The pulsed patterns of the lysogenized strains were compared to those of their parental strains, revealing a shift in size of approximately 50 kb in a single band which was shown by Southern blotting to contain prophage. One strain was lysogenized ten times, revealing a potential preferref attachment site for phage 118II. These results confirm that chromosomal integration of a phage can be responsible for minor stanle variations in DNA restriction patterns.     

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.     

Catecholamine inotropes as growth factors for Staphylococcus epidermidis and other coagulase-negative staphylococci

Drugs commonly used in intensive care settings were assayed for their ability to affect the growth of Staphylococcus epidermidis in a minimal salts medium containing 30% serum. Of 28 compounds tested, the inotropic catecholamines adrenaline, dobutamine, dopamine, isoprenaline and noradrenaline significantly stimulated bacterial growth. These drugs, but not structurally similar compounds lacking a dihydroxybenzoyl moiety (such as tyramine, phenylephrine and salbutamol), were able to remove iron from iron-saturated transferrin and to supply transferrin-bound 55Fe to S. epidermidis cells. Similar results were observed with a range of coagulase-negative staphylococci associated with line infections, but not with Staphylococcus aureus (including MRSA).     

Diversity and dynamics of communities of coagulase-negative staphylococci in traditional fermented sausages

AIMS: Evaluation of composition and evolution of the coagulase-negative staphylococci (CNS) communities in two traditionally fermented sausages (salsiccia and soppressata lucana) produced in Basilicata, southern Italy. METHODS AND RESULTS: A culture-dependent approach based on isolation on selective media and identification with phenotypic and molecular methods was used. Phenotypic data of 471 strains were analysed by multivariate statistical methods by using 28 strains from culture collections and 48 strains identified by molecular methods (such as 16S rDNA sequencing, species-specific PCR assays, intergenic spacer region-PCR and PCR-denaturing gradient gel electrophoresis) as a reference. The CNS microflora of the sausages was found to be dominated by different biotypes of Staphylococcus xylosus (51.2%), followed by S. pulvereri/vitulus, S. equorum and S. saprophyticus (13.4, 10.2 and 10%, respectively). Other species (S. succinus, S. pasteuri, S. epidermidis, S. warneri and Macrococcus caseolyticus) were also present at lower levels. Identification of 25% of the isolates was impossible. CONCLUSIONS: The composition of CNS communities varied significantly with sausage type, plant and ripening time and clear differences were found among communities of salsiccia and soppressata at the end of ripening. SIGNIFICANCE AND IMPACT OF THE STUDY: Phenotypic characterization, supported by molecular and statistical analyses, can be considered a useful approach for typing a large number of isolates and for monitoring the evolution of staphylococcal communities during sausage fermentation but does not always provide a satisfactory identification of the isolates.     

Adhesion of coagulase-negative staphylococci to biomaterials

The adhesion of two Staphylococcus epidermidis strains and one Staphylococcus saprophyticus strain on to poly(tetrafluorethylene-co-hexafluorpropylene) (FEP)-fluorocarbon and cellulose acetate was studied in vitro. Both S. epidermidis strains showed a more hydrophobic character than the encapsulated S. saprophyticus as determined by the bacterial affinity towards xylene. Staphylococcus epidermidis showed a significantly higher adhesion on to the hydrophobic FEP than S. saprophyticus. The adhesion of staphylococci on to the more hydrophilic cellulose acetate was always low. Treatment of S. epidermidis with pepsin or extraction with aqueous phenol yielded cells with a decreased hydrophobicity, which resulted in a decreased adhesion on to FEP. Cells with a decreased hydrophobicity showed a lower rate of reaggregation in suspension. The hydrophobicity and the adhesion on the FEP of S. epidermidis were not affected by exposure to a subminimal inhibitory concentration of penicillin. The strong interaction between S. epidermidis and FEP, which appeared not to be influenced by the age or the metabolic stage of the bacteria, is mainly caused by hydrophobic bonding.     

Encapsulation of coagulase-negative staphylococci of bovine origin

Capsule expression was assessed in six coagulase-negative staphylococcal strains in serum-soft agar and by india ink and electron microscopy. Classification of strains as encapsulated by serum-soft agar and india ink methods differed. Staphylococcus chromogenes, Staph. hyicus , and Staph. simulans grew as diffuse colonies in serum-soft agar and unstained halos were detected in india ink preparations. Staphylococcus hominis and Staph. simulans grew as diffuse colonies in serum-soft agar but no unstained halo was seen in india ink preparations. Staphylococcus hyicus was the only strain that gave negative results with serum-soft agar and india ink assays. Conventional electron microscopy revealed the presence of capsular polysaccharides on the cell surface of Staph. chromogenes, Staph. hominis and Staph. hyicus. Conventional electron microscopic technique used to examine the surface of cells was detrimental to capsule structure. During dehydration the capsule collapsed and appeared as electron dense aggregates at the surface of cells. To confirm results of conventional electron microscopy and to visualize clearly the cell surface, encapsulated Staph. hyicus and unencapsulated Staph. simulans were observed after freeze-fracture and etching by scanning electron microscopy. The fibrous nature of capsular polysaccharides surrounding cells of Staph. hyicus were distinct and confirmed observation by conventional electron microscopy. A rapid transmission electron microscopic technique is described also for observation of capsule. Results of the rapid TEM method agreed with conventional TEM and SEM. The finding that coagulase-negative staphylococci isolated from bovine milk are capable of capsule production may be important when investigating pathogenicity of these micro-organisms.     

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.     

Identification of coagulase-negative staphylococci from farm animals

The species identify of 661 strains of coagulase-negative staphylococci isolated from the skin and nares of cattle, pigs, poultry, goats and sheep was determined. They belonged either to the novobiocin-sensitive species Staphylococcus hyicus, Staph. simulans, Staph. epidermidis, Staph. haemolyticus and Staph. warneri or to the novobiocin-resistant species Staph. sciuri, Staph. lentus, Staph. xylosus, Staph. cohnii, Staph. saprophyticus and Staph. gallinarum; twenty-one strains remained unidentified. The staphylococcal flora of the farm animals studied differed markedly from that associated with man; several species which do not occur in man were isolated and novobiocin-resistant strains, which occur infrequently in man, were present in large numbers in animals. Two simplified schemes for the identification of staphylococci from farm animals and man are presented.     

Classification of coagulase-negative staphylococci in diagnostic practice

When the Schleifer and Kloos classification was used for the identification of 300 clinical isolates of coagulase-negative staphylococci (CNS), S. epidermidis together with S. saprophyticus was found to amount to 21.1%. A total of 48% of the cultures under test were identified. On the basis of these results and with respect to literary data the present authors propose to subdivide, in diagnostic studies, the mentioned microorganisms into groups of related species, i.e., the epidermidis group and the saprophyticus group, instead of classifying the CNS according to species. By means of the tests proposed (determination of phosphatase, fermentation of glucose, oxidation of mannitol, behaviour towards novobiocin), typical S. epidermidis and S. saprophyticus as well as cultures similar to them can be isolated within the groups. The method is easy to perform in diagnostic laboratories and, in contrast to methods practised up to now, enables us to characterize virtually all CNS variants isolated from patients, including the coagulase-negative S. aureus.     

Identification of coagulase-negative staphylococci from farm animals

The species identity of 661 strains of coagulase-negative staphylococci isolated from the skin and nares of cattle, pigs, poultry, goats and sheep was determined. They belonged either to the novobiocin-sensitive species Staphylococcus hyicus, Staph. simulans, Staph. epidermidis, Staph. haemolyticus and Staph. warneri or to the novobiocin-resistant species Staph. sciuri, Staph. lentus, Staph. xylosus, Staph. cohnii. Staph. saprophyticus and Staph. gallinarum ; twenty-one strains remained unidentified. The staphylococcal flora of the farm animals studied differed markedly from that associated with man; several species which do not occur in man were isolated and novobiocin-resistant strains, which occur infrequently in man, were present in large numbers in animals. Two simplified schemes for the identification of staphylococci from farm animals and man are presented.     

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.     

凝固酶阴性葡萄球菌临床耐药性的连续性研究

目的了解凝固酶阴性葡萄球菌的耐药性情况。方法分析2008年至2010年沈阳军区总医院临床分离的484株凝固酶阴性葡萄球菌的药敏结果。结果 2008年至2010年凝固酶阴性葡萄球菌的分离率分别为4.7%、3.6%和3.1%。耐甲氧西林凝固酶阴性葡萄球菌（MRSCN）分别为76.6%、78.5%和79.9%。青霉素G、红霉素和苯唑西林的耐药率较高,平均分别为91.2%、87.5%和82.6%。万古霉素、替考拉宁和利奈唑胺的耐药率均为0。结论 2008年至2010年凝固酶阴性葡萄球菌检出率相对稳定,对常用抗菌药物的耐药率相对稳定,这为临床用药选择及加强感染控制提供了有力指导。