Phenotypic Suppression of Methicillin Resistance in Staphylococcus aureus by Mutant Noninducible Penicillinase Plasmids

Methicillin (intrinsic) resistance of Staphylococcus aureus was suppressed almost completely by regulatory gene (penI₁) mutations of penicillinase plasmids that made penicillinase production strictly noninducible. Methicillin resistance was restored by secondary regulatory gene mutations that altered the noninducible phenotype or by complementation with a compatible plasmid that did not bear the noninducible mutation. No evidence was obtained for genetic linkage between a penicillinase plasmid and the gene for methicillin resistance. We suggest, therefore, that the mutant noninducible repressor acted in trans by binding to a site on the methicillin resistance determinant. This hypothesis would imply an appreciable degree of homology between penicillinase plasmids and methicillin resistance genes.     

Modulation of Protein A Formation in Staphylococcus aureus by Genetic Determinants for Methicillin Resistance

Many methicillin-resistant (Mec^r) strains of Staphylococcus aureus either produce no protein A or secrete it extracellularly (S. Winblad and C. Ericson, Acta Pathol. Microbiol. Scand. Sect. B 81:150–156, 1973). We found that methicillin resistance and protein A production were apparently lost coordinately from the natively Mec^r strain A676. Restoration of the genetic determinant for methicillin resistance (mec) by transduction or transformation restored protein A production. In two other Mec^r strains, loss of mec was accompanied by marked reduction in protein A formation. Genetic transfer of mec to derivatives of S. aureus 8325 affected protein A formation differently with different mec determinants. Those derived from strain A676 and two other Mec^r strains reduced the scanty amount of protein A produced by strain 8325 to even lower or undetectable levels, whereas mec from two more Mec^r strains increased its protein A content. This “mec-effect,” i.e., stimulation or inhibition of protein A formation dependent on the combination of host strain and mec determinant, was reduced in methicillin-susceptible (Mec^s) mutants produced by ethyl methane sulfonate treatment of Mec^r strains. The mec-effect reappeared in spontaneous revertants to methicillin resistance. Phenotypic reduction of methicillin resistance in Mec^r strains grown at 44°C was accompanied by reduction of the mec-effect on protein A, but it had no effect on protein A formation in Mec^s strains. Two independent mutants of strain 8325 produced large amounts of protein A at rates that were unaffected by growth at 44°C or by the introduction of mec determinants.     

Transduction of Methicillin Resistance in Staphylococcus aureus Dependent on an Unusual Specificity of the Recipient Strain

Resistance to methicillin was transduced by phage 80 or 53 from two naturally occurring methicillin-resistant strains of Staphylococcus aureus to methicillin-susceptible recipient strains at frequencies of 10⁻⁷ to 10⁻⁹. Ultraviolet irradiation of transducing phage and posttransductional incubation at 30 C were essential for useful frequencies of transduction. Effectiveness as a recipient for this transduction was highly specific. Strain NCTC 8325 (PS47) in its native state was an ineffective recipient but became effective after it had received by transduction one of several penicillinase plasmids. This acquired effectiveness was retained in most cases after elimination of the plasmid by ethidium bromide treatment. Like the donor strain, the progeny were heterogeneous in the degree of their resistance to methicillin, which was expressed by a higher proportion of cells as the temperature of incubation was lowered from 37 to 30 C. Separate transductants varied widely in the degree of resistance acquired by transduction. Methicillin resistance was stable in the donor and transductant strains. We favored the interpretation that methicillin resistance in our strains was determined by a single chromosomal gene, although the possibility that it was determined by two or more closely linked genes could not be excluded.     

Methicillin Resistance Transfer from Staphylocccus epidermidis to Methicillin-Susceptible Staphylococcus aureus in a Patient during Antibiotic Therapy

Background

The mecA gene, encoding methicillin resistance in staphylococci, is located on a mobile genetic element called Staphylococcal Cassette Chromosome mec (SCCmec). Horizontal, interspecies transfer of this element could be an important factor in the dissemination of methicillin-resistant S. aureus (MRSA). Previously, we reported the isolation of a closely related methicillin-susceptible Staphylococcus aureus (MSSA), MRSA and potential SCCmec donor Staphylococcus epidermidis isolate from the same patient. Based on fingerprint techniques we hypothesized that the S. epidermidis had transferred SCCmec to the MSSA to become MRSA. The aim of this study was to show that these isolates form an isogenic pair and that interspecies horizontal SCCmec transfer occurred.

Methodology/Results

Whole genome sequencing of both isolates was performed and for the MSSA gaps were closed by conventional sequencing. The SCCmec of the S. epidermidis was also sequenced by conventional methods. The results show no difference in nucleotide sequence between the two isolates except for the presence of SCCmec in the MRSA. The SCCmec of the S. epidermidis and the MRSA are identical except for a single nucleotide in the ccrB gene, which results in a valine to alanine substitution. The main difference with the closely related EMRSA-16 is the presence of SaPI2 encoding toxic shock syndrome toxin and exfoliative toxin A in the MSSA-MRSA pair. No transfer of SCCmec from the S. epidermidis to the MSSA could be demonstrated in vitro.

Conclusion

The MSSA and MRSA form an isogenic pair except for SCCmec. This strongly supports our hypothesis that the MRSA was derived from the MSSA by interspecies horizontal transfer of SCCmec from S. epidermidis O7.1.     

Absence of Circular Plasmid Deoxyribonucleic Acid Attributable to a Genetic Determinant for Methicillin Resistance in Staphylococcus aureus

Plasmid deoxyribonucleic acid was not detected by centrifugal analysis of lysates of penicillinase-negative strains of Staphylococcus aureus harboring a determinant of methicillin resistance derived from strain Villaluz. When these strains contained a penicillinase plasmid, the plasmid deoxyribonucleic acid of methicillin-resistant and methicillin-susceptible strains was indistinguishable by the methods employed. The results indicate that the genetic determinant for methicillin resistance in the strains examined was not associated with a circular plasmid comparable to those that have been shown to determine resistance to benzylpenicillin, tetracycline, and chloramphenicol in S. aureus.     

耐甲氧西林金黄色葡萄球菌小鼠腹膜炎模型的建立

"超级细菌"耐甲氧西林金黄色葡萄球菌(methicillin resistant Staphylococcus aureus,MRSA)是诱发连续腹膜透析患者腹膜炎的常见细菌,且治疗困难。目前缺少MRSA腹膜炎动物模型。腹腔注射2×109~2×1010CFU/m L 7组不同浓度的MRSA感染小鼠,观察小鼠死亡时间,测定肝脏与脾脏细菌定植量,进行肝、脾病理分析,确定适宜的建模浓度。研究发现,小鼠感染细菌浓度最小致死剂量为每只2×109CFU,最适建模浓度为每只1.4×109CFU。结果表明建立了耐甲氧西林金黄色葡萄球菌小鼠腹膜炎模型,为MRSA致腹膜炎的致病机制研究、疫苗的研制提供实验基础。     

Effect of Ethidium Bromide on Elimination of Exfoliative Toxin and Bacteriocin Production in Staphylococcus aureus

The scalded skin syndrome has been associated with phage group II staphylococci. The clinical manifestations of scalded skin syndrome, Ritter's disease, scarlatiniform erythema, and localized bullous impetigo, are due to the production of an extracellular protein, designated exfoliative toxin. Phage group II staphylococci can also produce an extracellular protein, bacteriocin, which is bacteriocidal for specific gram-positive microorganisms. Strain UT 0007 produces both bacteriocin and exfoliative toxin which appear to be products of extrachromosomal genes. These genes are jointly eliminated from strain UT 0007 after growth in either ethidium bromide or at high temperatures.     

耐甲氧西林金黄色葡萄球菌分型及流行现状

【目的】研究杭州地区耐甲氧西林金黄色葡萄球菌(Methicillin-resistant Staphylococcus aureus,MRSA)的基因型别,探讨MRSA菌株流行变化趋势及进化特点,为该地区MRSA的进一步防治提供科学依据。【方法】对86株MRSA进行葡萄球菌盒式染色体SCCmec基因、spa基因分型,并开展多位点序列分型(Multi-locus sequence typing,MLST),与国际上MRSA的流行型别进行比较,分析进化关系。【结果】86株MRSA共发现13个spa型(以t311型为主,占48.8%;其次为t6418型,占11.6%);MLST分型共发现9个ST型(以ST5为主,占59.3%;其次为ST239,占16.3%),经e BURST软件分析它们属于4个群(Group 1、Group 6、Group 8、Group 12)和8种克隆复合体(CC1、CC5、CC630、CC20、CC59、CC88、CC239、CC573);SCCmec基因分型以SCCmecⅡ型为主,占61.6%;其次为SCCmec III型,占22%;5株社区相关性MRSA(SCCmec-Ⅳ型)。其中第一流行克隆型为SCCmec-Ⅱ-ST5-t311-CC5(占47.7%)、其次为SCCmec-III-ST239-t030/t037-CC239(占12.8%)。【结论】SCCmec-Ⅱ-ST5-t311为杭州地区当前流行菌株;CA-MRSA菌株的出现,提示MRSA菌株有由医院向社区播散的趋势;此外,对新发展了单位点变体的菌株(SCCmec-Ⅰ-ST1921-t164-CC20和SCCmec-Ⅳ-ST965-t062-CC5),应加强重视。     

Molecular Analysis of Human and Canine Staphylococcus aureus Strains Reveals Distinct Extended-Host-Spectrum Genotypes Independent of Their Methicillin Resistance

Staphylococcus aureus causes a wide range of infectious diseases in humans and various animal species. Although presumptive host-specific factors have been reported, certain genetic lineages seem to lack specific host tropism, infecting a broad range of hosts. Such Extended-Host-Spectrum Genotypes (EHSGs) have been described in canine infections, caused by common regional human methicillin-resistant S. aureus (MRSA) lineages. However, information is scarce about the occurrence of methicillin-susceptible S. aureus (MSSA) EHSGs. To gain deeper insight into EHSG MSSA and EHSG MRSA of human and canine origin, a comparative molecular study was carried out, including a convenience sample of 120 current S. aureus (70 MRSA and 50 MSSA) isolates obtained from infected dogs. spa typing revealed 48 different spa types belonging to 16 different multilocus sequence typing clonal complexes (MLST-CCs). Based on these results, we further compared a subset of canine (n = 48) and human (n = 14) strains, including isolates of clonal complexes CC5, CC22, CC8, CC398, CC15, CC45, and CC30 by macrorestriction (pulsed-field gel electrophoresis [PFGE]) and DNA-microarray analysis. None of the methods employed was able to differentiate between clusters of human and canine strains independently of their methicillin resistance. In contrast, DNA-microarray analysis revealed 79% of the 48 canine isolates as carriers of the bacteriophage-encoded human-specific immune evasion cluster (IEC). In conclusion, the high degree of similarity between human and canine S. aureus strains regardless of whether they are MRSA or MSSA envisions the existence of common genetic traits that enable these strains as EHSGs, challenging the concept of resistance-driven spillover of MRSA.     

Macrolide Resistance in Staphylococcus aureus

A heat-inducible mutant, resistant to macrolide antibiotics (Mac), was isolated from Staphylococcus aureus MS537 in which Mac-resistance was induced by subinhibitory concentrations of erythromycin (EM). After induction at 42 C, this mutant acquired a high resistance to both Mac and lincomycin (LMC). Transduction and biochemical studies revealed that spiramycin (SP)-resistance in this mutant was induced by exposure to a high temperature (42 C) or by treatment with EM in broth but not in phosphate buffer. Induction did not take place when chloramphenicol (CM) was added to the induction mixture. Ribosomes from the mutant cultured at 42 C decreased their affinity for SP and consequently polypeptide synthesis on such ribosomes was not inhibited by SP, when compared with those cultured at 30 C. From these results, it was concluded that alteration of ribosomes took place after induction by exposure at high temperatures or by EM-treatment and that the mechanism of SP-resistance after induction was accounted for by a decrease in SP-binding to ribosomes.     

Macrolide Resistance in Staphylococcus aureus

It was demonstrated that spiramycin (SP)-resistance could be related to the decrease in binding of ribosomes to SP and that the SP-binding to ribosomes was related with inhibition of polypeptide synthesis by SP in a cell-free system in staphylococcal strains. These facts were also observed in Mac (macrolide)-inducible strains, in which resistance to Mac antibiotics is enhanced by prior treatment with subinhibitory concentrations of erythromycin. From these results, it was concluded that the mechanism of resistance to Mac antibiotics is accounted for by alteration of ribosomes in staphylococcal strains and that this alteration of ribosomes is caused not only by mutation but also by induction.     

Drug Resistance in Staphylococcus aureus

Antibacterial and inducer activities concerning inducible macrolide resistance in Staphylococcus aureus were investigated using 32 erythromycin, oleandomycin and other macrolide antibiotic derivatives and analogues. The macrolides were classified into five groups from very high to none according to their inducer activity.     

Methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci: epidemiological and molecular aspects

Infections caused by the genus Staphylococcus are of great importance for human health. Staphylococcus species are divided into coagulase-positive staphylococci, represented by S. aureus, a pathogen that can cause infections of the skin and other organs in immunocompetent patients, and coagulase-negative staphylococci (CNS) which comprise different species normally involved in infectious processes in immunocompromised patients or patients using catheters. Oxacillin has been one of the main drugs used for the treatment of staphylococcal infections; however, a large number of S. aureus and CNS isolates of nosocomial origin are resistant to this drug. Methicillin resistance is encoded by the mecA gene which is inserted in the SCC mec cassette. This cassette is a mobile genetic element consisting of five different types and several subtypes. Oxacillin-resistant strains are detected by phenotypic and genotypic methods. Epidemiologically, methicillin-resistant S. aureus strains can be divided into five large pandemic clones, called Brazilian, Hungarian, Iberian, New York/Japan and Pediatric. The objective of the present review was to discuss aspects of resistance, epidemiology, genetics and detection of oxacillin resistance in Staphylococcus spp., since these microorganisms are increasingly more frequent in Brazil.     

Matched-Cohort DNA Microarray Diversity Analysis of Methicillin Sensitive and Methicillin Resistant Staphylococcus aureus Isolates from Hospital Admission Patients

As genotyping of S. aureus is important for epidemiologic research and for hygiene management, methods are required for standardized fast and easily applicable evaluation of closely related epidemic strains with high prevalence in hospitals. In this single centre matched control study we compared a new commercially available DNA microarray (IdentiBAC) with standard spa-typing for S. aureus genotyping. Included in the study was a subgroup of 46 MRSA and matched 46 MSSA nasal isolates of the Saarland University Medical Center collected during a state-wide admission prevalence screening. Microarray (MA) and also spa-typing could easily differentiate the genetically diverse MSSA group. However, due to the predominance of CC5/t003 in the MRSA group a sufficient subtyping required analysis of more complex genetic profiles as was shown here by the MA comprising a total number of 334 different hybridization probes. The genetic repertoire of the MRSA group was characterized by more virulence genes as compared to the MSSA group. The standard evaluation of MA results by the original software into CCs, agr-, SCCmec- and capsule-types was substituted in the present study by implementation of multivariate subtyping of closely related CC5 isolates using three different bioinformatic methods (splits graph, cluster dendrogram, and principal component analysis). Each method used was applicable for standardized and highly discriminative subtyping with high concordance. We propose that the identified S. aureus subtypes with characteristic virulence gene profiles are presumably associated also with virulence and pathogenicity in vivo; however, this remains to be analyzed in future studies. MA was superior to spa-typing for epidemiologic and presumably also provide functional respectively virulence associated characterization of S. aureus isolates. This is of specific importance for the hospital setting. In future, MA could become a new standard test for S. aureus typing in combination with multivariate bioinformatic analysis.     

ST59型社区获得性耐甲氧西林金黄色葡萄球菌毒力因子研究

了解ST59型社区获得性耐甲氧西林金黄色葡萄球菌(community-acquired methicillin-resistant Staphy-lococcus aureus,CA-MRSA)携带毒力因子的情况。用PCR方法扩增ST59型CA-MRSA PSMα、PVL、SEA、SEB、SEC、SED、SEE、TSST-1、ETA、ETB基因。5株CA-MRSA全部检出PSMα基因和PVL基因,均未检出SEA、SEB、SEC、SED、SEE、TSST-1、ETA、ETB基因。PSMα和PVL基因是ST59型社区获得性耐甲氧西林金黄色葡萄球菌常见的毒力因子。