Extracellular DNA-dependent biofilm formation by Staphylococcus epidermidis RP62A in response to subminimal inhibitory concentrations of antibiotics

We measured the ability of Staphylococcus epidermidis to form biofilms in the presence of subminimal inhibitory concentrations (sub-MICs) of vancomycin, tigecycline, linezolid and novobiocin. Six strains that produce different amounts of biofilm were tested. The three strains that produced the highest amounts of biofilm exhibited steady-state or decreased biofilm formation in the presence of sub-MIC antibiotics, whereas the three strains that produced lower amounts of biofilm exhibited up to 10-fold-increased biofilm formation in the presence of sub-MIC antibiotics. In two of the inducible strains (9142 and 456a), antibiotic-induced biofilm formation was inhibited by dispersin B, an enzyme that degrades poly-N-acetylglucosamine (PNAG) biofilm polysaccharide. In the third inducible strain (RP62A), dispersin B inhibited biofilm formation in response to sub-MIC vancomycin, but not to sub-MIC tigecycline. In contrast, DNase I efficiently inhibited biofilm formation by strain RP62A in response to sub-MIC tigecycline and vancomycin. DNase I had no effect on antibiotic-induced biofilm formation in strains 9142 and 456a. Our findings indicate that antibiotic-induced biofilm formation in S. epidermidis is both strain- and antibiotic-dependent and that S. epidermidis RP62A utilizes an extracellular DNA-dependent mechanism to form biofilms in response to sub-MIC antibiotics.     

XTT assay for evaluating the effect of alcohols, hydrogen peroxide and benzalkonium chloride on biofilm formation of Staphylococcus epidermidis

To analyze the degree of biofilm formation on three ica-positives Staphylococcus epidermidis as a function of biocides, the medium was supplemented with increasing concentrations of isopropanol, ethanol, and methanol at 0, 1, 4, 6, 8, 10, 12 and 14% (v/v), hydrogen peroxide (0, 0.125, 0.25, 0.5, 1, 2, 3, 4 and 5% v/v) and benzalkonium chloride (0, 0.125, 0.25, 0.5, 1, 2, 3, 4 and 6 μg ml⁻¹).     

生物材料植入感染与表皮葡萄球菌生物膜形成的相关基因调控

表皮葡萄球菌是寄居于人体皮肤和黏膜表面的共生菌群,现已发现其是引发临床生物材料相关感染的主要条件致病菌,在生物材料植入感染中占有重要地位.医用生物材料表面细菌生物膜的形成是其主要致病因素,细菌生物膜可有效抵御机体的防御反应和抗生素治疗,导致生物材料植入感染难以彻底治愈,使感染呈慢性、持续性和反复性特点,从而在临床上造成了极高的死亡率.就表皮葡萄球菌生物膜的形成、胞间黏附素基因(ica)操纵子和附属基因调节子(agr)基因对表皮葡萄球菌生物膜的调控及其在临床生物材料植入感染中的作用等方面作一综述.     

Clonality of clinical methicillin-resistant Staphylococcus epidermidis isolates in a neonatal intensive care unit

OBJECTIVE: Study of the clonality of methicillin-resistant Staphylococcus epidermidis responsible of epidemic infections in a neonatal intensive care unit. PATIENTS AND METHODS: All S. epidermidis isolates (mecA+) were collected during the epidemic period (December 2003-September 2004) from different pathological products of newborns. Isolates were characterized by genotyping in pulsed-field gel electrophoresis and by electrophoretic profiles obtained by PCR-based analysis of inter-IS256 spacer polymorphisms. RESULTS: Twenty methicillin-resistant S. epidermidis isolates were collected from newborns during the epidemic period and represented 41.6% of the total isolates of S. epidermidis, which is the first Staphylococcus species isolated from the unit. These isolates were collected from blood cultures (80%), vascular catheters (5%), pus (10%), and intra-tracheal tube (5%). Six genotypic profiles were individualized: type A, type B, type C, type D, type E, and type F, with clear dominance of type A. Five different PCR patterns were found with poor correlation to genotypes defined by PFGE. CONCLUSION: Neonatal nosocomial outbreak of methicillin-resistant S. epidermidis was caused by multiple clones of this species with predominance of one epidemic and multiresistant clone. This clone may be transmitted between babies and was able to persist in the unit. PCR IS 256 proved to be less discriminative than PFGE for typing MRSE.     

Enhanced activity of carvacrol against biofilm of Staphylococcus aureus and Staphylococcus epidermidis in an acidic environment

Carvacrol is an antimicrobial monoterpenic phenol which occurs in many plant essential oils. The aim of this study was to investigate its activity at acidic pH on staphylococcal forming and yet established biofilms, with particular focus to improve its effectiveness on Staphylococcus epidermidis biofilm. The results showed that the subinhibitory doses (1/2, 1/4 and 1/8 MIC) of carvacrol determined a higher reduction of S. epidermidis biofilm formation than that observed at neutral pH. A potentiated inhibitory effect was also observed on established biofilm, carvacrol caused either a strong reduction of biomass (>50%) and bacteria attached to polystyrene (>7 log units). The images of scanning electron microscopy and the gas‐chromatographic analysis support these results. The development of acidic formulations containing carvacrol could be an important tool to control the staphylococcal biofilm in the medical and food environment.     

The ArlR-MgrA regulatory cascade regulates PIA-dependent and protein-mediated biofilm formation in Rbf-dependent and Rbf-independent pathways

The two-component system response regulator ArlR and the global regulator MgrA in Staphylococcus aureus participated in numerous biological processes including biofilm formation inhibition. Previous studies have shown that these two regulators could function as a regulatory cascade. Rbf is a positive regulator of biofilm formation enhancing the production of PIA (polysaccharide intercellular adhesin). Here we have demonstrated that both ArlR and MgrA can directly bind to the promoter of rbf and repress its expression. ArlR and MgrA can also directly bind to the promoter of ica operon and enhance the expression of icaA and PIA production, revealing that the ArlR-MgrA regulatory cascade controls PIA-dependent biofilm formation. In addition, we have found that Rbf can directly bind to the aur promoter and repress the expression of aur, which encodes a protease initiating a protease cascade to inhibit protein-mediated biofilm formation. Moreover, our data indicate that the ArlR-MgrA regulatory cascade can promote the expression of aur by directly binding to its promoter and inhibit protein-mediated biofilm formation. These findings shed light on the molecular mechanisms of both PIA-dependent and protein-mediated biofilm formation modulated by the ArlR-MgrA regulatory cascade and the new role of Rbf in protein-mediated biofilm formation, and broaden our understanding of the biofilm formation regulation in S. aureus.     

Microfluidic devices for studying growth and detachment of Staphylococcus epidermidis biofilms

Microfluidic devices were used to study the influences of hydrodynamics of local microenvironments on Staphylococcus epidermidis (S. epidermidis) biofilm formation and the effects of a poly(beta-1,6-N-acetyl glucosamine)-hydrolyzing enzyme (dispersin B) and/or an antibiotic (rifampicin) on the detachment of the biofilm. Elongated, monolayered biofilm morphologies were observed at high flow velocity and fluid shear locations whereas large clump-like, multilayered biofilm structures were produced at low flow velocity and fluid shear locations. Upon dispersin B treatment, most of the biofilm was detached from the microchannel surface. However, a trace amount of bacterial cells could not be removed from corner locations most likely due to the insufficient wall shear stress of the fluid at these locations. Dispersin B or rifampicin treatment was effective in delaying the dispersal behavior of bacterial cells, but could not completely remove the biofilm. Combined dynamic delivery of dispersin B and rifampicin was found to be effective for complete removal of the S. epidermidis biofilm.     

Inhibition of Staphylococcus epidermidis adhesion on titanium surface with bioactive water-soluble copolymers bearing sulfonate, phosphate or carboxylate functions

Implanted prostheses are sometimes subject to bacterial infections, which can threat their benefit rule on a long-term basis. Various methods are studied to fight against these infections. Among them, the grafting of bioactive polymers onto the prosthesis surface shows up as a promising way to the problem of infections. This work presents the influence of various water-soluble bioactive polymers on the inhibition of the Staphylococcus epidermidis adhesion on the titanium samples surfaces initially preadsorbed with various proteins. Whatever the studied protein is, it is shown that the bioactive polymer containing sulfonate functions generates an inhibition of the adhesion of Staphylococcus epidermidis. For a plasma preadsorption, the inhibition rate rises up to 68% when the concentration of sulfonate function is 2.5μmol/L. Titanium surfaces grafted with the bioactive polymer were also tested. We find an inhibitive activity of the adhesion close to that of the previous case. These preliminary results can point up a clinical interest in the fight against the medical devices infection, because they highlight a clear local effect of S. epidermidis adhesion inhibition. Copolymers containing other functional groups (phosphate or carboxylate) were dissolved in a bacterial suspension to monitor the influence of the composition on the adhesion inhibition. Their inhibition rates are not significantly lower than those of pNaSS homopolymers, as much as the sulfonate function proportion remains higher than 50%. Thus, the sulfonate function is the main responsible for the inhibition of the S. epidermidis adhesion.     

Prevalence of resistance phenotypes and genotypes to macrolide, lincosamide and streptogramin antibiotics in Gram-positive cocci isolated in Tunisian Bone Marrow Transplant Center

To investigate the prevalence of resistance to macrolide, lincosamide and streptogramin (MLS) antibiotics in Gram-positive cocci isolated in a Bone Marrow Transplant Center of Tunisia, we tested the antibiotic susceptibility of 172 clinical isolates of Staphylococcus epidermidis, Streptococcus mitis and Enterococcus faecium to macrolide erythromycin and spiramycin, the lincosamide clindamycin and the streptogramin pristinamycin. These three groups of organisms were mostly resistant to macrolides and lincosamide, but were commonly susceptible to pristinamycin. The resistance phenotypes of erythromycin-resistant isolates were determined by the five-disc test with erythromycin, spiramycin, lincomycin, clindamycin and pristinamycin, which showed that most exhibited constitutive MLS resistance. In order to determine the prevalence of the resistance genotypes and the resistance mechanisms, the prevalence of the erythromycin resistance methylase (erm) (A), erm(B), erm(C), msr(A) and macrolide efflux (mef) (A) genes in the erythromycin-resistant isolates was identified by polymerase chain reaction (PCR) analysis. The resistance was due mainly to the presence of ermB in E. faecium (80%), ermC in S. epidermidis (53%) and mefA in S. mitis (65%).     

Mechanisms of biofilm formation in Staphylococcus epidermidis and Staphylococcus aureus: functional molecules, regulatory circuits, and adaptive responses

Biomaterial-associated infections, most frequently caused by Staphylococcus epidermidis and Staphylococcus aureus, are of increasing importance in modern medicine. Regularly, antimicrobial therapy fails without removal of the implanted device. The most important factor in the pathogenesis of biomaterial-associated staphylococcal infections is the formation of adherent, multilayered bacterial biofilms. In this review, recent insights regarding factors functional in biofilm formation of S. epidermidis, their role in pathogenesis, and regulation of their expression are presented. Similarly, in S. aureus the biofilm mode of growth affects gene expression and the overall metabolic status. Experimental approaches for analysis of differential expression of genes involved in these adaptive responses and evolving patterns of gene expression are discussed.     

Role of insertion elements and yycFG in the development of decreased susceptibility to vancomycin in Staphylococcus aureus

The glycopeptide antibiotic vancomycin acts by binding to the D-alanyl-D-alanine terminus of the cell wall precursor lipid II in the cytoplasmic membrane. The purpose of this study was the identification of genes that might be involved in the vancomycin resistance mechanism. To this end, the expression profiles of two vancomycin intermediately resistant Staphylococcus aureus (VISA) strains, the clinical isolate S. aureus SA137/93A (Etest: 8 microg/ml) and its laboratory mutant S. aureus SA137/93G (Etest: 12 microg/ml) were analyzed using an S. aureus full-genome chip. The results indicated that an essential two-component regulatory system, yycF (vicR) and yycG (vicK) was drastically up-regulated in strain SA137/93A. Sequencing of the yycFG promoter region of strain SA137/93A revealed an insertion of IS256 in the predicted promoter region creating a potentially stronger hybrid promoter. In strain SA137/93G, IS256 was not integrated in the yycFG promoter region but, in previous studies, a copy of IS256 had been found to inactivate the tcaA gene (Maki et al. Antimicrob. Agents and Chemother. 48, 1953-1959 (2004)). Detailed population analyses showed that, in addition to the loss of SCCmec, the inactivation of tcaA seems to cause at least part of the increase in teicoplanin and vancomycin resistance in strain SA137/93G.     

Enhanced biofilm formation and reduced virulence of Actinobacillus pleuropneumoniae luxS mutant

Actinobacillus pleuropneumoniae is the pathogen of porcine contagious pleuropneumonia causing great economic losses globally. LuxS is known to be involved in the interspecies quorum sensing by mediating the production of AI-2 signal molecule and play important roles in regulating various behaviors of bacteria. In this study, A. pleuropneumoniae was tested to be able to produce AI-2 like molecule. A luxS deletion mutant strain was constructed by homologous replacement, and its growth features, biofilm formation and virulence were characterized. The luxS mutant showed obvious growth deficiency when cultured in the serum-free medium. Biofilm formation of the mutant strain was significantly enhanced. In a mouse infection model, the 50% lethal dose of the mutant strain was increased up to 96-folds, and the ability to colonize in different mouse tissues was significantly decreased. Down-regulation of apxIIA, a major virulence factor of A. pleuropneumoniae, may contribute to the virulence attenuation of the mutant strain. Our data demonstrated that LuxS is functional in the AI-2-mediated quorum sensing in A. pleuropneumoniae and LuxS may regulate different behaviors including biofilm formation and virulence of this important pathogen.     

Staphylococcal biofilm formation as affected by type acidulant

Staphylococcal growth and biofilm formation in culture medium where pH was lowered with weak organic (acetic and lactic) or strong inorganic (hydrochloric) acids were studied. The effects were evaluated by biomass measurements, cell‐surface hydrophobicity, scanning electron microscopy (SEM), and confocal laser scanning microscopy (CLSM). The results demonstrated that the inhibition was related to type of acidulant and pH value. At pH 5.0, the antibacterial effect was more pronounced in the presence of acetic acid (58–60% growth reduction) compared with that in the presence of lactic (7–16% growth reduction) and hydrochloric acids (23–24% reduction). The biofilm biomass of Staphylococcus aureus and Staphylococcus epidermidis was reduced by 92, 85, 63, and 93, 87, 81% after exposition to acetic, lactic, and hydrochloric acids, respectively. Increasing the pH from 5.0 to 6.0 resulted in a noticeable reduction in the effectiveness of acids. A minor cells hydrophobic character was also documented. The SEM and CLSM revealed a poorly structured and thinner biofilm compared with the dense and multilayered control. Acidic environment could have important implications for food‐processing system to prevent bacterial colonization and control biofilm formation. The findings of this study lead to consider the rational use of the type of acid to achieve acidic environments.     

Phenol-soluble modulins

PSMs are a recently discovered family of short, amphipathic, α-helical peptides in staphylococci. Several PSMs are key virulence determinants, particularly in highly virulent Staphylococcus aureus strains. PSMα peptides of S. aureus facilitate neutrophil lysis after phagocytosis, and are key contributors to several infection types, including skin infection and bacteremia. Furthermore, all PSMs contribute to biofilm structuring and the dissemination of biofilm-associated infection. Cytolytic PSMs as produced by S. aureus appear to have evolved from original functions in the non-infectious lifestyle of staphylococci. The surfactant properties of PSMs, which they all share, are believed to facilitate growth on epithelial surfaces. The basic role of PSMs in staphylococcal physiology is underscored, for example, by their exceptionally strict and direct control by quorum-sensing and the presence of a dedicated secretion system. Targeting PSMs for anti-staphylococcal drug development may be a promising approach to overcome the problems associated with widespread antibiotic resistance in staphylococci.     

The potential of phages to prevent MRSA infections

This short review attempts to examine whether there is a potential for the use of phages capable of infecting Staphylococcus aureus to eradicate or reduce nasal colonisation, thereby reducing the overall infection burden in patient populations identified as being at risk from MRSA infections. There is clear evidence that nasal decolonisation may be of benefit to certain patient groups and also that phages can effectively combat experimentally induced S. aureus infections in animals. However, this is not in itself enough to validate the use of phages for decolonisation and, given the appearance of strains resistant to currently used topical antibiotics, there is a need for clinical trials of this prophylactic use of phages.     

Biofilm and the role of the ica operon and aap in Staphylococcus epidermidis isolates causing neurosurgical meningitis

Fifty-five Staphylococcus epidermidis isolates, classified as contaminants or causing device-related meningitis, from external ventricular drain (EVD) and non-EVD cerebrospinal fluid specimens were characterized. Thirty-three of 42 (78.6%) meningitis isolates were PCR-positive for ica and aap , known determinants of polysaccharide- and protein-mediated biofilm production, whereas five of 13 (38.5%) contaminants were ica - and aap -negative; 71.4% of meningitis isolates and 84.6% of contaminants produced biofilm. ica ⁺ aap ⁺ meningitis isolates produced more biofilm than ica ⁺ aap ⁻ isolates (p 0.0020). ica ⁺ aap ⁻ isolates did not produce more biofilm than ica ⁻ aap ⁺ isolates (p 0.4368). Apparently, ica and aap are associated with biofilm production in S. epidermidis device-related meningitis isolates.     

Resistance to linezolid in a methicillin-susceptible Staphylococcus aureus clinical isolate without previous exposure to oxazolidinones

A linezolid-resistant, methicillin-susceptible isolate of Staphylococcus aureus was obtained from an infected surgical wound in an ambulatory patient. The isolate belonged to ST125 and was susceptible to all the antibiotics tested except linezolid (MIC 8 μg/ml) and levofloxacin. Linezolid resistance could be ascribed to the presence of the mutation G2576T in 2 of the 23S rRNA alleles. The mutant alleles were stably maintained in the absence of antibiotic selection.