Dimethyl sulfoxide inhibits killing of Staphylococcus aureus by polymorphonuclear leukocytes.

Increasing concentrations of the highly permeable, hydroxyl radical scavenger dimethyl sulfoxide progressively decreased killing of Staphylococcus aureus 502A by human polymorphonuclear leukocytes; methane, a product of the reaction of the hydroxyl radical with dimethyl sulfoxide, was generated in the process.     

Involvement of superoxide and myeloperoxidase in oxygen-dependent killing of Staphylococcus aureus by neutrophils.

We have used a quantitative assay that measures independent rate constants for phagocytosis and killing of Staphylococcus aureus to investigate the involvement of superoxide and myeloperoxidase in bacterial killing by human neutrophils. To inhibit superoxide-dependent processes, superoxide dismutase was cross-linked to immunoglobulin G and the conjugate was attached to the surface of S. aureus via protein A in its cell wall. Myeloperoxidase was inhibited with azide, and myeloperoxidase-deficient neutrophils were used. Adding the NADPH oxidase inhibitor diphenyleneiodonium, to prevent superoxide production, decreased the killing rate to 25%, indicating that oxidative killing mechanisms predominate in this system. The rate constant for killing of S. aureus with superoxide dismutase attached was 70% of that for control bacteria linked to inactivated enzyme. Superoxide dismutase had no effect in the presence of diphenyleneiodonium. The rate of killing was decreased to 33% in the presence of azide and to 40% with myeloperoxidase-deficient neutrophils. Superoxide dismutase had no effect in the presence of azide. On the assumption that the oxidative and nonoxidative components of killing can be considered separately, the oxidative rate was decreased by almost half by superoxide dismutase and was about six times lower when myeloperoxidase was inactive. We conclude that myeloperoxidase-dependent processes are strongly favored by human neutrophils as their prime mechanism of oxidative killing of S. aureus and that superoxide makes a direct contribution to killing. Our results also suggest that superoxide acts in conjunction with a myeloperoxidase-dependent pathway.     

Milk complement and the opsonophagocytosis and killing of Staphylococcus aureus mastitis isolates by bovine neutrophils

Phagocytosis of bacteria by bovine polymorphonuclear neutrophils (PMN) has long been regarded as essential for host defense against mastitis infection. Complement-mediated opsonisation by complement component 3 (C3) binding is an important component of the innate immune system. We investigated the role of milk complement as an opsonin and its involvement in the phagocytosis and killing of Staphylococcus aureus isolates from cases of bovine mastitis by bovine blood PMN. We show that deposition of milk C3 component occurred on six different isolates of S. aureus and that the alternative pathway was the sole complement pathway operating in milk of uninflamed mammary gland. This deposition was shown to occur at the same location as the capsule, but not on capsular antigen. Milk complement enhanced the chemiluminescence response of PMN induced by S. aureus. Nevertheless, the association of S. aureus to cells and the overall killing of bacteria by bovine PMN were not affected by the presence of milk complement. Therefore, as all milk samples contained antibodies to capsular polysaccharide type 5 and to other surface antigens, it is likely that milk antibodies were responsible for these two phagocytic events. Results of this study suggest that the deposition of milk complement components on the surface of S. aureus does not contribute to the defence of the mammary gland against S. aureus.     

Staphylococcus aureus capsular polysaccharide types 5 and 8 reduce killing by bovine neutrophils in vitro

Isogenic variants of Staphylococcus aureus strain Reynolds expressing either no capsule or capsular polysaccharide (CP) type 5 (CP5) or type 8 (CP8) were used to assess the effect of CP on bacterial killing and the respiratory burst of bovine neutrophils. The effects of antisera specific for CP5 and CP8 were also evaluated. The killing of live bacteria by isolated neutrophils was quantified in a bactericidal assay, while the respiratory burst after stimulation with live bacteria in whole blood was measured by flow cytometry. The expression of a CP5 or CP8 capsule protected the bacteria from being killed by bovine neutrophils in vitro (P <0.001), and the capsule-expressing variants did not stimulate respiratory burst activity in calf whole blood. The addition of serotype-specific antisera increased the killing of the capsule-expressing bacteria and enhanced their stimulating effect in the respiratory burst assay (P <0.01). When the S. aureus variants were grown under conditions known not to promote capsule expression, there were no significant differences between them. The present study demonstrates that the expression of S. aureus CP5 or CP8 confers resistance to opsonophagocytic killing and prevents the bacteria from inducing respiratory burst of bovine neutrophils in vitro and that these effects can be reversed by the addition of serotype-specific antisera.     

Bacterial iron enhances oxygen radical-mediated killing of Staphylococcus aureus by phagocytes.

It has been shown that increasing bacterial iron concentration enhances killing by hydrogen peroxide (H2O2) but not by polymorphonuclear granulocytes (PMN). It is possible that owing to the multiple bactericidal mechanisms of the PMN, differences in the killing rate of iron-loaded bacteria and control bacteria are obscured. We decided, therefore, to compare the killing of iron-loaded bacteria with that of control bacteria using human monocytes (MN), PMN, and PMN-derived cytoplasts. Incubation of Staphylococcus aureus with increasing concentrations of ferrous ammonium sulfate (0 to 1,000 microM) progressively increased the iron content in the bacteria (from 0.01 to 0.24 mumol of iron per 10(9) bacteria). Iron loading of the bacteria markedly increased their susceptibility to killing by H2O2. After 1 h of incubation with 1 mM H2O2, 95 +/- 2% of the iron-loaded bacteria were killed compared with 18 +/- 4% of the control bacteria (P less than 0.0001). Iron loading of bacteria did not alter their susceptibility to killing by human PMN. However, iron-loaded bacteria were more susceptible to killing by MN (after 12 min of incubation, 81 +/- 2 versus 74 +/- 2% killing; P less than 0.008) and to killing by PMN-derived cytoplasts (after 60 min of incubation, 52 +/- 8 versus 33 +/- 5%; P = 0.003) than the controls. Moreover, iron loading enhanced luminol-mediated chemiluminescence of MN, PMN, and PMN-derived cytoplasts. The hydroxyl radical scavenger thiourea inhibited H2O2-mediated killing of iron-loaded staphylococci as well as luminol-mediated chemiluminescence. These results suggest that alterations in intrinsic iron content increase killing of staphylococci by H2O2, MN, and PMN-derived cytoplasts by a free radical-mediated mechanism.     

Pertussis toxin partially inhibits phagocytosis of immunoglobulin G-opsonized Staphylococcus aureus by human granulocytes but does not affect intracellular killing.

The aim of the present study was to determine whether pertussis toxin (PT)-sensitive GTP-binding proteins (G proteins) are involved in the signal transduction pathway(s) used for phagocytosis and intracellular killing of bacteria by human granulocytes. Treatment of granulocytes with PT resulted in decreased phagocytosis of immunoglobulin G (IgG)-opsonized Staphylococcus aureus but did not affect subsequent intracellular killing of these bacteria. PT also caused a decrease in the extracellular release of superoxide anion (O2-) and hydrogen peroxide (H2O2) by granulocytes in response to S. aureus opsonized by IgG. However, neither the phagocytosis nor the intracellular killing of S. aureus opsonized by fresh serum was affected by PT, and the release of O2- was partially inhibited. The release of O2- in response to serum-treated zymosan, opsonized mainly by complement components, was also only partially inhibited by PT. It is therefore possible that PT inhibits responses mediated through complement receptors to a lesser extent than those mediated via Fc gamma receptors. The results of this study indicate that PT-sensitive G proteins are involved in the signal transduction pathways that mediate the phagocytosis of IgG-opsonized bacteria and the accompanying respiratory burst.     

Phagocytosis and intracellular killing of Staphylococcus aureus by normal mouse peritoneal macrophages.

Although Staphylococcus aureus is incapable of intracellular multiplication in cultured mouse peritoneal macrophages, it is killed at a much slower rate than the avirulent Staphylococcus epidermidis. In addition to the presence of capsular material which inhibits phagocytosis of specific strains of S. aureus, the data show that a number of cellular and environmental factors affect the functional capacities of mononuclear phagocytic cells. The data obtained by varying the initial level of infection indicate that the number of ingested bacteria may subsequently alter the kinetics of intracellular killing. In vitro maturation of macrophages in culture was also found to exert a pronounced effect on the kinetics of bacterial death.     

Phagocytic killing of encapsulated and microencapsulated Staphylococcus aureus by human polymorphonuclear leukocytes.

Phagocytosis by human polymorphonuclear leukocytes (PMNs) is an important host defense against infections caused by Staphylococcus aureus. Using an in vitro assay, we compared the opsonic requirements for phagocytic killing of prototype strains of encapsulated (type 1) and microencapsulated (type 5 and type 8) S. aureus by human PMNs. More than 85% of broth-grown, logarithmic-phase type 5 and 8 S. aureus organisms were killed by PMNs incubated with fresh normal human, rabbit, or guinea pig serum with complement activity. Under similar conditions, the highly encapsulated type 1 strain was not killed. Both encapsulated and microencapsulated strains were opsonized for phagocytosis by heat-inactivated serum raised in rabbits to killed bacteria. Opsonization by homologous serum was required for phagocytosis of the type 1 strain. In contrast, microencapsulated type 5 and 8 S. aureus organisms were killed by heat-inactivated rabbit serum raised to type 5, type 8, or nonencapsulated isolates; this result suggested that antibodies to the capsule or to cell wall components other than the capsule could opsonize these organisms for phagocytosis. The specificity of the assay was confirmed with capsule type 5-specific monoclonal antibodies, which were opsonic only for the type 5 S. aureus isolate. These studies indicate that, unlike the highly encapsulated type 1 strain, broth-grown microencapsulated S. aureus strains do not resist opsonophagocytic killing in vitro by normal serum.     

Effect of concanavalin A on intracellular killing of Staphylococcus aureus by human phagocytes.

This study concerns the influence of concanavalin A (Con A) on phagocytosis and intracellular killing of Staphylococcus aureus by human monocytes and granulocytes. Con A binds to S. aureus, monocytes, and granulocytes, and is not opsonic. Con A stimulates the killing of intracellular serum opsonized S. aureus by monocytes, but not by granulocytes. This stimulation of intracellular killing was inhibited by alpha-methyl-mannoside, indicating that the process occurs via Con A specific membrane binding sites. Unlike (tetravalent) Con A, divalent succinyl-Con A does not stimulate intracellular killing, indicating that the lectin valency is important for this stimulation. Con A bound to Sephadex particles, that can not be ingested by monocytes, does not stimulate intracellular killing of S. aureus either, although it, like free Con A, stimulates H2O2 production. Pre-incubation of monocytes with Con A inhibited Fc gamma and C3b-mediated ingestion of S. aureus as well as stimulation of the killing by serum. Divalent Con A had no effect on these functions. This inhibition by Con A is in all probability due to a steric impedance of Con A with respect to the interaction of IgG and C3b with their membrane receptors. Fluorescence techniques showed that Con A was localized on the membrane and in the cytoplasm of the monocytes, whereas granulocytes had only membrane bound lectin. Taken together, these findings suggest that cell penetration by the lectin is obligatory for the stimulation of intracellular killing.     

P594 Intracellular killing of drug-resistant Staphylococcus aureus by different antibiotics

Objectives:  The aim of this study was to assess the carbapenem susceptibility of four nosocomial pathogens and to evaluate the reliability of the susceptibility results determined by E-test and disc diffusion (DD) methods.
Methods:  Escherichia coli ( n  = 73), Klebsiella pneumoniae ( n  = 60), Pseudomonas aeruginosa ( n  = 70) and Acinetobacter spp. ( n  = 70) isolated from nosocomial infections in 2002–2003 were included in the study. Thirty-five per cent of the strains were isolated from intensive care units. After determining antimicrobial susceptibility against imipenem and meropenem by DD (10  μ g; Oxoid, UK) and Etest (AB Biodisk, Solna, Sweden) methods, the results were categorised as susceptible (S), intermediate (I) and resistant (R) according to the NCCLS criteria. For statistical analyses, the intermediate group was included in the resistant category because of the low numbers of bacteria in the former group.
Results:  None of E. coli or K. pneumoniae strains were resistant to carbapenems, whereas, resistance reached up to 59.0% in Acinetobacter spp. and P. aeruginosa isolates. By either method, the pattern of the susceptibility of the four bacteria was not statistically significantly different for imipenem vs. meropenem. Total agreement of DD and E-test methods for susceptibility to imipenem was 95.7%, and 90.0% in Acinetobacter spp. and P. aeruginosa , respectively; and susceptibility to meropenem was 90.0% for both bacteria. However, the difference of the results obtained by either method was statistically significant for Acinetobacter spp.
Conclusion:  Study results suggest a high resistance rate for Acinetobacter spp. and P. aeruginosa strains against carbapenem antibiotics in our hospital. Further studies are needed to clarify whether E-test should be used to confirm meropenem resistance of Acinetobacter spp. determined by DD method.     

Role of neutrophils in experimental septicemia and septic arthritis induced by Staphylococcus aureus.

We have previously described a murine model of hematogenously induced Staphylococcus aureus sepsis and arthritis. In this model, large numbers of granulocytes can be observed both in the circulation and locally in the inflamed synovium within 24 h after bacterial inoculation. To assess the role of neutrophils in this severe infection, mice were given granulocyte-depleting monoclonal antibody RB6-8C5 before being inoculated with S. aureus. All the control mice survived their intravenous injection with 3 x 10(7) CFU of S. aureus, whereas all the mice given RB6-8C5 antibody died of sepsis within 2 to 3 days. Even when the inoculum size was reduced sixfold (i.e., 6 x 10(6) CFU/mouse), 50% of the RB6-8C5-treated animals died within 6 days. The RB6-8C5-treated mice had a significantly higher burden of bacteria in their blood and kidneys 24 and 48 h after bacterial inoculation. In addition, when a suboptimal dose of bacteria was administered, the neutrophil-depleted animals displayed a higher frequency of arthritis than did the controls. The granulocyte-depleted animals exhibited increased levels of the proinflammatory cytokines tumor necrosis factor alpha, interleukin-6, and gamma interferon, reflecting the severity of their disease. This is the first direct demonstration of neutrophils playing a crucial protective role in the early phase of S. aureus infection.     

Effect of staphylococcal iron content on the killing of Staphylococcus aureus by polymorphonuclear leukocytes.

Preincubation of Staphylococcus aureus 502A in broth with increasing concentrations of ferrous sulfate progressively increased their iron content, markedly increased their susceptibility to killing by hydrogen peroxide, and did not alter their susceptibility to killing by polymorphonuclear leukocytes.     

Rabbit intestinal fluid stimulation by an enterotoxigenic factor of Staphylococcus aureus.

An exoprotein of Staphylococcus aureus 100 that elicited a positive ileal loop response in the rabbit model was investigated in this study. The protein, as it occurred in the culture supernatant fluid, could be detected initially in the late log phase of growth under aerobic and anaerobic conditions. It was stable under acidic conditions to pH 2.0 after 24 h at 4 degrees C. Thirty-minute treatments at 80 degrees C destroyed the ileal loop activity whereas similar trials at 70 degrees C had no effect. Although preparations of staphylococcal enterotoxins purified by other investigators did not produce positive ileal loops, the enterotoxigenic activity of the S. aureus 100 supernatant fluid could be neutralized by antisera prepared against enterotoxins A and B. Throughout purification studies, the active moiety reacted serologically with antiserum A. Polyacrylamide gel electrophoresis of the partially purified protein produced migration patterns nearly identical to those of enterotoxin A.     

Kinetics of intracellular killing of Staphylococcus aureus and Escherichia coli by human granulocytes

The intracellular killing of Staphylococcus aureus and Escherichia coli by human granulocytes was investigated independently of the ingestion of these bacteria. Granulocytes were allowed to phagocytose preopsonized bacteria for only 3 min, after which the noningested bacteria were removed by differential centrifugation and 2 washes. With this technique, the number of viable cell-associated bacteria at the start of the assay, determined after lysis of the granulocytes, includes about 80% intracellular bacteria. Intracellular killing depends on (a) the temperature (no killing occurring at 4°C, maximal killing at 33–39 °C, and a decrease in the capacity of the granulocytes to kill ingested bacteria at temperatures above 42 °C), and (b) the number of bacteria ingested (after phagocytosis at bacteria-to-cell ratios of 100 : 1 and 1000 : 1, not all of the ingested bacteria are killed, whereas after phagocytosis at lower bacteria-to-cell ratios, almost all ingested bacteria are killed). To determine the maximum number of bacteria that can be killed by granulocytes, intracellular killing was measured after phagocytosis of bacteria at various bacteria-to-granulocyte ratios in the presence of phenylbutazone, a drug which inhibits killing during the ingestion period. Phenyl-butazone proved to be a useful tool in the study of intracellular killing, since this drug provides a reversible inhibition of the killing when granulocytes are incubated in its presence for up to 3 min, whereas after longer incubation, the inhibitory effect is irreversible. Calculation based on the data obtained in this study gave maximum rates of intracellular killing amounting to 3.7 × 10⁵ bacteria/5 × 10⁶ granulocytes/min for Staph. aureus and 8.5 × 10⁵ bacteria/5 × 10⁶ granulocytes/min for E. coli. Using the rate of intracellular killing after phagocytosis at a bacteria-to-granulocyte ratio of 1 : 1 and the rate of ingestion obtained in an earlier study, we were able to compute the theoretical numbers of viable extracellular not (yet) ingested, viable intracellular, killed intracellular and total intracellular bacteria. The theoretical curves fit well with the experimental data.     

Flow cytometric assay for quantifying opsonophagocytosis and killing of Staphylococcus aureus by peripheral blood leukocytes.

We describe a novel flow cytometric method for quantifying opsonophagocytosis and killing of Staphylococcus aureus in cell-rich plasma obtained after dextran sedimentation of erythrocytes. To analyze opsonophagocytosis, phagocytes were labeled with a phycoerythrin-conjugated monoclonal antibody and were incubated with viable staphylococci containing carboxyfluorescein as a vital fluorescent dye. Phagocytosing cells assumed a dual, orange-green fluorescence. The relative numbers of bacteria associating with phagocytes could be determined by quantifying the decrease of free green fluorescent particles. A parallel incubation of fluorescent bacteria with unlabeled cell-rich plasma was performed to assess phagocytic killing. Blood cells were lysed with 3-[(3-cholamidopropyl)-dimethyl-ammonio]-1-propanesulfonate. This detergent spared viable bacteria, and residual green fluorescent particles were counted. The decrease in the number of these particles relative to the controls yielded the degree of killing. At bacteria-to-phagocyte ratios of 1:1 and 10:1, approximately 36 and 75% of the phagocytes participated in opsonophagocytosis, respectively. Over 90% of the staphylococci were phagocyte associated after 30 to 60 min. Killing rates were on the order of 66% +/- 12% and 80% +/- 7% after 1 and 2 h of incubation, respectively. These numbers, which were confirmed by colony countings, were significantly lower than those reported in the majority of past reports.     

Virulent Staphylococcus aureus colonizes pediatric nares by resisting killing of human antimicrobial peptides

BackgroundThe nasal carriage of Staphylococcus aureus introduces risks for subsequent infections, the rate of which is particularly high in children. The colonization mechanisms of S. aureus are not fully understood.MethodsThe epidemiological characteristics of nasal colonizing strains from pediatric patients undergoing liver transplantation and healthy pre-school children were analyzed first. Phenotypes, including biofilm formation and hemolytic activity, were tested for all the isolates. Bacterial pathogenicity indicated by a mouse skin abscess model and resistance to antimicrobial peptides (AMPs) was compared between the predominant genotypes from each group.ResultsThe ST188 clone dominated in healthy children, whereas ST59 was prevalent for the pediatric patients. Although ST22 was the second most abundant genotype in the patient group, it was rarely found in healthy children. Interestingly, the colonizing ST59 and ST22 genotypes were more virulent, as indicated by the increased ability for hemolysis in vitro and severe subcutaneous abscesses in the mouse model, compared with ST188. We observed that the virulent ST59 and ST22 displayed higher resistance to antibiotics compared with ST188. Most of the ST59 and ST22 were methicillin-resistant S. aureus (MRSA), and all of the ST188 strains were methicillin-susceptible (MSSA). Moreover, we observed that the virulent ST59 and ST22 can resist killing by human antimicrobial peptides (AMPs). Mechanically, upon stimulation by AMPs, the virulent S. aureus can induce high expression of a phenol-soluble modulin transporter (Pmt) system.ConclusionPediatric patients can be colonized by virulent S. aureus clones, which are able to resist AMPs’ killing through the Pmt system. The residence of virulent strains necessitates the continuous monitoring of potential infections, as well as annealing, to take protective decolonization measures.     

Rate of penicillin killing of Staphylococcus aureus and Autobac 1 susceptibility test results.

A clinical isolate of Staphylococcus aureus interpreted as resistant to penicillin by the Autobac 1 susceptibility testing method (i.e., light-scattering index of 0.77) was found to be susceptible to penicillin by both the disk diffusion and broth dilution techniques. The growth rate of the clinical isolate during a 4-h incubation interval was similar to that of a known sensitive reference strain (S. aureus ATCC 25923) used as a control organism for the Autobac test. The bactericidal effect of penicillin was evaluated by measuring the rate of killing over a 4-h interval. The percentages of organisms surviving exposure to 5.0 or 2.5 U of penicillin G per ml (number of organisms recovered at 3 h/number of organisms introduced as inoculum) were 68 and 76%, respectively, for the clinical isolate and 15 and 21%, respectively, for the reference strain. After 24 h of incubation, penicillin was bactericidal for both strains. The need to increase the time of incubation for those S. aureus isolates resistant to penicillin after 3 h of standard incubation time in the Autobac system is discussed.     

Cytosolic free calcium is essential for immunoglobulin G-stimulated intracellular killing of Staphylococcus aureus by human monocytes.

Earlier studies have shown that the intracellular killing of Staphylococcus aureus by human monocytes requires continuous stimulation by serum factors, e.g., immunoglobulin G (IgG). In the present study, we demonstrate that IgG, at concentrations that stimulate the intracellular killing of S. aureus, induces a transient increase in the intracellular free calcium concentration ([Ca2+]i) in monocytes. The Ca2+ ionophores A23187 and ionomycin stimulate the killing process as efficiently as IgG does and initiate O2- production in resting monocytes but not in monocytes containing bacteria. The Ca2+ ionophore-stimulated killing process was markedly inhibited by the NADPH oxidase inhibitor diphenyleneiodonium bisulfate, which indicates that these ionophores stimulate oxygen-dependent bactericidal mechanisms. Reduction of the [Ca2+]i to values below 1 nM, obtained by loading monocytes with MAPT/AM (1,2-bis-5-methyl-aminophenoxylethane-N,N,N',N'-tetraacetoxymet hyl acetate) in the absence of extracellular Ca2+, rendered the cells unresponsive to IgG or Ca2+ ionophore stimulation of the intracellular killing of S. aureus, but the response could be restored by reincubating these cells in the presence of extracellular Ca2+. It is concluded that cytosolic free Ca2+ is essential for the IgG-stimulated intracellular killing of S. aureus by human monocytes.     

Saliva inhibits the chemiluminescence response, phagocytosis, and killing of Staphylococcus epidermidis by polymorphonuclear leukocytes.

Saliva inhibited several functional properties of polymorphonuclear leukocytes (PMNs) from murine peritoneal exudate, namely, luminol-mediated chemiluminescence (CL) induced by either Staphylococcus epidermidis or formylmethionyl-leucyl-phenylalanine (FMLP), phagocytosis, and killing of bacteria in vitro. The concentration of saliva in the reaction mixture that caused a complete inhibition of the CL response of PMNs to both S. epidermidis and FMLP was 25%. However, there was no catalase or superoxide dismutase activity in saliva that could influence the CL response of PMNs. The production of superoxide by PMNs stimulated with S. epidermidis was assayed in the presence or absence of saliva by inhibition of the reduction of cytochrome c by superoxide dismutase. In the presence of 50% saliva, O2- generation by PMNs was only 7.3% of that observed in the absence of saliva. After gel filtration of salivary material through Sephadex G-25 or Sephacryl S-200, several fractions were obtained that inhibited the CL response of PMNs to either FMLP or S. epidermidis or to both. Two inhibitory fractions were analyzed. One contained immunoglobulin A, and the other contained a peptide which was composed of 14 different amino acids. The two fractions of high molecular weight included in the first protein peak of Sephacryl S-200 gel filtration were able to inhibit the CL response to S. epidermidis and to inhibit phagocytic activity, while fractions of low molecular weight (under 12,500 Mr) inhibited the CL response to FMLP and to S. epidermidis but did not inhibit phagocytic activity.