Bactericidal Effect of Oleic Acid on Group A Streptococci: Mechanism of Action

In contrast to Staphylococcus aureus and coagulase-negative staphylococci, group A streptococci are infrequently present on normal human skin, except in certain populations with endemic impetigo. This has been attributed to differences in susceptibility to the bactericidal effect of skin surface lipids, particularly unsaturated fatty acids. When an M type 6 strain group A streptococcus was exposed to 500 mug of oleic acid per ml, viable counts decreased by 4 logs in 5 min. The rank order of killing was 35 > 20 > 4 degrees C. Oleic acid did not kill a strain of S. aureus, a strain of coagulase-negative staphylococcus, or a strain of Escherichia coli, but bound rapidly to these bacteria as well as to the group A streptococcus. The loss of [(3)H]uridine from labeled oleic acid-treated group A streptococcal cells was greater than 100 times that of controls. There was no loss of [(3)H]-thymidine from group A streptococci or of [(3)H]uridine or [(3)H]thymidine from identically exposed coagulase-negative staphylococci. When [(3)H]uridine was added to group A streptococci during mid-log-phase growth, cessation of uptake occurred within 5 min of addition of 50 mug of oleic acid per ml. Electron microscopic changes seen within 5 min included condensation of the nucleoid and distortion of the streptococcal surface by numerous clumps and blebs. Coagulase-negative staphylococci, S. aureus, and E. coli similarly exposed showed no comparable electron microscopic changes. We propose that oleic acid kills group A streptococci by altering the integrity of the cell membrane with resulting loss of ribonucleic acid but not deoxyribonucleic acid.     

A study of the action of the cationic proteins from rabbit polymorphonuclear leucocytes on the staphylococcal cell membrane.

The inhibitory effect of cationic proteins from rabbit polymorphonuclear leucocytes on the oxidation of NADH by staphylococcal membrane preparations is described. Both cyanide and haematin are shown to interfere with the inhibitory process, by different mechanisms. Other authors have shown that glucose repressed staphylococci are diverted to a fermentative mode of metabolism. These findings were confirmed by demonstrating that membrane preparations from staphylococci grown in the presence of glucose have diminished cytochrome and succinic dehydrogenase levels. From a comparison of the effect of the cationic proteins on NADH oxidation in membrane preparations from organisms grown normally and under conditions of glucose repression, and from knowledge of the different susceptibility to the cationic proteins of the two types of organisms, it is suggested that the cationic proteins exert their bactericidal action on staphylococci following an energy dependent binding to the membrane.     

Bactericidal cationic peptides can also function as bacteriolysis-inducing agents mimicking beta-lactam antibiotics?; it is enigmatic why this concept is consistently disregarded

Although there is a general consensus that highly cationic peptides kill bacteria primarily by injuring their membranes, an additional hypothesis is proposed suggesting that a large variety of cationic peptides might also render bacteria non viable by activating their autolytic wall enzymes - muramidases (a "Trojan Horse" phenomenon), resulting in bacteriolysis. This group of cationic peptides includes: lysozyme, lactoferrin, neutrophil-derived permeability increasing peptides, defensins, elastase, cathepsin G, and secretory phopholipase A2. In this respect, cationic peptides mimic the bactericidal/bacteriolytic effects exerted by of beta-lactam antibiotics. Bacteriolysis results in a massive release of the pro-inflammatory cell-wall components, endotoxin (LPS), lipoteichoic acid (LTA) and peptidoglycan (PPG), which if not effectively controlled, can trigger the coagulation and complement cascades, the release from phagocytes of inflammatory cytokines, reactive oxygen and nitrogen species, and proteinases. Synergism (a "cross-talk") among such agonists released following bacteriolysis, is probably the main cause for septic shock and multiple organ failure. It is proposed that a use of bacteriolysis-inducing antibiotics should be avoided in bacteremic patients and particularly in those patients already suspected of developing shock symptoms as these might further enhance bacteriolysis and the release of LPS, LTA and PPG. Furthermore, in additonal to the supportive regimen exercised in intensive care settings, a use of non bacteriolysis-inducing antibiotics when combined with highly sulfated compounds (e.g. heparin, and other clinically certified polysufates) should be considered instead, as these might prevent the activation of the microbial own autolytic systems induced either by highly cationic peptides released by activated phagocytes or by the highly bacteriolytic beta-lactams. Polysulfates might also depress the deleterious effects of the complement cascade and the use of combinations among anti-oxidants ( N-acetyl cysteine), proteinase inhibitors and phospholipids might prove effective to depress the synergistic cytotoxic effects induced by inflammatory agonists. Also, a use of gamma globulin enriched either in anti-LPS or in anti-LTA activities might serve to prevent the binding of these toxins to receptors upon macrophage which upon activation generate inflammatory cytokines. Thus, a use of "cocktails" of anti-inflammatory agents might replace the unsuccessful use of single antagonists proven in scores of clinical trials of sepsis to by ineffective in prolonging the lives of patients. It is enigmatic why the concept, and the publications which support a role for cationic peptides also as potent inducers of bacteriolysis, an arch evil and a deleterious phenomenon which undoubtedly plays a pivotal role in the pathophysiology of post-infectious sequelae, has been consistently disregarded.     

Lysis and killing of bacteria by lysosomal proteinases.

The bacteriolytic and bactericidal effects of the human proteinases cathepsin B, cathepsin D, cathepsin G, and elastase were investigated. Cathepsin G and elastase were 5 to 10% as active as egg white lysozyme in the lysis of Micrococcus lysodeikticus. All four enzymes slowly lysed the lysozyme-resistant Staphylococcus aureus. The gram-negative Acinetobacter 199A was rendered sensitive to lysozyme by all of the proteinases. Only elastase caused marked proteolysis of the outer membrane, which would permit access by lysozyme to the underlying peptidoglycan. When the surface layer of regularly arranged a protein was removed, however, the outer membrane proteins became susceptible to the other proteinases. Cathepsin G, elastase, and cathepsin D were bactericidal to Acinetobacter 199A. The bactericidal activity of cathepsin D was shown to be dependent on enzymatic activity, unlike that of cathepsin G, which was related to its cationic nature.     

High-performance liquid chromatographic analysis of bacterial fatty acid composition for chemotaxonomic characterization of oral streptococci.

A high-performance liquid chromatographic method was developed to analyze the fatty acid composition of bacterial lipids. After saponification of lipids extracted from bacteria, the liberated fatty acids were labeled with a fluorescence reagent, 4-bromomethyl-7-acetoxycoumarin, followed by reversed-phase high-performance liquid chromatographic separation and fluorescence detection. All bacterial fatty acids were simultaneously separated within 30 min and sensitively determined. This method was applied to the chemotaxonomic characterization of oral streptococci. The fatty acid composition of phospholipids and total lipids distinguished Streptococcus mutans from any other species examined and showed that Streptococcus sanguis had a close taxonomic relationship with Streptococcus salivarius.     

Bacterial evasion of innate host defenses--the Staphylococcus aureus lesson

Bacterial pathogens such as Staphylococcus aureus use highly efficient mechanisms to evade recognition and elimination by the innate immune system. S. aureus produces sophisticated anti-inflammatory molecules and it employs several mechanisms protecting the bacteria against host cationic antimicrobial molecules such as defensin-like peptides and bacteriolytic enzymes such as lysozyme. Cell wall teichoic acids and lipoteichoic acids, complex Gram-positive surface polymers, and modified membrane lipids such as lysylphosphatidylglycerol are crucial in defensin resistance and other important aspects of staphylococcal virulence such as nasal colonization and biofilm formation on biomaterials. Certain S. aureus genes conferring escape from innate host defenses are conserved in many human pathogens suggesting that the underlying mechanisms are of general significance in bacterial virulence.     

Attachment of staphylococci and streptococci on fibronectin, fibronectin fragments, and fibrinogen bound to a solid phase.

The attachment of Staphylococcus aureus (Cowan I) and two strains of group A and G streptococci on glass cover slips coated with fibronectin, fibronectin fragments, or fibrinogen was studied. The attachment was quantitated by counting the attached bacteria on glass surfaces coated with a similar molarity of the proteins. Fibronectin was a more effective attachment factor than fibrinogen for staphylococci, while group G streptococci attached better on fibrinogen- than on fibronectin-coated cover slips. In this system, group A streptococci bound almost exclusively to substrate-bound fibrinogen. Attachment experiments involving the use of staphylococci pretreated with soluble fibronectin or fibrinogen revealed that bacterium-bound fibronectin and fibrinogen were able to enhance the adherence on cover slips coated with fibronectin. The 30-kilodalton NH2-terminal and the 120- to 140-kilodalton COOH-terminal fragments of fibronectin, both of which contain bacterial binding sites, mediated the staphylococcal attachment, suggesting that both parts of the molecule are involved in the attachment mediated by fibronectin.     

Bacterial Interference IV. Epidemiological Determinants of the Antagonistic Activity of the Normal Throat Flora Against Group A Streptococci

A study was performed to identify epidemiological factors such as age, race, sex, and time of culture that might influence the ability of the normal pharyngeal flora to interfere with growth of group A streptococci. From March 1974 through February 1975, throat swabs were obtained from 952 individuals. Cultures were assayed by an agar overlay procedure for the presence of bacteria capable of inhibiting growth of group A streptococci. The observed inhibition was then determined to be bacteriostatic or bactericidal by use of a broth filtrate technique. Regardless of age, race, or sex, subjects were more likely to harbor interfering flora if cultured during the months of March and April, which coincided with the highest prevalence of group A streptococci in the community. Race and sex of subjects appeared not to influence the inhibitory activity of throat flora either quantitatively or qualitatively. However, among individuals with interfering flora, the prevalence of bactericidal organisms increased and bacteriostatic organisms decreased with advancing age. Since the presence of bactericidal, and not bacteriostatic, organisms has been associated with resistance to colonization of the throat by group A streptococci, this higher prevalence of bactericidal organisms in older individuals suggests that bacterial interference may be one of the mechanisms that account for the greater resistance of adults than children to streptococcal throat infection.     

Effect of leukocyte hydrolases on bacteria

A heat-stable factor present in extracts of human blood leukocytes is capable of lysing young Staphylococcus aureus at pH 5.0. Lysis is characterized by breakdown of cell-wall components as judged by electron microscopic and biochemical analysis. The leukocyte extracts can be replaced by a variety of agents known to injure cell membranes, e.g., leukocyte cationic protein histone, polymyxin B, colimycin, phospholipase A, and lysolecithin. The mechanisms by which all these agents bring about the degradation of the staphylococcal walls was studied. By using 14C-labeled cell walls devoid of cytoplasmic structures, it was demonstrated that none of the above-mentioned agents had a direct lytic effect on purified cell walls. On the other hand, when any of these agents first interacted with intact staphylococci, a factor (presumably an autolysin) was generated that directly lysed the cell walls. Lysis of cell walls in the presence of intact staphylococci used as a source of autolysin was strongly inhibited by a variety of anionic polyelectrolytes such as heparine and liquoid. The possible role played by bacterial autolysins in the generation of microbial cell-wall components capable of triggering chronic inflammation is discussed.     

Evidence for lipid-protein interactions in the attachment of antigens to a low-density membrane fraction isolated from Trypanosoma rhodesiense.

A putative Trypanosoma rhodesiense flagella pocket membrane fraction (FPM) was previously found to possess a range of antigenic components that were released after exposure to a detergent mixture containing 0.1% Zwittergent 3-12 and 0.4% Triton X-100. In the present investigation, and effort was made to determine the role of membrane lipid in binding FPM antigens, using phospholipases A2 and C as membrane probes. Exposure to the former was notable for the release of one antigen in particular that was only poorly extracted with the above detergents. Evidence was obtained suggesting that this release was not due to the detergent action of degradation products formed by the action of phospholipase A2 on membrane phospholipids. This phospholipase-released antigen, as were most other FPM antigens, was a glycoprotein, although the carbohydrate sequences do not appear to influence antigenicity. It was also possible to demonstrate the presence of a group of three cross-reacting FPM antigens that partitioned as hydrophobic membrane proteins by using Triton X-114 extraction. This was in contrast to the predominantly hydrophilic nature of most other FPM antigens.     

Phospholipids inhibit cytotoxic effects ofActinobacillus actinomycetemcomitans leukotoxin on human polymorphonuclear leukocytes

Isolated human peripheral blood neutrophils were exposed to sonic extracts ofActinobacillus actinomycetemcomitans. Such bacterial preparations contain a potent leukotoxin which rapidly kills the leukocytes as reflected by cellular uptake of trypan blue, extracellular release of lactate dehydrogenase, or discharge of⁵¹Cr from pre-labeled cells. Exogenous phospholipids with a glycerol skeleton esterified by fatty acids or positively charged liposomes inhibited cytotoxic phenomena. The data suggest that cell damage may involve the interaction of leukotoxin with phospholipids in the neutrophil cell membrane and that exogenous lipids either compete for or sterically block binding of the leukotoxin to these moieties in the membrane.     

Identification of streptococcal groups A,B,C, and G by slide co-agglutination of antibody-sensitized protein A-containing staphylococci.

A total of 98.7% of streptococci, groups A,B,C, and G, isolated from various sources was correctly identified by the co-agglutination technique. The active components in this technique are protein A-containing staphylococci coated with antibodies specific for group A,B,C, and G streptococci. A suspension of streptococci belonging to one of these four groups co-agglutinates with the antibody-sensitized staphylococci specific for this group. The technique is extremely rapid and simple and requires no special equipment. It should therefore be a valuable alternative to other techniques used in the grouping of streptococci and is shown here to be as reliable as the Lancefield technique.     

Inhibition of bactericidal and bacteriolytic activities of poly-D-lysine and lysozyme by chitotriose and ferric iron.

In a previous report from this laboratory (N. J. Laible and G. R. Germaine, Infect. Immun. 48:720-728, 1985), evidence was presented to suggest that the bactericidal actions of both reduced (i.e., muramidase-inactive) human placental lysozyme and the synthetic cationic homopolymer poly-D-lysine involved the activation of a bacterial endogenous activity that was inhibitable by N,N',N"-triacetylchitotriose (chitotriose). In the present investigation however, we found that the bactericidal and bacteriolytic action of poly-D-lysine could be prevented only by some commercially available chitotriose preparations and not by others. Analysis by physical and chemical methods failed to distinguish protective chitotriose (CTa) and nonprotective chitotriose (CTi) preparations. CTi and CTa preparations displayed equal capacities to competitively inhibit binding of [3H]chitotriose by immobilized lysozyme and were indistinguishable in their abilities to block the lytic activity of lysozyme against Micrococcus lysodeikticus cells. Elemental analysis revealed significantly higher levels of phosphorus, calcium, iron, sodium, manganese, and copper in CTa. Removal of metals from CTa by chelate chromatography completely abolished the poly-D-lysine-protective capacity. Of the metals detected, only ferric iron (5 to 10 microM) mimicked the protective action of CTa. A Fe(III) concentration of 50 microM was required to inhibit lysozyme (5 micrograms/ml). Both Fe(III) and CTa (but not CTi) quantitatively blocked the labeling of poly-D-lysine by fluorescamine, suggesting that the primary amino groups of the lysine residues participate in iron binding. Thus, it appears that the poly-D-lysine-protective capacity of certain chitotriose preparations was due not to the chitotriose itself but to contaminating metal ions which interact directly with the polycationic agent. In contrast, Fe(III) cannot account for inhibition of either the bactericidal or bacteriolytic activity of lysozyme by chitotriose.     

Properties of a Hemolysin Produced by Group B Streptococci

A hemolysin that appears to be responsible for the zones of beta-hemolysis surrounding colonies of group B streptococci (Streptococcus agalactiae) on blood agar plates has been isolated and partially purified. No soluble hemolysin was detectable in the supernatants of streptococcal cultures grown in several types of media. However, hemolytic activity was detected when streptococci were incubated with erythrocytes, and soluble hemolysin was isolated when bacterial suspensions were incubated in the presence of a variety of agents, including calf serum, albumin, Tween 80, and starch. Glucose and other fermentable carbohydrates stimulated hemolysin production, and metabolic inhibitors greatly reduced the titer of hemolysin that could be recovered, suggesting that cellular metabolism is necessary for hemolysin production or release. The soluble hemolysin was concentrated by ammonium sulfate precipitation and partially purified by gel filtration. Agents known to inhibit other streptococcal hemolysins, including phospholipids, trypan blue, proteases, and cholesterol, were tested for their effect on the group B hemolysin. Only the phospholipids inhibited hemolysin activity. The group B streptococcal hemolysin appears to be similar to, but distinct from, streptolysin S produced by Streptococcus pyogenes.     

Bactericidal activity and synergy studies of BAL9141, a novel pyrrolidinone-3-ylidenemethyl cephem, tested against streptococci, enterococci and methicillin-resistant staphylococci

BAL9141 has been reported to have inhibitory activity against methicillin-resistant Staphylococcus aureus (MRSA), many enterococci, and streptococci with various resistant patterns. BAL9141 potency was assessed by time–kill curves alone or with subinhibitory concentrations of gentamicin (MIC/4). BAL9141 exhibited bactericidal activity alone against all the streptococci and staphylococci. Among ampicillin-susceptible enterococci, BAL9141 was bactericidal against some strains, but no BAL9141 inhibition was observed of ampicillin-resistant Enterococcus faecium . The activity of BAL9141 with gentamicin was slightly enhanced (not synergy) or indifferent against staphylococci. BAL9141 demonstrated bactericidal action alone against Enterococcus faecalis and some E. faecium strains (− 4.8 to −6.0 log₁₀ CFU/mL), but static effects were also noted. Drug interactions with gentamicin showed early synergy (4–8 h) for all enterococci, and indifference or synergy at 24 h (no antagonism). BAL9141 (≤8 mg/L) showed promising bactericidal activity alone and synergy with gentamicin against some of the vancomycin-resistant enterococci tested.     

Is streptolysin S of group A streptococci a virulence factor?

The possible role played by streptolysin S (SLS) of group A streptococci in the pathophysiology of streptococcal infections and in post-streptococcal sequelae is discussed. The following properties of SLS justify its definition as a distinct virulence factor: 1) its presence on the streptococcus surface in a cell-bound form, 2) its continuous and prolonged synthesis by resting streptococci, 3) its non-immunogenicity, 4) its extractability by serum proteins (albumin, alpha lipoprotein), 5) its ability to become transferred directly to target cells while being protected from inhibitory agents in the milieu of inflammation, 6) its ability to bore holes in the membrane phospholipids in a large variety of mammalian cells, 7) its ability to synergize with oxidants, proteolytic enzymes, and with additional host-derived proinflammatory agonists, and 8) its absence in streptococcal mutants associated with a lower pathogenicity for animals. Because tissue damage in streptococcal and post-streptococcal sequelae might be the end result of a distinct synergism between streptococcal and host-derived proinflammatory agonists it is proposed that only cocktails of anti-inflammatory agents including distinct inhibitors of SLS (phospholipids), gamma globulin, inhibitors of reactive oxygen species, proteinases, cationic proteins cytokines etc., will be effective in inhibiting the multiple synergistic interactions which lead to fasciitis, myositis and the flesh-eating syndromes, and often develop into sepsis, septic shock and multiple organ failure. The creation of mutants deficient in SLS and in proteases will help shed light on the specific role played by SLS in the virulence of group A hemolytic streptococci.     

Helicobacter pylori associated phospholipase A2 activity: a factor in peptic ulcer production?

AIMS: To examine the potential role of the lipolytic enzyme phospholipase A2, produced by Helicobacter pylori in ulcer formation. METHODS: Phospholipase A2 activity in H pylori was compared with that in 10 commonly occurring pathogenic bacteria. Phospholipase A2 activity and its cytotoxic metabolite, lysolecithin, in the basal gastric aspirates of 12 patients infected with H pylori were compared with those in 12 subjects not infected with H pylori. RESULTS: The phospholipase A2 activity in H pylori was substantially higher than that in most of the other bacteria tested, and the activities of phospholipase A2 and lysolecithin in the basal gastric aspirates of those infected with H pylori were significantly higher than the activities found in the basal gastric aspirates of subjects who were not infected. The lysolecithin proportion of total phospholipids in the gastric aspirates was also much higher in the infected than the non-infected group and a weak positive correlation (0.415) was found between phospholipase A2 and lysolecithin in the infected group. CONCLUSIONS: H pylori has clinically important concentrations of phospholipase A2, an enzyme capable of hydrolysing gastric mucosal phospholipids. The high values of phospholipase A2 and lysolecithin in gastric fluid from subjects with H pylori infections supports the notion that phospholipase A2 is involved in the inflammation and mucosal damage associated with peptic ulcer formation.     

Routine separation of staphylococci from micrococci based on bacteriolytic activity production.

A new method is described by which separation of staphylococci from micrococci can be achieved in routine laboratory use. The basis of this method is that bacteriolytic activity is produced by staphylococci but not by micrococci.     

Heterogeneity of nonimmune immunoglobulin Fc reactivity among gram-positive cocci: description of three major types of receptors for human immunoglobulin G.

Two hundred and thirty strains of various gram-positive cocci were tested for quantitative, nonimmune binding of radiolabeled human polyclonal immunoglobulin G (IgG). The majority of coagulase-positive staphylococci and streptococci belonging to serogroups C and G showed a high uptake of IgG. The binding of immunoglobulin to group A streptococci was considerably less, with a number of strains completely negative. None of the pneumococcal or the group B or D streptococcal strains displayed any binding capacity. Heterogeneity of the IgG reactivity of various reactive strains was studied in an inhibition assay using 10 different animal serum pools. Three different inhibition patterns were seen, each of them revealing a striking degree of homogeneity within single bacterial species. Staphylococcus aureus and group A streptococci, respectively, constituted two homogeneous groups which differed markedly from each other and from C and G streptococci. No differences were observed between group C and G streptococci. Based on the profound differences between these homogeneous groups, three major types of Fc receptors could be defined. Type I and II Fc receptors were found on S. aureus and on group A streptococci, respectively. Fc receptor type III represented the immunoglobulin-binding structure of both group C and G streptococci.