Phosphatase reaction of coagulase-negative staphylococci and micrococci

Fluorogenic and chromogenic substrates used in bacterial diagnostics

Methods based on the application of chromogenic and fluorogenic substrates enable specific and rapid detection of a variety of bacterial enzymatic activities. By using these techniques, enzymatic reactions can be examined simultaneously or individually, either directly on the isolation plate or in cell suspensions. For this purpose, various testing principles and test kits for clinical and food microbiology have been introduced successfully during the last few years. In this paper we present a survey of different enzymes of microbial origin that are utilized for microbiological identification and differentiation and the corresponding methods. Particular emphasis is given to the examination of Escherichia coli and the description of the different techniques as used in routine analysis.

Phosphatase activity of staphylococci is constitutive in some species and repressed by phosphates in others

The phosphatase activities of colonies of staphylococcal strains belonging to the 10 species most frequently isolated from specimens of human origin were evaluated on media with undetermined inorganic phosphate contents and on media supplemented with known amounts of phosphates. All strains of all species tested were phosphatase positive on plates that were not supplemented with inorganic phosphates when the pH of the medium was high. In media supplemented with 0.3% phosphates at low and high pH, all strains of Staphylococcus aureus, almost all strains of S. epidermidis and S. xylosus, and none of the other species tested were phosphatase positive. Thirty S. simulans strains were grown in broths at pH 7 with and without phosphates, and the phosphatase activities of the cells were assayed at pH 5.5 and 8 in the absence of phosphates. At pH 8, all strains gave a strong positive reaction when grown in the absence of phosphates and a negative reaction when grown in the presence of these salts at 0.3%. It was concluded that all the species of staphylococci tested possess phosphatase activity and that the staphylococcal phosphatases are constitutive in some species and repressed in others.

Isolation and identification of coagulase-negative Staphylococcus species from bovine body sites and streak canals of nulliparous heifers

Heifers (n = 103) ranging in age from 1d to 2 yr were sampled to determine the coagulase-negative staphylococcal flora of haircoat, nares, vagina, teat skin, and streak canal. A total of 2706 staphylococal strains were identified from 3612 bacterial isolates. Other genera or groups identified included Bacillus, Micrococcus, Corynebacterium, and coliforms. Staphylococci were identified utilizing a simplified biochemical scheme. Staphylococcus xylosus, S. chromogenes, and S. warneri were the predominant species recovered from anatomic sites and streak canal. Staphylococcal strains identified from specific body sites (expressed as percentage of heifers harboring these species) were: nares 74% S. xylosus and 48% S. warneri; haircoat, 70% S. xylosus and 57% S. chromogenes; vagina, 60% S. chromogenes and 54% S. xylosus; teat skin 62% S. chromogenes and 61% S. warneri; streak canal 53% S. chromogenes, and 43% S. warneri. The prevalent staphylococcal strains identified differed from heifers in confined housing compared with heifers on pasture. Differences observed in distribution of Staphylococcus species among body sites, particularly those between teat skin and streak canal, suggest that establishment of staphylococcal microflora depends on the ability of a species to adapt to and colonize anatomic sites as well as on environmental conditions present.

Species distribution of coagulase-negative staphylococci isolated from clinical sources

The distribution of coagulase-negative staphylococcal species from clinical material was investigated in order to detect possible tropisms. 398 strains of staphylococci (336 coagulase-negative and 62 coagulase-positive strains) and 3 micrococcus strains were isolated. Differentiation between the two genera was achieved by testing sensitivity to lysostaphin and anaerobic growth in thioglycolate. Four S. hominis strains reacted like micrococci in these tests. Staphylococci were classified according to the Kloos and Schleifer biotyping scheme in a modified way on microtitre plates. Additionally coagulation and reduction of methylene blue milk were determined and the test proved to be useful. Identified coagulase-negative species included S. epidermidis (205 strains), S. hominis (64), S. haemolyticus (35), S. warneri (15), S. capitis (5), S. simulans (6), S. saprophyticus (5), and S. species (1). A high predominance of S. epidermidis was found among isolates from nasopharyngeal (91%) and tracheobronchial (80%) tracts and most other localizations. A different distribution of species was observed in urine and vaginal swabs where non-S. epidermidis species accounted for over 50% of identified strains. The majority of S. hominis and S. haemolyticus strains was isolated from these sources. S. simulans, like S. saprophyticus was found in urine specimens only and occurred predominantly in women of the sexually active age.

Characterization of staphylococci

A total of 158 Staphylococcus strains from various sources were characterized by biochemical, physiological, and morphological tests. Numerical taxonomy was applied by using these features. Taxonomic analysis was done with programs run under the MVS-TSO system of the IBM 370 complex and PDP-10 system of the National Institutes of Health. DNA-DNA hybridization with nitrocellulose filters was done to compare selected atypical cultures with American Type Culture Collection reference strains. We found that the use of the nomenclature of Bergey's Manual (8th edition) to identify these strains by species was not adequate. DNA homology values supported the formation of Staphylococcus hyicus subsp. hyicus separate from Staphylococcus aureus, Staphylococcus epidermidis, and Staphylococcus saprophyticus. The three tests that best separated these strains into four species were (i) tube coagulase (6-h or 24-h porcine plasma or 24-h Difco rabbit plasma), (ii) production of acetoin or acid aerobically from ribose, maltose, or trehalose, and (iii) growth in the presence of novobiocin. Four strains of S. hyicus subsp. hyicus (VII76, VII113, VII131, and VA519) gave typical enterotoxigenic responses in monkey-feeding tests but were negative for enterotoxins A through E, suggesting the presence of one or more new enterotoxins. Two coagulase-negative, heat-stable DNase-positive strains (D143 and ARM) could not be classified by either DNA-DNA hybridization or numerical taxonomy, and D143 was enterotoxigenic as measured by the monkey-feeding bioassay. DNA homology showed that strain FRI-698M was more closely related to S. epidermidis than to S. aureus, yet it produced enterotoxin D. These data suggest the occurrence of coagulase-negative enterotoxigenic strains that are not S. aureus; nonetheless, a positive tube coagulase test and heat-stable DNase test should together be useful for routine screening of most potentially enterotoxigenic staphylococci in foods.

Characterization of clinically significant strains of coagulase-negative staphylococci

On occasion, a patient may have two or more clinical cultures yielding a coagulase-negative staphylococcus If these multiple isolates have the same phenotype, one might conclude that the same strain was reisolated from the patient, indicating its persistent and pathological presence. We examined the validity of this conclusion when we applied a number of characterizing systems to a collection of 143 isolates of coagulase-negative staphylococci collected during an outbreak of intravascular catheter-associated sepsis. The probability of classifying two random isolates as the same phenotype or species was as follows: P = 0.356 for phage typing, P = 0.348 for Baird-Parker biotyping, P = 0.346 for the API STAPH-IDENT (Analytab Products) system, P = 0.327 for Bentley et al. biotyping, and P = 0.077 for antimicrobial susceptibility patterns. Although antimicrobial susceptibility patterns had the lowest probability, a variability in test results of 7.7% and a tendency for strains to have similar antibiograms effectively raised the probability to P = 0.897. The combination of the API STAPH-IDENT with antibiograms resulted in a probability of P = 0.037 to P = 0.147. When all of the above methods were used together a probability of P = 0.014 was achieved. Five patients had isolates from two or more blood cultures spaced more than 1 day apart that were identical by all of the above criteria, thus confirming prolonged bacteremia. The collection was also examined for the incidence of slime production. Slime production was not associated with any of the above groups, but was associated with symptomatic infections (P less than 0.05) and gentamicin resistance (P less than 0.01). Slime production was strain stable and was of assistance in typing strains of coagulase-negative staphylococci.

Identification of coagulase-negative staphylococci with the API STAPH-IDENT system

A group of 300 clinically derived isolates of coagulase-negative staphylococci were tested in parallel with the API STAPH-IDENT system (Analytab Products) and 14 conventional biochemical tests contained in Kloos and Schleifer's simplified scheme for identification of human Staphylococcus species. STAPH-IDENT is a miniaturized biochemical test strip that incorporates four synthetic chromogenic substrates, urea, arginine, and four carbohydrates and that requires only a 5-h test period. Use of the STAPH-IDENT system alone allowed correct or partly correct classification of 67% (201 of 300) of the study isolates. However, if a supplemental test was performed (most often novobiocin susceptibility), correct classification of an additional 25.7% (77) was possible, for a total of 92.7% of isolates identified to the species level. Species correctly identified included 94% (116 of 123) of Staphylococcus epidermidis isolates, 98% (63 of 64) of S. saprophyticus, 71% (34 of 48) of S. hominis, 100% (22) of S. simulans, 100% (18) of S. haemolyticus, 100% (17) of S. warneri, and 100% (8) of S. capitis. Fourteen percent (42 of 300) of profile codes encountered in this study were not included in the STAPH-IDENT profile register, but were included in Analytab Products' expanded computer data base.

Toxigenic strains of Staphylococcus epidermidis and their experimental corneal pathogenicity in rabbits

Thirty strains of Staphylococcus epidermidis, ten each from normal conjunctival sacs, corneal ulcer cases and from those who developed postoperative endophthalmitis, were examined for their dermonecrotic and haemolytic activities. Dermonecrosis was studied on rabbit skin whereas haemolysis was determined against sheep, guinea pig, rabbit and human erythrocytes. None of the cell free filtrates from strains derived from normal sacs showed any evidence of toxin production. Four strains from corneal ulcer cases and five from postoperative infections produced + to + + + dermonecrosis whereas haemolytic activity was exhibited by one strain in the former and by two in the latter. Only those strains that were highly dermonecrotoxic were haemolytic. Experimental corneal lesions in the rabbit were mild by strains from normal sacs. Those showing highest dermonecrotoxic reaction, irrespective of their source, produced identical and most severe corneal pathology when compared to those producing minimal necrosis.

Evaluation of a micromethod gallery (API Staph) for the identification of staphylococci and micrococci

A collection of 300 well-characterised strains of staphylococci and micrococci was examined by a commercially available gallery micromethod (API Staph). The results were compared with biotyping by conventional methods. The gallery micromethod broadly agreed with the biotyping scheme used but gave an identification from the index supplied in less than 30% of the trials. Reproducibility was better after 48 h incubation than after 24 h but was poor for the tests for phosphatase and acetoin. When compared with the results of conventional tests, the tests for acetoin, phosphatase and urea were unsatisfactory.

Role of coagulase-negative staphylococci and micrococci in ocular disease

Forty-nine strains of coagulase-negative staphylococci and 26 strains of micrococci isolated from human eyes were classified by the Baird-Parker system of 1966. The staphylococci belonged to subgroups II, III, IV, and V with one strain each in subgroups III and IV. However, when biotyped by Baird-Parker's system of 1974, less than 50% (23/49) of strains were typable and they belonged to biotypes 1 and 2. With our proposed modified classification all strains could be classified into biotypes 1, 2, and 3. All the 26 strains of micrococci belonged to subgroup VII. Staphylococci isolated from diverse sources produced, qualitatively and quantitatively, different corneal pathology in rabbits when compared to those isolated from healthy conjunctiva. This bore no relation to the present system of subtyping based on biochemical reactions. Micrococci were incapable of producing experimental corneal lesions in the rabbit.

Classification and characteristics of coagulase-negative, methicillin-resistant staphylococci

Sixty-five clinical isolates of coagulase-negative, methicillin-resistant staphylococci have been classified as Staphylococcus epidermidis (63.0%), "phosphatase-negative S. epidermidis" (12.3%), coagulase-negative Staphylococcus aureus (6.2%), Staphylococcus hemolyticus (6.2%), Staphylococcus hominis (3.1%), and Staphylococcus warneri (1.5%). Five of the organisms (7.7%) could not be classified with certainty as currently recognized species. Novobiocin resistance was encountered in eight of the strains, but these were not classified as the accepted novobiocin-resistant staphylococcal species. Some differences in antibiotic resistance patterns to those typical of methicillin-resistant S. aureus were noted in that, although 29 strains were resistant to methicillin, penicillin, sulfamethizole, streptomycin, and tetracycline, the remainder of the strains were sensitive to streptomycin or tetracycline or both. In a majority of the strains (42 of 65), methicillin susceptibility testing by the disk method at 30 or at 37 degrees C in the presence of NaCl did not appear to enhance resistance expression. Most of the strains produced beta-lactamase (EC 3.5.2.6), but none of the 21 strains tested produced enterotoxin B.

Classification of coagulase-negative staphylococci in the diagnostic laboratory

One hundred and ninety-eight coagulase-negative staphylococci isolated from urines, blood cultures, and pus samples were classified by means of two identification schemes, and their wall teichoic acids were determined serologically. S. epidermidis, S. saprophyticus, and S. cohnii were identified reliably by the use of five criteria: acid aerobically from sucrose, trehalose, and mannitol, phosphatase production, and sensitivity to novobiocin. Further species, notably S. haemolyticus and S. hominis, could be identified when haemolysis on blood agar plates was included in the criteria group. The investigation shows, that a considerable number of coagulase-negative staphylococci isolated from human specimens belong to species other than S. epidermidis and S. saprophyticus. These staphylococci can cause human infections and should be identified in the diagnostic laboratory. S. epidermidis and S. saprophyticus were found to contain the teichoic acids previously identified in these species. S. cohnii contained the same teichoic acids as S. saprophyticus. No characteristic teichoic acid was demonstrated in the other species, but several strains contained poly C (beta-N-acetylglucosaminylglycerol teichoic acid).

The identification of staphylococci in clinical and food microbiology laboratories

A comprehensive review of the methods which have been utilized for the identification of staphylococci is presented. Biochemical characteristics which have assisted in the primary isolation of staphylococci, such as pigmentation, hemolytic activity, the egg yolk phenomenon, and deoxyribonuclease and coagulase production, are also analyzed. The potential applicability of advanced techniques to identify staphylococci, such as the detection of enterotoxin production, base ratio analysis, cell wall analysis, phage typing, and serology, is discussed. The following procedures are recommended for routine use: Idnetification of Staphylococcus sp. (clinical laboratories): microscopic observation, catalase activity, coagulase production, lysostaphin sensitivity, and (optional) facultative growth in thioglycolate medium. Identification of Staphylococcus aureus (food laboratories): microscopic observation, catalase activity, coagulase production, thermonuclease production, and (optional) lysostaphin sensitivity.

Some properties of coagulase-negative deoxyribonuclease-producing strains of staphylococci from human infections

Twenty-seven coagulase-negative and deoxyribonuclease-positive staphylococci were isolated from more than 3000 specimens from human infections. The strains were tested by conventional biochemical tests and by simple agar plate assays for production of different extracellular enzymes and toxins. Three strains were lysed by S. epidermidis phages and 7 strains by S. aureus phages. All strains produced thermolabile nuclease but only 21 strains produced thermostable nuclease. The investigated strains belonged to a heterogeneous intermediate group sharing characters of S. aureus and S. epidermidis. Tests for production of coagulase and thermostable nuclease should be used in the classification of these intermediate strains in diagnostic bacteriology.

Coagulase-negative staphylococci and micrococci in urinary tract infections

One hundred catalase-positive, coagulase-negative, Gram-positive cocci isolated in significant numbers from the urine of patients with urinary tract infections, provisionally subdivided by their sensitivity to nonoviocin, were classified according to a slightly model version of Baird-Parker's schemes (1965 and 1972). It appeared that strains of Micrococcus were nearly all of sub-group 3, and that these were important pathogens of young women presenting with urinary infections in general practice. All such strains were resistant to novobiocin. Strains of staphylococcus were heterogeneous, and were found principally in infections arising in hospital, among older prople. Most staphylococci were sensitive to novobiocin. It is suggested that it is easy and sufficiently accurate to separate staphylococci and micrococci isolated from cases of urinary tract infection on the basis of their sensitivity or resistance to novo-biocin. The distinction is useful because of its therapeutic and epidemiological significance.

Coagulase-negative staphylococci causing endocarditis after cardiac surgery

The laboratory findings in seven cases of endocarditis caused by coagulase-negative staphylococci are presented. The usefulness of biochemical characterization of the strains in diagnosis and the selection of antibiotics for prophylaxis and treatment are discussed.