Staphylococcal toxins: screening of burn wound isolates and evidence for alpha-haemolysin production in the burn wound

Alpha-toxin of Staphylococcus aureus

Alpha-toxin, the major cytotoxic agent elaborated by Staphylococcus aureus, was the first bacterial exotoxin to be identified as a pore former. The protein is secreted as a single-chain, water-soluble molecule of Mr 33,000. At low concentrations (less than 100 nM), the toxin binds to as yet unidentified, high-affinity acceptor sites that have been detected on a variety of cells including rabbit erythrocytes, human platelets, monocytes and endothelial cells. At high concentrations, the toxin additionally binds via nonspecific absorption to lipid bilayers; it can thus damage both cells lacking significant numbers of the acceptor and protein-free artificial lipid bilayers. Membrane damage occurs in both cases after membrane-bound toxin molecules collide via lateral diffusion to form ring-structured hexamers. The latter insert spontaneously into the lipid bilayer to form discrete transmembrane pores of effective diameter 1 to 2 nm. A hypothetical model is advanced in which the pore is lined by amphiphilic beta-sheets, one surface of which interacts with lipids whereas the other repels apolar membrane constitutents to force open an aqueous passage. The detrimental effects of alpha-toxin are due not only to the death of susceptible targets, but also to the presence of secondary cellular reactions that can be triggered via Ca2+ influx through the pores. Well-studied phenomena include the stimulation of arachidonic acid metabolism, triggering of granule exocytosis, and contractile dysfunction. Such processes cause profound long-range disturbances such as development of pulmonary edema and promotion of blood coagulation.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of bacterial products on human fibroblast and keratinocyte detachment and viability

An in vitro model has been developed to study the effect of soluble bacterial products on the viability and detachment of skin cell types utilized cultured grafts. Microbial products prepared from clinical isolates of bacterial species which most commonly colonize burn lesions showed marked variation in their ability to detach and kill both keratinocytes and fibroblasts. All three isolates of Acinetobacter spp. tested were effective in causing detachment and death of keratinocytes and fibroblasts, whereas Escherichia coli, Proteus mirabilis and Enterobacter spp. tested had little, or no, effect on detachment or viability for either skin cell type. Four Staphylococcus aureus isolates elicited variable strain-dependent results with regard to detachment and viability. One isolate possessed activity specific for keratinocyte detachment and death. These results indicate the possible undesirable effects such bacterial species may have on graft success in colonized burn wounds.