Toxic shock syndrome and lysogeny in Staphylococcus aureus

Plasmon-Mediated Peroxidase-like Activity on an Asymmetric Nanotube Architecture for Rapid Visual Detection of Bacteria

Rapid and sensitive detection of bacteria from a complex real media remains a challenge. Herein, we report a visual bacterial sensing assay with excellent specificity, anti-interference ability, and sensitivity based on a surface plasmon resonance (SPR)-enhanced peroxidase (POD) mimetic. The POD mimetic based on Pt nanoparticles (NPs) asymmetrically decorated on Au/TiO₂ magnetic nanotubes (Au/Pt/MTNTs) is designed by combining the intrinsic photocatalytic activity of TiO₂ and the limited transport depth of light. It is revealed that the localized surface plasmon resonance (LSPR) effect of the asymmetric nanotubes is more effective in facilitating the generation of hot electrons, which are subsequently transferred to Pt and MTNTs, thus greatly promoting the catalytic performance. Using Staphylococcus aureus (S. aureus) as a model of Gram-positive bacteria, the dependence of the colorimetric reaction on the active sites of the POD mimetic is used for the sensing of target bacteria. Owing to the specific recognition between S. aureus and peptide, the fluorescein isothiocyanate (FITC) labeled peptide probes are captured by S. aureus and removed from the Au/Pt/MTNTs, leading to the recovery of POD-like activity and fluorescence emission of S. aureus. Particularly, benefiting from the Au-SPR effect and the magnetic feature of the Au/Pt/MTNTs, the recovery of catalytic activity induced an improved colorimetric assay with a wider linear response for S. aureus qualification and a detection limit of four cells, as well as satisfactory selectivity and feasibility for application in real samples. The plasmon-enhanced POD activity would provide a simple-yet-effective approach to achieve a colorimetric bioassay with high efficiency and sensitivity. This asymmetric design can also be utilized to engineer nanozymes in colorimetric assays for the specific detection of biotoxins, biomarkers, and cancer cells.

The Phage-Inducible Chromosomal Islands: A Family of Highly Evolved Molecular Parasites

The phage-inducible chromosomal islands (PICIs) are a family of highly mobile genetic elements that contribute substantively to horizontal gene transfer, host adaptation, and virulence. Initially identified in Staphylococcus aureus, these elements are now thought to occur widely in gram-positive bacteria. They are molecular parasites that exploit certain temperate phages as helpers, using a variety of elegant strategies to manipulate the phage life cycle and promote their own spread, both intra- and intergenerically. At the same time, these PICI-encoded mechanisms severely interfere with helper phage reproduction, thereby enhancing survival of the bacterial population. In this review we discuss the genetics and the life cycle of these elements, with special emphasis on how they interact and interfere with the helper phage machinery for their own benefit. We also analyze the role that these elements play in driving bacterial and viral evolution.

Streptococcus suis infection: an emerging/reemerging challenge of bacterial infectious diseases?

Streptococcus suis (S. suis) is a family of pathogenic gram-positive bacterial strains that represents a primary health problem in the swine industry worldwide. S. suis is also an emerging zoonotic pathogen that causes severe human infections clinically featuring with varied diseases/syndromes (such as meningitis, septicemia, and arthritis). Over the past few decades, continued efforts have made significant progress toward better understanding this zoonotic infectious entity, contributing in part to the elucidation of the molecular mechanism underlying its high pathogenicity. This review is aimed at presenting an updated overview of this pathogen from the perspective of molecular epidemiology, clinical diagnosis and typing, virulence mechanism, and protective antigens contributing to its zoonosis.

Uncovering newly emerging variants of Streptococcus suis, an important zoonotic agent

Streptococcus suis is recognized as a major swine pathogen and an emerging zoonotic agent. Two large-scale outbreaks of severe S. suis epidemics occurred in China in 1998 and 2005 that posed serious concerns to public health and challenged the conventional conception that opportunistic infections of S. suis serotype 2 (SS2) in humans were only sporadic cases. An extensive, collaborative study on Chinese SS2 variants, which exhibit strong invasiveness and high pathogenicity, has resulted in the description of a new disease form of streptococcal toxic shock syndrome (STSS) and a putative pathogenicity island (termed 89K). The abbreviation of STSS is used for the severe disease caused by both Staphylococci and Streptococci. The main virulence factors involved in STSS caused by either Staphylococcus aureus or Streptococcus pyogenes consist of so-called superantigens or molecules that trigger a nonspecific, uncontrolled activation of T cells and massive cytokine release. However, although a collection of new virulence factors have been described, no superantigen candidates have been found for SS2 strains, implying that a different mechanism could be involved in the STSS form caused by SS2 variants.

Solid phase synthesis and evaluation of Tyr-Tic-Phe-Phe(p-NHCOCH(2)Br) ([Phe(p-bromoacetamide)(4)]TIPP), a potent affinity label for delta opioid receptors

Derivatives of the delta opioid receptor selective peptide Tyr-Tic-Phe-Phe-OH (TIPP) containing a p-bromoacetamide moiety on the phenyl ring of Phe(3) or Phe(4) were prepared by solid phase synthesis. [Phe(p-NHCOCH(2)Br)(4)]TIPP exhibited high affinity for cloned delta receptors (IC(50) = 5.4 nM), and incubation with only 2.5 nM resulted in 85% wash resistant inhibition of radioligand binding to delta receptors. Therefore, this peptide is a potent affinity label for further study of delta opioid receptors.

Synthesis and evaluation of isothiocyanate-containing derivatives of the delta-opioid receptor antagonist Tyr-Tic-Phe-Phe (TIPP) as potential affinity labels for delta-opioid receptors

Derivatives of the delta-opioid receptor-selective peptide antagonist H-Tyr-Tic-Phe-Phe-OH (TIPP) containing an isothiocyanate moiety at the para position of either Phe(3) or Phe(4) were prepared as potential affinity labels for delta-opioid receptors. The synthesis was accomplished using a general solution-phase synthetic procedure which allows for introduction of affinity labeling groups late in the synthesis of a variety of small peptide substrates. The target peptides and their corresponding amines were then evaluated in radioligand binding experiments using Chinese hamster ovary (CHO) cells expressing delta- and mu-opioid receptors. The peptides [Phe(p-NCS)(3)]TIPP (2) and [Phe(p-NCS)(4)]TIPP (4) showed affinity for delta-receptors comparable to the parent compound TIPP (IC(50) = 12 and 5 nM, respectively, vs 6 nM for TIPP). Both peptides 2 and 4 were able to inhibit radioligand binding to delta-receptors in a wash-resistant manner at a concentration of 10 nM. Therefore, the peptides [Phe(p-NCS)(3)]TIPP (2) and [Phe(p-NCS)(4)]TIPP (4) represent two affinity labels that may prove useful in the study of delta-opioid receptors.

Synthesis and evaluation of N,N-dialkyl enkephalin-based affinity labels for delta opioid receptors

To develop affinity labels for delta opioid receptors based on peptide antagonists, the Phe(4) residues of N,N-dibenzylleucine enkephalin and N,N-diallyl[Aib(2),Aib(3)]leucine enkephalin (ICI-174, 864) were substituted with either Phe(p-NCS) or Phe(p-NHCOCH(2)Br). A general synthetic method was developed for the conversion of small peptide substrates into potential affinity labels. The target peptides were synthesized using Phe(p-NH(2)) and a Boc/Fmoc orthogonal protection strategy which allowed for late functional group conversion of a p-amine group in the peptides to the desired affinity labeling moieties. A key step in the synthesis was the selective deprotection of a Boc group in the presence of a tert-butyl ester using trimethylsilyl trifluoromethanesulfonate (TMS-OTf). The target peptides were evaluated in radioligand binding experiments in Chinese hamster ovary (CHO) cells expressing delta or mu opioid receptors. The delta receptor affinities of the N, N-dibenzylleucine enkephalin analogues were 2.5-10-fold higher than those for the corresponding ICI-174,864 analogues. In general, substitution at the para position of Phe(4) decreased binding affinity at both delta and mu receptors in standard radioligand binding assays; the one exception was N, N-dibenzyl[Phe(p-NCS)(4)]leucine enkephalin (2) which exhibited a 2-fold increase in affinity for delta receptors (IC(50) = 34.9 nM) compared to N,N-dibenzylleucine enkephalin (IC(50) = 78.2 nM). The decreases in mu receptor affinities were greater than in delta receptor affinities so that all of the analogues tested exhibited significantly greater delta receptor selectivity than the unsubstituted parent peptides. Of the target peptides tested, only N, N-dibenzyl[Phe(p-NCS)(4)]leucine enkephalin (2) exhibited wash-resistant inhibition of radioligand binding to delta receptors. To our knowledge, 2 represents the first peptide-based affinity label to utilize an isothiocyanate group as the electrophilic affinity labeling moiety. As a result of this study, enkephalin analogue 2 emerges as a potential affinity label useful for the further study of delta opioid receptors.

Selection and evolution of virulence in bacteria: an ecumenical excursion and modest suggestion

Why do parasites kill their hosts? During this past decade, research in three different areas; evolutionary ecology, medical microbiology, and population genetics has provided theory and data that address this and related questions of selection and the evolution and maintenance of parasite virulence. A general theory of parasite-host coevolution and the conditions for selection to favour parasite virulence has been put forth. Considerable advances have been made in elucidating the mechanisms of pathogenicity and inheritance of virulence in bacteria. The population genetic structure and the relationship between pathogenic and non-pathogenic forms has been determined for a number of species of bacteria. We critically review these developments and their implications for questions of selection and the evolution and maintenance of virulence in bacteria. We postulate how selection may operate on specific types of bacterial virulence and present a general protocol to experimentally test hypotheses concerning selection and the evolution of virulence in bacteria.

A single clone of Staphylococcus aureus causes the majority of cases of toxic shock syndrome

Genetic relationships among 315 isolates of the bacterium Staphylococcus aureus expressing toxic shock syndrome toxin-1 (TSST-1) recovered primarily from humans with toxic shock syndrome (TSS) in five countries on two continents were determined by analyzing electrophoretically demonstrable allelic variation at 20 chromosomal enzyme loci. Forty-nine distinctive electrophoretic types (ETs), representing multilocus enzyme genotypes, were identified. Cluster analysis of the ETs revealed two major phylogenetic divisions separated at a genetic distance of 0.35 and seven branches diverging from one another at distances greater than or equal to 0.20. A single clone (ET 41) accounted for 88% of cases of TSS with a female urogenital focus and 53% of TSS cases involving nonurogenital (predominantly wound) infections. With few exceptions, strains representing different phylogenetic lines had characteristic TSST-1 gene (tst) restriction fragment length polymorphism patterns obtained by digestion of genomic DNA with Cla I. Strains recovered from ovine and bovine hosts with mastitis were genotypically distinct from the major human TSS clone. The expression of TSST-1 in cell lineages representing the total breadth of multilocus genotypic diversity in the species S. aureus as a whole is interpreted as evidence that the TSST-1 gene is evolutionarily old. The recovery of a single clone from the majority of individuals afflicted with TSS having a urogenital focus and from the genital tract of a large proportion of asymptomatic female carriers strongly suggests that this clone is especially well adapted for colonization of these anatomic sites.

Staphylococcal and streptococcal pyrogenic toxins involved in toxic shock syndrome and related illnesses

Toxic-shock syndrome (TSS) is an acute onset, multiorgan illness which resembles severe scarlet fever. The illness is caused by Staphylococcus aureus strains that express TSS toxin-1 (TSST-1), enterotoxin B, or enterotoxin C. TSST-1 is associated with menstrual TSS and approximately one-half of nonmenstrual cases; the other two toxins cause nonmenstrual cases, 47% and 3%, respectively. The three toxins are expressed in culture media under similar environmental conditions. These conditions may explain the association of certain tampons with menstrual TSS. Biochemically, the toxins are all relatively low molecular weight and fairly heat and protease stable. Enterotoxins B and C, share nearly 50% sequence homology with streptococcal scarlet fever toxin A; they share no homology with TSST-1 despite sharing numerous biological properties. Numerous animal models for development of TSS have suggested mechanisms of toxin action, though the exact molecular action is not known. The toxins are all potent pyrogens, induce T lymphocyte proliferation, requiring interleukin 1 release from macrophages, suppress immunoglobulin production, enhance endotoxin shock, and enhance hypersensitivity skin reactions. The genetic control of the toxins has been studied and suggests the exotoxins are variable traits. Some additional properties of TSS S. aureus which facilitate disease causation have been clarified.

Toxic shock syndrome

In the past 10 years, we have learned much about TSS and S. aureus and its toxins. A number of important biologic principles have been reemphasized in this first decade of TSS research: S. aureus is a very complex organism, one not likely to yield quick answers; in vitro observations must always be confirmed in the patient; animal models may not always be reliable replicates of human disease; and epidemiologic associations cannot be equated with causation. Toxic shock is an intricate phenomenon with many interesting scientific facets. Unraveling its mysteries will undoubtedly teach us more about the complex interaction of patients and microorganisms.

Staphylococcal enterotoxin A is encoded by phage

The gene for staphylococcal enterotoxin A (entA), in two wild-type strains, is carried by related temperate bacteriophages. Hybridization analysis of DNA from entA-converting phage PS42-D and its bacterial host suggests that this phage integrates into the bacterial chromosome by circularization and reciprocal crossover (the Campbell model) and that the entA gene is located near the phage attachment site. DNA from three of eight staphylococcal strains that did not produce enterotoxin A and seven wild-type enterotoxin A-producing (EntA+) strains had extensive homology to the entA-converting phage PS42-D DNA, although there was a high degree of restriction-fragment length polymorphisms. At least one EntA+ strain did not produce detectable viable phage after induction. These data indicate that a polymorphic family of Staphylococcus aureus phages (some of which may be defective) can carry the entA gene.

Acquired ability of Staphylococcus aureus to produce toxic shock-associated protein and resulting illness in a rabbit model

Staphylococcus aureus from patients with toxic shock syndrome (TSS) produce TSS toxin 1. We transferred, by a bacteriophage, the ability to produce TSS toxin 1 from a TSS toxin 1-positive to a TSS toxin 1-negative strain of S. aureus. This recombinant strain produced TSS toxin 1 as confirmed by isoelectric focusing, immunodiffusion, radioimmunoassay, and autoradiography. The recombinant produced TSS-like illness in rabbits, and was significantly (P less than 0.001) more lethal than the recipient strain. Both strains produced fever and diarrhea, but, in addition, rabbits challenged with the recombinant also developed lowered blood pressure (P = 0.002), conjunctival hyperemia, erythroderma, and respiratory distress. Histopathological findings in rabbits challenged with the recombinant strain were remarkably similar to those described for humans with TSS, e.g., erythrophagocytosis, liver "triaditis," and vasodilatation. This study demonstrates that this protein may contribute to the pathogenesis of the TSS.

In vitro amplification of toxic shock syndrome toxin-1 by intravaginal devices

Super-absorbent tampons and an exotoxin of Staphylococcus aureus have been associated with the recent emergence of toxic shock syndrome (TSS). In the majority of cases, when a TSS strain of S. aureus was cultivated in the presence of various tampons and a contraceptive sponge, increased amounts of toxic shock syndrome toxin-1 (TSST-1) were observed to be produced into the blood medium by the bacterium. The amplification of toxin by these products adds support to the epidemiologic data in establishing the causal link between tampons and TSS.

Animal studies of toxic shock syndrome

Toxic shock syndrome (TSS) was first described in 1978 and since that year over 2990 cases have been reported to the Communicable Disease Center. The estimated case-fatality rate is 5.6%. The disease is characterized by fever, hypotension, rash, desquamation, and involvement of at least three other organ systems. Approximately 85% of the cases are menstrually related and tampon use has been identified as a risk factor. The remaining 15% of the cases occur in both sexes and are not specifically related to age or geographic location. In all cases where sought there is evidence for infection by Staphylococcus aureus. Nearly all S. aureus isolates are phage type 52/29 and elaborate a unique exotoxin (toxic shock toxin). This review explores both the successful and unsuccessful attempts to induce toxic shock or a TSS-like syndrome in animals other than man. The review identifies the baboon as an animal model of TSS and discusses the clinical and pathologic sequellae, in this species, after exposure to purified toxic shock toxin.

Phenotypic distinctiveness of Staphylococcus aureus strains associated with toxic shock syndrome

Twenty Staphylococcus aureus strains from patients with toxic shock syndrome (TSS) and 20 from control patients (non-TSS) with infection but no clinical evidence of TSS were compared phenotypically in a collaborative, blinded, randomized study. TSS strains were significantly (P less than 0.05) more likely than non-TSS strains to produce various previously described but related toxic shock-associated proteins (pyrogenic exotoxin C, enterotoxin F, and TSS marker protein), as well as differing in other distinctive phenotypic characteristics, such as hemolysis, bacteriocin susceptibility, arsenate resistance, pigment production, and casein proteolysis. TSS strains were significantly less likely to carry plasmids than control strains. A combination of two variables--proteolysis and toxic shock-associated protein production--statistically accounted for all other phenotypic variations between TSS and non-TSS strains. Only proteolysis covaried with all other significant variables, suggesting a primary role in the phenotypic distinctiveness of TSS S. aureus strains and possibly in the pathogenesis of TSS.

The toxic shock syndrome exotoxin structural gene is not detectably transmitted by a prophage

Toxic shock syndrome (TSS) is a complex of generalized symptoms caused by a local staphylococcal infection, and a circulating toxin is thought to be involved. Indeed, nearly 100% of TSS isolates produce an exoprotein, TSSE, that is thought to have an aetiological role on the basis of positive animal tests (refs 1,2 and F. Quimby, personal communication) and human serological data. Although the precise role of TSSE in TSS remains unclear (E. Kass, personal communication), no other staphylococcal factor has been implicated. Our preliminary studies of the genetics of TSSE production failed to demonstrate plasmid or phage involvement or linkage with known chromosomal genes (ref. 4 and B.N.K. et al., unpublished data); however, Schutzer et al. have found that most TSS strains harbour prophages with common plating characteristics and suggest that the toxin(s) involved in TSS are transmitted by lysogenic conversion. We show here that TSSE is not demonstrably transferred by lysogeny; moreover, we have cloned the gene and found that the cloned product is serologically and biologically indistinguishable from the native protein, and that the TSSE determinant is associated with a larger DNA segment that is absent or rearranged in TSSE- strains.

Toxic-shock syndrome: a commentary and review of the characteristics of Staphylococcus aureus strains

Toxic-shock syndrome (TSS) was first identified in 1978 in children as a toxin-mediated illness associated with Staphylococcus aureus. Extensive publicity ensued when the strong association of this disease with menses and tampon use was recognized in 1980. Since that time, investigation into the epidemiology, clinical manifestations and pathogenesis of TSS has coincided with a decreasing incidence of disease. A unique exotoxin has been isolated under varying physico-chemical conditions from TSS-associated strains of S. aureus and its effect on immune function and other parameters both in vitro and in vivo described. In addition, TSS-associated S. aureus strains have been found to have characteristic heavy metal susceptibility patterns, to be lysogenized and to show decreased hemolysis on sheep blood agar. Preliminary results of the prevalence of TSS-associated strains of S. aureus and of the theories of pathogenesis are reviewed.