BACTERIOPHAGE TYPING OF THE STAPHYLOCOCCI

Genotyping and characterization of prophage patterns in clinical isolates of Staphylococcus aureus

Objective

Staphylococcus aureus is considered an important pathogen with a variety of virulence factors in communities and hospitals all around the world. Prophage typing is a practical technique for categorizing this bacterium. In this study, we focused on the detection of prophage patterns in methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains based on their virulence factors, antimicrobial resistance patterns, and molecular typing by rep-PCR.

Results

Out of 126 S. aureus isolates, 45 (35.7%) were identified as MRSA. In total, 17 different prophage types were detected and 112 strains out of 126 strains contained at least one prophage. There was a statistically significant relationship between hld, hlg, eta and SGA, SGA, and SGFb, respectively. The results of the rep-PCR analysis revealed 14 different patterns among the MRSA and MSSA isolates. In conclusion, the presence of different prophage-encoded virulence factors and antibiotic-resistant genes among MRSA strains enables them to produce a broad range of diseases. Thus, diverse MRSA strains which have these prophages can be considered as a potential threat to the patient’s health in either the hospital or the community.

Antibiotic resistance patterns of methicillin-resistant Staphylococcus aureus (MRSA) isolated from livestock and associated farmers in Anuradhapura, Sri Lanka

INTRODUCTION

The animal husbandry comes to play an important role according to new economic reforms of the rural economy in South Asia including Sri Lanka, and the rural farming community has a poor knowledge about hygienic issues of animal husbandry, which can lead to spread of pathogenic bacterial strains from animals to humans. Our study was conducted to evaluate methicillin susceptible Staphylococcus aureus (MRSA) colonization and its antimicrobial resistance pattern among livestock (n=188) and related farmers (n=94) in Anuradhapura District, Sri Lanka.

METHODS

S. aureus isolates were identified using mannitol salt agar, coagulase test and DNAase test. The agar plate dilution method was conducted to determine the minimum inhibitory concentration (MIC) of oxacillin against S. aureus. Antimicrobial susceptibility testing for other antibiotics was performed against MRSA isolates using antibiotic containing discs. To assess the MRSA transmission from livestock to humans, we have grouped MRSA strains according to antimicrobial susceptibility patterns against the tested antibiotics.

RESULTS

Among MRSA isolates, 14 different groups with similar MIC and antibiotic susceptibility patterns were identified. Of those, 2 groups amongst pigs and pig farmers showed a significant relationship (p=0.031). The other groups did not show any significant relationship between animals and the farmers. The percentages of MRSA prevalence in pigs and pig farmers were 26.6% each, in poultry and poultry farmers 8.3% and 13.3% respectively, in cattle and cattle farmers 8.3% and 3%. Compared to human MRSA isolates, animal isolates were significantly more resistant to ciprofloxacin (p=0.031), gentamicin (p=0.010) and clindamycin (p=0.011). Similarly, animal methicillin susceptible Staphylococcus aureus (MSSA) isolates were significantly more resistant to ciprofloxacin (p=0.022) and doxycycline (p=0.012).

CONCLUSION

Pig farming showed a higher prevalence and 2.4 times higher risk (OR=2.4, CI95%: 1.2-4.8) of likely transmission of MRSA between animals and humans than cattle and poultry farming. Overall, 65% of MRSA and MSSA animal isolates were multidrug resistant.

Simultaneous Identification and Susceptibility Determination to Multiple Antibiotics of Staphylococcus aureus by Bacteriophage Amplification Detection Combined with Mass Spectrometry

The continued advance of antibiotic resistance in clinically relevant bacterial strains necessitates the development and refinement of assays that can rapidly and cost-effectively identify bacteria and determine their susceptibility to a panel of antibiotics. A methodology is described herein that exploits the specificity and physiology of the Staphylococci bacteriophage K to identify Staphylococcus aureus (S. aureus) and determine its susceptibility to clindamycin and cefoxitin. The method uses liquid chromatography-mass spectrometry to monitor the replication of bacteriophage after it is used to infect samples thought to contain S. aureus. Amplification of bacteriophage K indicates the sample contains S. aureus, for it is only in the presence of a suitable host that bacteriophage K can amplify. If bacteriophage amplification is detected in samples containing the antibiotics clindamycin or cefoxitin, the sample is deemed to be resistant to these antibiotics, respectively, for bacteriophage can only amplify in a viable host. Thus, with a single work flow, S. aureus can be detected in an unknown sample and susceptibility to clindamycin and cefoxitin can be ascertained. This Article discusses implications for the use of bacteriophage amplification in the clinical laboratory.

Mobilization of pathogenicity islands by Staphylococcus aureus strain Newman bacteriophages

Staphylococcus aureus pathogenicity islands (SaPIs) are mobile genetic elements that encode virulence factors and depend on helper phages for their mobilization. Such mobilization is specific and depends on the ability of a phage protein to inactivate the SaPI repressor Stl. Phage 80α can mobilize several SaPIs, including SaPI1 and SaPIbov1, via its Sri and Dut proteins, respectively. In many cases, the capsids formed in the presence of the SaPI are smaller than those normally produced by the phage. Two SaPI-encoded proteins, CpmA and CpmB, are involved in this size determination process. S. aureus strain Newman contains four prophages, named φNM1 through φNM4. Phages φNM1 and φNM2 are very similar to phage 80α in the structural genes, and encode almost identical Sri proteins, while their Dut proteins are highly divergent. We show that φNM1 and φNM2 are able to mobilize both SaPI1 and SaPIbov1 and yield infectious transducing particles. The majority of the capsids formed in all cases are small, showing that both SaPIs can redirect the capsid size of both φNM1 and φNM2.

The Staphylococci phages family: an overview

Due to their crucial role in pathogenesis and virulence, phages of Staphylococcus aureus have been extensively studied. Most of them encode and disseminate potent staphylococcal virulence factors. In addition, their movements contribute to the extraordinary versatility and adaptability of this prominent pathogen by improving genome plasticity. In addition to S. aureus, phages from coagulase-negative Staphylococci (CoNS) are gaining increasing interest. Some of these species, such as S. epidermidis, cause nosocomial infections and are therefore problematic for public health. This review provides an overview of the staphylococcal phages family extended to CoNS phages. At the morphological level, all these phages characterized so far belong to the Caudovirales order and are mainly temperate Siphoviridae. At the molecular level, comparative genomics revealed an extensive mosaicism, with genes organized into functional modules that are frequently exchanged between phages. Evolutionary relationships within this family, as well as with other families, have been highlighted. All these aspects are of crucial importance for our understanding of evolution and emergence of pathogens among bacterial species such as Staphylococci.

Dispersing biofilms with engineered enzymatic bacteriophage

Synthetic biology involves the engineering of biological organisms by using modular and generalizable designs with the ultimate goal of developing useful solutions to real-world problems. One such problem involves bacterial biofilms, which are crucial in the pathogenesis of many clinically important infections and are difficult to eradicate because they exhibit resistance to antimicrobial treatments and removal by host immune systems. To address this issue, we engineered bacteriophage to express a biofilm-degrading enzyme during infection to simultaneously attack the bacterial cells in the biofilm and the biofilm matrix, which is composed of extracellular polymeric substances. We show that the efficacy of biofilm removal by this two-pronged enzymatic bacteriophage strategy is significantly greater than that of nonenzymatic bacteriophage treatment. Our engineered enzymatic phage substantially reduced bacterial biofilm cell counts by approximately 4.5 orders of magnitude ( approximately 99.997% removal), which was about two orders of magnitude better than that of nonenzymatic phage. This work demonstrates the feasibility and benefits of using engineered enzymatic bacteriophage to reduce bacterial biofilms and the applicability of synthetic biology to an important medical and industrial problem.

STAPHYLOCOCCUS AUREUS STRAINS ASSOCIATED WITH THE HEDGEHOG, ERINACEUS EUROPAEUS

1. Strains ofStaphylococcus aureuswere obtained from the nostrils of twenty-three of fifty-eight hedgehogs; the skin of thirty-eight of fifty-six hedgehogs; the paws of thirty-six of fifty-seven hedgehogs and the anus of six of eleven hedgehogs.

2. Of 118 strains, 106 (90%) were typable with human staphylophages. Seventeen were phage group I, three phage group II, twenty-five phage group III, sixty-one were typable but unclassifiable into groups, and twelve were untypable.

3. Male hedgehogs were more heavily infected than females, while all ages of hedgehogs appeared equally susceptible to infection.

4. Of the 124 coagulase positive strains obtained, 107 (86·3%) were resistant to penicillin. Resistance to other antibiotics—chloramphenicol, streptomycin, tetracycline, erythromycin, celbenin—was not encountered.

5. Thirty-three (83%) of forty strains produced β-lysin.

6. Mites (Caparinia tripilis) and fungi (Trichophyton mentagrophytesvar.erinacei) did not appear to directly influence the carriage ofStaphylococcus aureuson the hedgehog skin.

Molecular relationships among serogroup B bacteriophages of Staphylococcus aureus

The typing bacteriophages 55, 80, 83A, and 85 of Staphylococcus aureus, representative of the three major lytic groups of serological group B aureophages, have been examined for relatedness of their genomes and virion proteins. Phages 11 and 80 alpha were also examined to determine the relationship of phage 80 alpha to phages 11 and 80. Total genome hybridization measurements divided the phages into two groups. Phages 55 and 80, in the first group, had DNA homology of 50%. Phages 11, 80 alpha, 83A, and 85 formed a second group with 27 to 65% homology. Homology between the two groups was in the range of 14 to 22%. Phage 80 alpha is more closely related to phage 11 than to phage 80, though it is probably not a simple recombinant of phages 11 and 80. Restriction enzyme digestion and phage [32P]DNA hybridization analysis of the endonuclease-generated fragments from each phage DNA confirmed the findings of the DNA homology measurements. The endonuclease fragment patterns generated by EcoRI and HindIII were distinctive for each phage, confirming that none of the phages are closely related. Common sequences were present in most fragments from the phage DNAs when the labeled probe DNA was from a different phage in the same group. Cross-group probing of endonuclease fragments revealed both a diminished level of homology when similar sequences were present and the probable absence of some sequences. Virion proteins, examined by polyacrylamide gel electrophoresis, were similar in number and molecular weight for phages 11, 80 alpha, 83A, and 85, reflecting the DNA homology analyses. The virion proteins from phages 55 and 80, however, were more distinctive, and both differed from the phages in the other group.

Prevalence of Staphylococcus aureus, phage type 29/52/80, in Michigan

Staphylococcus aureus, phage type 29/52/80, caused an outbreak of infections in Michigan over a period of two years and continues to be the most prevalent type seen. Of 3,752 isolates typed in 1980-81, 25 per cent were this phage type, which was strongly associated with methicillin resistance. Using this phage type as an indicator, we could demonstrate the spread of methicillin resistant staphylococci from Detroit metropolitan hospitals to suburban and, to a lesser extent, to hospitals outside the Detroit area.

Genetic transformation in Staphylococcus aureus: demonstration of a competence-conferring factor of bacteriophage origin in bacteriophage 80 alpha lysates

A virion component that is responsible for conferring competence to Staphylococcus aureus was demonstrated in lysates of bacteriophage 80 alpha, a serological group B phage. Isolated particles of 80 alpha could not be shown to confer significant levels of competence. The phage component had a density of about 1.3 g/cm3, was inactivated by pronase, and was inhibited by antiserum prepared against isolated infectious particles of a serological group B phage. Centrifugation through a Ficoll gradient resulted in separation of competence-conferring activity and plaque-forming units. It is concluded that this proteinaceous subvirion component constitutes a bona fide competence factor of bacteriophage origin.

The role of lysogeny in the modification of phage typing patterns of Staphylococcus aureus isolated from dairy cows

Strains of Staphylococcus aureus were isolated at a single sampling from cows in a dairy herd. When typed by phage most showed a complex pattern of lysis with group III and IV phages. Cross-spotting of strains showed great lytic activity and ten phages were isolated. The parent strains were lysogenized with these phages and the effect on the phage typing pattern of 202 daughter strains from 25 parent cultures was studied. Phage action was often blocked completely, with up to four being blocked on the one strain. Those most frequently blocked were phage 101, 117, 367 and 42D.

Transformation in Staphylococcus aureus: role of bacteriophage and incidence of competence among strains

When used in a helper phage capacity, phages 29, 52, 52A, 79, 80, 55, 71, 53, 83A, 85, 95, 96, phi11, and 80 alpha, all serological group B Staphylococcus phages, conferred competence for transformation to S. aureus 8325-4, a strain that does not normally become competent. Of the serological group A phages tested, only phage 3A showed significant competence-conferring activity. Phages 29, 55, 53, 83A, .85, 95, phi11, and 80 alpha showed an enhancement of competence-conferring activity if exposure to the cells occurred in the presence of nromal rabbit serum. All of the propagating strains for the Staphylococcus reference typing phages were rendered competent for transformation by exposure to at least one of these helper phages. The use of a helper phage to confer competence to S. aureus did not result in distortion of the genetic linkages observed in an inherently competent strain. Lysogenization by phages phi11 or 83A is shown not to be required for the expression of competence, and evidence is presented which indicates that competence in the inherently competent 8325 strain is due to a helper phage effect initiated by the adsorption to cells of phi11 virion parts [or phi11 particles in the case of the single lysogen 8325-4(phi11)] that have been liberated by prophage induction.

Staphylococcal scalded-skin syndrome: development of a primary binding assay for human antibody to the exfoliative toxin

Exfoliative toxin (ET) from a phage group II Staphylococcus aureus strain causing staphylococcal scalded-skin syndrome was purified by electrofocusing. Ampholytes and salts were removed from the final product by column chromatography on G-50 Sephadex. Sodium dodecyl sulfate-polyacrylamide gels of the final product yielded a single band upon gel electrophoresis, even when 60 mug of protein was placed in the gels. Radiolabeling of the purified toxin with 125I yielded a product that still caused exfoliation of suckling mice, indicating that the toxin was still biologically active. A radioimmunobinding assay was developed and used to test rabbit and human sera for antibodies to exfoliative toxin. Although the maximum percentage of binding was not as high as expected (approximately 40%), it was postulated that either iodination had not been sufficiently vigorous or the toxin had sustained immunological damage. The assay was reproducible and more sensitive than the existing neutralization method and readily applicable to the testing of human sera for exfoliative toxin antibodies.

Experiences and observations with the typing of Staphylococcus aureus phage 94

During a 28-month period, 5,078 cultures from a variety of anatomical sites were received for staphylococcal phage typing. Of these, 503 (10%) were not suitable for the procedure requested. Of the 4,575 viable cultures, 1,030 (23%) of the microorganisms were nontypable at both the routine test dilution (RTD) and at 100 times RTD. Of the 3,545 typable organisms, 3,061 (86%) were lysed at RTD, whereas 484 (14%) were typed only at 100 times RTD. Observations pertaining to the typing efficacy of staphylococcal phage 94 indicate that 651 (18%) of the typable microorganisms were lysed only by phage 94 at RTD or at 100 times RTD. Without the addition of this new phage to the international basic set, the number of nontypable strains (1,030 or 23%) would have been 1,681 (39%). Data regarding the geographic distribution of Staphylococcus aureus phage 94 point to the occurrence of the host strain in 13 (68%) of 19 states and 18 (62%) of the 29 hospitals submitting specimens to this laboratory. The assumed origin and speculated mode of dissemination of this microorganism are discussed.

Chemical characterization of a new surface antigenic polysaccharide from a mutant of Staphylococcus aureus

A mutant of Staphylococcus aureus H was isolated by virtue of its inability to agglutinate with antibodies against teichoic acid of S. aureus. Immunological studies revealed that the mutant, S. aureus T, possessed a new surface antigen in addition to having the antigenic determinant of the wild-type strain, the ribitol teichoic acid. The presence of this additional surface component rendered strain T resistant to staphylococcal typing phages, presumably by masking the phage-receptor sites. The polymer was separated from teichoic acid by chromatography on diethylaminoethyl cellulose and was shown to be composed of two amino sugars, N-acetyl-d-fucosamine and N-acetyl-d-mannosamin uronic acid.

Use of bacteriophage-resistant mutants to study the nature of the bacteriophage receptor site of Staphylococcus aureus

Bacteriophage-resistant strains of Staphylococcus aureus H were isolated after mutagenesis with N-methyl-N'-nitro-N-nitrosoguanidine. Cell walls isolated from about half of these resistant strains were incapable of inactivating phages and were shown to lack N-acetyl-d-glucosamine (GlcNAc) in their cell wall teichoic acid. Apart from the lack of GlcNAc, two of these mutant strains were deficient in cell wall phosphorus and ester-linked d-alanine. These two strains were also found to be resistant to both phage K and a host-range mutant isolated from the parent phage. These two phages could lyse the other phage-resistant mutants which lacked GlcNAc in their teichoic acid. Cell walls from the remaining phage-resistant mutant strains did inactivate phages and were found to have normal cell wall teichoic acid. Although GlcNAc in teichoic acid was required for phage inactivation, no difference in phage inactivation ability was detected with cell walls isolated from strains of S. aureus having exclusively alpha- or exclusively beta-linked GlcNAc in their cell wall teichoic acid.