Fulminant arterial vasculitis as an unusual complication of disseminated staphylococcal disease due to the emerging CC1 methicillin-susceptible Staphylococcus aureus clone: a case report

Genome-wide comparative analysis of CC1 Staphylococcus aureus between colonization and infection

BACKGROUND

Staphylococcus aureus is one of the most important bacteria in human colonization and infection. Clonal complex1 (CC1) is one of the largest and most important S. aureus CCs, and it is a predominant clone in S. aureus colonization and can cause a series of S. aureus infections including bloodstream infections. No studies on the relationship of CC1 S. aureus between colonization and infection have been published.

METHODS

To figure out if there are some significant factors in CC1 S. aureus help its colonization or infection, 15 CC1 S. aureus isolates including ten from colonization and five from bloodstream infections were enrolled in this study. Whole-genome sequencing and bioinformatics analysis were performed.

RESULTS

Virulence factor regulators XdrA, YSIRK signal peptide, CPBP family and OmpR family specifically found in infection isolates can promote virulence factors and enhance the pathogenicity of S. aureus. In addition, some significant differences in metabolism and human diseases were discovered between colonization and infection. Fst family of type I toxin-antitoxin system that mainly maintains stable inheritance was specifically found in CC1 S. aureus colonization isolates and might help S. aureus survive for colonization. No significant differences in genomic evolutionary relationship were found among CC1 S. aureus isolates between colonization and infection.

CONCLUSIONS

Virulence factor regulators and metabolic state can promote CC1 S. aureus pathogenic process compared with colonization, and it seems that the strains of colonization origin cannot have pathogenic potential. Experimental confirmation and a bigger number of CC1 S. aureus strains are necessary for further study about the details and mechanism between colonization and infection.

Reactive Oxygen Species-Dependent Innate Immune Mechanisms Control Methicillin-Resistant Staphylococcus aureus Virulence in the Drosophila Larval Model

Antibiotic-resistant Staphylococcus aureus strains constitute a major public health concern worldwide and are responsible for both health care- and community-associated infections. Here, we establish a robust and easy-to-implement model of oral S. aureus infection using Drosophila melanogaster larvae that allowed us to follow the fate of S. aureus at the whole-organism level as well as the host immune responses. Our study demonstrates that S. aureus infection triggers H₂O₂ production by the host via the Duox enzyme, thereby promoting antimicrobial peptide production through activation of the Toll pathway. Staphylococcal catalase mediates H₂O₂ neutralization, which not only promotes S. aureus survival but also minimizes the host antimicrobial response, hence reducing bacterial clearance in vivo. We show that while catalase expression is regulated in vitro by the accessory gene regulatory system (Agr) and the general stress response regulator sigma B (SigB), it no longer depends on these two master regulators in vivo. Finally, we confirm the versatility of this model by demonstrating the colonization and host stimulation capabilities of S. aureus strains belonging to different sequence types (CC8 and CC5) as well as of two other bacterial pathogens, Salmonella enterica serovar Typhimurium and Shigella flexneri. Thus, the Drosophila larva can be a general model to follow in vivo the innate host immune responses triggered during infection by human pathogens.

Constellation of methicillin-resistant genomic islands (SCCmec) among nasal meticillin-resistant Staphylococcus aureus isolates

The apprehensiveness for the knowledge vacuum on existential threat of nasal carriage of pvl+ healthcare-acquired meticillin-resistant Staphylococcus aureus (HA-MRSA) strains amongst subjects in hospitals have led us to pursue a grasp on the constellation of staphylococcal cassette chromosome mec (SCCmec) types and pvl gene among mecA positive MRSA nasal strains. This was accomplished by phenotypic (catalase, coagulase, Microgen staph ID, ORSAB) and genotypic (polymerase chain reaction) biotyping techniques. All the mecA+ strains harboured the SCCmec gene; SCCmec type I prevailed in 43.75% and pvl was found in 42.1% of the isolates. Dual carriage of mecA and pvl genes occurred in six (37.5%, n = 6/16) strains. Overall, majority of the mecA+ MRSA strains documented in this study carried SCCmec elements of the HA genotype with a hint of community-acquired (CA)genotype suggesting a possible coexistence of both HA-MRSA and community-acquiredhealthcare-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) strains. Consequently, the implementation of methodical surveillance is needed for the evaluation of potential shifts in directionality of (HA-MRSA/CA-MRSA) pvl+ MRSA clones in our hospitals for effective and prudent antimicrobial stewardship.