Phenotypic and Genotypic Characterization of Antimicrobial Resistance in Streptococci Isolated from Human and Animal Clinical Specimens

Recently, the phenomenon of infection of humans as hosts by animal pathogens has been increasing. Streptococcus is an example of a genus in which bacteria overcome the species barrier. Therefore, monitoring infections caused by new species of human pathogens is critical to their spread. Seventy-five isolates belonging to streptococcal species that have recently been reported as a cause of human infections with varying frequency, were tested. The aim of the study was to determine the drug resistance profiles of the tested strains, the occurrence of resistance genes and genes encoding the most important streptococcal virulence factors. All tested isolates retained sensitivity to β-lactam antibiotics. Resistance to tetracyclines occurred in 56% of the tested strains. We have detected the MLS_B type resistance (cross-resistance to macrolide, lincosamide, and streptogramin B) in 20% of the tested strains. 99% of the strains had tetracycline resistance genes. The erm class genes encoding MLS_B resistance were present in 47% of strains. Among the strains with MLS_B resistance, 92% had the streptokinase gene, 58% the streptolysin O gene and 33% the streptolysin S gene. The most extensive resistance concerned isolates that accumulated the most traits and genes, both resistance genes and virulence genes, increasing their pathogenic potential. Among the tested strains, the gene encoding streptokinase was the most common. The results of the prove that bacteria of the species S. uberis, S. dysgalactiae and S. gallolyticus are characterized by a high pathogenic potential and can pose a significant threat in case of infection of the human body.

Vancomycin heteroresistance among methicillin-resistant clinical isolates S. haemolyticus, S. hominis, S. simulans, and S. warneri

Besides being an essential part of the skin microbiome, coagulase-negative staphylococci are the etiological factors of serious infections. The aim of the study was to evaluate the heteroresistance to vancomycin and the potential antimicrobial efficacy of teicoplanin and daptomycin against the multiresistant strains of S. haemolyticus, S. hominis, S. warneri, and S. simulans. The study covered 80 clinical coagulase-negative staphylococci. Teicoplanin, vancomycin, and daptomycin MICs for the tested strains were determined according to EUCAST recommendation. The vanA and vanB genes were searched. The brain heart infusion screen agar method detected vancomycin heteroresistance. The population analysis profile method and analysis of autolytic activity were applied for the strains growing on BHI containing 4 mg/L vancomycin. Seven S. haemolyticus, two S. hominis, and two S. warneri strains presented a heterogeneous resistance to vancomycin. Their subpopulations were able to grow on a medium containing 4-12 mg/L of vancomycin. Monitoring heteroresistance to peptide antibiotics, which are often the last resort in staphylococcal infections, is essential due to the severe crisis in antibiotic therapy and the lack of alternatives to treat infections with multiresistant strains. Our work highlights the selection of resistant strains and the need for more careful use of peptide antibiotics.

Pathogenic potential and antimicrobial resistance of Staphylococcus pseudintermedius isolated from human and animals

Crossing of interspecies barriers by microorganisms is observed. In recent years, Staphylococcus pseudintermedius-a species formerly thought to be animal-has also been isolated from human clinical materials. Many virulence factors are responsible for the colonization, which is the first step an infection, of the new host organism. We analyzed the factors influencing this colonization as well as susceptibility to antibiotics in fourteen S. pseudintermedius strains isolated from clinical cases from humans and animals. The occurrence of genes responsible for binding elastin, fibronectin, and fibrinogen and some phenotypic features, although different between strains, is comparable in both groups. However, the animal isolates had more genes coding for virulence factors. All isolates tested had the exfoliating toxin gene and the leukotoxin determining genes, but only the human strains had enterotoxin genes. The assessment of antibiotic resistance of strains of both groups indicates their broad resistance to antibiotics commonly used in veterinary medicine. Antibiotic resistance was more common among animal isolates. The multilocus sequence typing analysis of the studied strains was performed. The results indicated a large diversity of the S. pseudintermedius population in both studied groups of strains. Equipped with important virulence factors, they showed the ability to infect animals and humans. The clonal differentiation of the methicillin-susceptible strains and the multidrug resistance of the strains of both studied groups should be emphasized. The considerable genetic diversity of strains from a limited geographical area indicates the processes of change taking place within this species. Thus, careful observation of the ongoing process of variation is necessary, as they may lead to the selection of S. pseudintermedius, which will pose a significant threat to humans.

Factors Affecting the Formation and Treatment of Thrombosis by Natural and Synthetic Compounds

Venous thromboembolism (VTE) refers to deep vein thrombosis (DVT), whose consequence may be a pulmonary embolism (PE). Thrombosis is associated with significant morbidity and mortality and is the third most common cardiovascular disease after myocardial infarction and stroke. DVT is associated with the formation of a blood clot in a deep vein in the body. Thrombosis promotes slowed blood flow, hypoxia, cell activation, and the associated release of many active substances involved in blood clot formation. All thrombi which adhere to endothelium consist of fibrin, platelets, and trapped red and white blood cells. In this review, we summarise the impact of various factors affecting haemostatic disorders leading to blood clot formation. The paper discusses the causes of thrombosis, the mechanism of blood clot formation, and factors such as hypoxia, the involvement of endothelial cells (ECs), and the activation of platelets and neutrophils along with the effects of bacteria and reactive oxygen species (ROS). Mechanisms related to the action of anticoagulants affecting coagulation factors including antiplatelet drugs have also been discussed. However, many aspects related to the pathogenesis of thrombosis still need to be clarified. A review of the drugs used to treat and prevent thrombosis and natural anticoagulants that occur in the plant world and are traditionally used in Far Eastern medicine has also been carried out.

Microbial Modulation of Coagulation Disorders in Venous Thromboembolism

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third leading cause of cardiovascular death in the world. Important risk factors of thrombosis include bed restraint, surgery, major trauma, long journeys, inflammation, pregnancy, and oral contraceptives, previous venous thromboembolism, cancer, and bacterial infections. Sepsis increases the risk of blood clot formation 2–20 times. In this review, we discussed various mechanisms related to the role of bacteria in venous thrombosis also taking into consideration the role of the human microbiome. Many known bacteria, such as Helicobacter pylori, Chlamydia pneumoniae, Mycoplasma pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, and Escherichia coli, causing infections may increase the risk of thrombotic complications through platelet activation or may lead to an inflammatory reaction involving the fibrinolytic system. Additionally, the bacteria participate in the production of factors causing or increasing the risk of cardiovascular diseases. An example can be trimethylamine N-oxide (TMAO) but also uremic toxins (indoxyl sulfate), short-chain fatty acids (SCFA) phytoestrogens, and bile acids. Finally, we presented the involvement of many bacteria in the development of venous thromboembolism and other cardiovascular diseases.

Staphylococcal species less frequently isolated from human clinical specimens - are they a threat for hospital patients?

Background

Coagulase-negative staphylococci belonging to S. haemolyticus, S. hominis subsp. hominis, S. simulans, and S. warneri are often described as etiological factors of infections. Staphylococci are a phylogenetically coherent group; nevertheless, there are differences among the species which may be important to clinicians.

Methods

We investigated selected virulence factors and antibiotic resistance that were phenotypically demonstrated, the presence and expression of genes encoding the virulence factors, and the type of the SCCmec cassette.

Results

The differences between the tested species were revealed. A great number of isolates produced a biofilm and many of them contained single icaADBC operon genes. Clear differences between species in the lipolytic activity spectrum could be related to their ability to cause various types of infections. Our studies also revealed the presence of genes encoding virulence factors homologous to S. aureus in the analysed species such as enterotoxin and pvl genes, which were also expressed in single isolates of S. simulans and S. warneri. S. haemolyticus and S. hominis subsp. hominis isolates were resistant to all clinically important antibiotics including ß-lactams. The identified SCCmec cassettes belonged to IV, V, VII, and IX type but most of the detected cassettes were non-typeable. Among the investigated species, S. hominis subsp. hominis isolates accumulated virulence genes typical for S. aureus in the most efficient way and were widely resistant to antibiotics.

Conclusions

Our results clearly indicated significant differences between the tested species, which might be a result of the horizontal gene transfer (HGT) and can lead to the formation and selection of multi-drug resistant strains as well as strains with new virulence features. Such strains can have a new clinical relevance.

New Gene Responsible for Resistance of Clinical Corynebacteria to Macrolide, Lincosamide and Streptogramin B

The subject of the study was phenotypic marking of the antibiotic susceptibility and MLS_B resistance mechanism in Corynebacterium spp. isolated from human skin (18 isolates) and from clinical materials (19 isolates). The strains were tested for the presence of the erm(A), erm(B), erm(C), erm(X), lnu(A), msr(A), msr(B) and mph(C) genes. Clinical isolates showed wide resistance to antibiotics. In 89% clinical isolates and 72% skin microbiota a constitutive type of MLS_B resistance was found. In 12 clinical isolates the erm(C) gene was detected-eight of which had erm(X) as well as erm(C), two harboured erm(X), erm(C) and erm(A) and two demonstrated only erm(C).

Differences in distribution of MLS antibiotics resistance genes in clinical isolates of staphylococci belonging to species: S. epidermidis, S. hominis, S. haemolyticus, S. simulans and S. warneri

Background

Macrolides and lincosamides are two leading types of antibiotics commonly used in therapies. The study examines the differences in resistance to these antibiotics and their molecular bases in S. epidermidis as well as in rarely isolated species of coagulase-negative staphylococci such as S. hominis, S. haemolyticus, S. warneri and S. simulans. The isolates were tested for the presence of the erm(A), erm(B), erm(C), lnu(A), msr(A), msr(B), mph(C), ere(A) and ere(B) genes. Phenotypic resistance to methicillin and mecA presence were also determined.

Results

The MLS_B resistance mechanism was phenotypically found in isolates of species included in the study. The most prevalent MLS_B resistance mechanism was observed in S. hominis, S. haemolyticus and S. epidermidis isolates mainly of the MLS_B resistance constitutive type. Macrolide, lincosamide and streptogramin B resistance genes were rarely detected in isolates individually. The erm(B), ere(A) and ere(B) genes were not found in any of the strains. The erm(A) gene was determined only in four strains of S. epidermidis and S. hominis while lnu(A) was seen in eight strains (mainly in S. hominis). The erm(C) gene was present in most of S. epidermidis strains and predominant in S. hominis and S. simulans isolates. The examined species clearly differed between one another in the repertoire of accumulated genes.

Conclusions

The presence of genes encoding the MLS_B resistance among CoNS strains demonstrates these genes’ widespread prevalence and accumulation in opportunistic pathogens that might become gene reservoir for bacteria with superior pathogenic potential.

Outpatient Antibiotic Consumption Fluctuations in a View of Unreasonable Antibacterial Therapy

Unreasonable antibacterial therapy is suspected to be the main reason of emergence of multi-resistant bacteria. The connection between seasonal variability of antibiotic use and reasonable antibacterial therapy has been described. We examined the issue basing on the data obtained from the primary care system in Szczecin (Poland) in order to verify the situation in this region of Central Europe. Increase in antibiotic consumption in a viral infection season was proved to be statistically significant. Statistically significant differences in various drug forms dispensation were also observed. Increased consumption of antibiotics in seasons of influenza-like illnesses might be connected with a lack of proper diagnostics or numerous cases of bacterial co-infections.

Original Multivalent Gold(III) and Dual Gold(III)-Copper(II) Conjugated Phosphorus Dendrimers as Potent Antitumoral and Antimicrobial Agents

Original metallophosphorus dendrimers (generation 3, 48 terminal groups) have been prepared via the complexation of phosphorus dendrimers bearing imino-pyridino end groups with Au(III) or with both Au(III) and Cu(II). The complexation of the dendrimer with Au(III), leading to 1G3-[Au₄₈][AuCl₄]₄₈, strongly increased the antiproliferative activities against both KB and HL-60 tumoral cell lines, showing IC₅₀s in the low nanomolar range. It can be noticed also that this gold conjugated phosphorus dendrimer displayed low activity on the quiescent cell line EPC versus its potent antiproliferative activity against actively dividing cells. In order to evaluate the potential synergistic effect between Au(III) and Cu(II) and the influence of the number of Au(III) moieties on the surface of dendrimer against the proliferative activities, nine other original dendrimers with several surface modifications have been prepared. Whatever the number of Au(III) moieties introduced on the surface of dendrimers, all the dendrimers prepared displayed similar potency (nanomolar range) to 1G3-[Au₄₈][AuCl₄]₄₈ against KB and HL60. In marked contrast synergistic effects on the antimicrobial activity of some of these phosphorus dendrimers are observed when both Au(III) and Cu(II) are present on the dendritic structure.

Antibacterial and antifungal properties of dendronized silver and gold nanoparticles with cationic carbosilane dendrons

Water soluble silver nanoparticles (AgNPs) capped with cationic carbosilane dendrons have been synthesized by direct reaction in water of dendrons, silver precursor and a reducing agent. These nanoparticles have been characterized by nuclear magnetic resonance (NMR), transmission electron microscopy (TEM), dynamic light scattering (DLS), thermogravimetric analysis (TGA), ultraviolet spectroscopy (UV), elemental analysis, and zeta potential (ZP). The antibacterial and antifungal properties of the cationic dendrons and dendronized AgNPs and AuNPs with these dendrons have been evaluated against Gram-negative and Gram-positive bacterial -including resistant strains- and yeast strains, respectively. The results stand out for the activity of AgNPs covered with first generation dendron compared with this free dendron and corresponding dendronized AuNPs.

Potential Factors Enabling Human Body Colonization by Animal Streptococcus dysgalactiae subsp. equisimilis Strains

Streptococcus dysgalactiae subsp. equisimilis (SDSE) is a pyogenic, Lancefield C or G streptococcal pathogen. Until recently, it has been considered as an exclusive animal pathogen. Nowadays, it is responsible for both animal infections in wild animals, pets, and livestock and human infections often clinically similar to the ones caused by group A streptococcus (Streptococcus pyogenes). The risk of zoonotic infection is the most significant in people having regular contact with animals, such as veterinarians, cattlemen, and farmers. SDSE is also prevalent on skin of healthy dogs, cats, and horses, which pose a risk also to people having contact with companion animals. The main aim of this study was to evaluate if there are features differentiating animal and human SDSE isolates, especially in virulence factors involved in the first stages of pathogenesis (adhesion and colonization). Equal groups of human and animal SDSE clinical strains were obtained from superficial infections (skin, wounds, abscesses). The presence of five virulence genes (prtF1, prtF2, lmb, cbp, emm type) was evaluated, as well as ability to form bacterial biofilm and produce BLIS (bacteriocin-like inhibitory substances) which are active against human skin microbiota. The study showed that the presence of genes coding for fibronectin-binding protein and M protein, as well as BLIS activity inhibiting the growth of Corynebacterium spp. strains might constitute the virulence factors which are necessary to colonize human organism, whereas they are not crucial in animal infections. Those virulence factors might be horizontally transferred from human streptococci to animal SDSE strains, enabling their ability to colonize human organism.

[Tick-borne diseases in Poland: Prevalence and difficulties in diagnostics]

The article presents an overview of diagnostics of tick-borne diseases in Poland, which form one of the most prevalent group of occupational illnesses in the Polish area. This is a current issue due to a constantly growing number of tick-borne infections, i.e., Lyme borreliosis, tick-borne encephalitis, tularemia, Q fever, human granulocytic anaplasmosis and babesiosis. The scale of the problem is well illustrated by the latest reports of the Polish National Institute of Public Health - National Institute of Hygiene (NIPH - NIH). The article also covers the taxonomy of vectors of etiological factors, as well as their reservoirs and possible transmission to humans. The highest risk of tick-borne infection is particularly connected with people either resting or working in the forest or meadow surroundings (i.e., foresters, farmers, hunters). The article contains up-to-date data on epidemiology, etiopathogenesis, symptomatology, laboratory medicine and factors affecting the credibility of results according to current recommendations of the Polish Society of Epidemiology and Physicians of Infectious Diseases and the Polish National Chamber of Laboratory Diagnosticians. The presented review focuses on modern laboratory techniques used in difficult diagnostics of tick-borne diseases, mainly diagnostics algorithms, pre-analytical phase (type of biological material) and analytical phase of diagnostics (reference methods, efficacy of different techniques, interfering factors, proper diagnostic procedures).

Biological Activity of Mesoporous Dendrimer-Coated Titanium Dioxide: Insight on the Role of the Surface-Interface Composition and the Framework Crystallinity

Hitherto, the field of nanomedicine has been overwhelmingly dominated by the use of mesoporous organosilicas compared to their metal oxide congeners. Despite their remarkable reactivity, titanium oxide-based materials have been seldom evaluated and little knowledge has been gained with respect to their "structure-biological activity" relationship. Herein, a fruitful association of phosphorus dendrimers (both "ammonium-terminated" and "phosphonate-terminated") and titanium dioxide has been performed by means of the sol-gel process, resulting in mesoporous dendrimer-coated nanosized crystalline titanium dioxide. A similar organo-coating has been reproduced using single branch-mimicking dendrimers that allow isolation of an amorphous titanium dioxide. The impact of these materials on red blood cells was evaluated by studying cell hemolysis. Next, their cytotoxicity toward B14 Chinese fibroblasts and their antimicrobial activity were also investigated. Based on their variants (cationic versus anionic terminal groups and amorphous versus crystalline titanium dioxide phase), better understanding of the role of the surface-interface composition and the nature of the framework has been gained. No noticeable discrimination was observed for amorphous and crystalline material. In contrast, hemolysis and cytotoxicity were found to be sensitive to the nature of the interface composition, with the ammonium-terminated dendrimer-coated titanium dioxide being the most hemolytic and cytotoxic material. This surface-functionalization opens the door for creating a new synergistic machineries mechanism at the cellular level and seems promising for tailoring the biological activity of nanosized organic-inorganic hybrid materials.

Staphylococcus haemolyticus - an emerging threat in the twilight of the antibiotics age

Staphylococcus haemolyticus is one of the most frequent aetiological factors of staphylococcal infections. This species seems to lack the important virulence attributes described in other staphylococci. However, studies have shown that the presence of various enzymes, cytolysins and surface substances affects the virulence of S. haemolyticus. Nevertheless, none of them has been identified as crucial and determinative. Despite this, S. haemolyticus is, after Staphylococcus epidermidis, the second most frequently isolated coagulase-negative staphylococcus from clinical cases, notably from blood infections, including sepsis. This raises the question of what is the reason for the increasing clinical significance of S. haemolyticus? The most important factor might be the ability to acquire multiresistance against available antimicrobial agents, even glycopeptides. The unusual genome plasticity of S. haemolyticus strains manifested by a large number of insertion sequences and identified SNPs might contribute to its acquisition of antibiotic resistance. Interspecies transfer of SCCmec cassettes suggests that S. haemolyticus might also be the reservoir of resistance genes for other staphylococci, including Staphylococcus aureus. Taking into consideration the great adaptability and the ability to survive in the hospital environment, especially on medical devices, S. haemolyticus becomes a crucial factor in nosocomial infections caused by multiresistant staphylococci.

Cohabitation--relationships of corynebacteria and staphylococci on human skin

Skin microbiome main cultivable aerobes in human are coagulase-negative staphylococci and lipophilic corynebacteria. Staphylococcus strains (155) belonging to 10 species and 105 strains of Corynebacterium belonging to nine species from the skin swabs of healthy male volunteers were investigated to determine their enzymatic activity to main metabolic substrates: carbohydrates, proteins, lipids, and response to factors present on the skin such as osmotic pressure, pH, and organic acids. The results showed that lipophilic corynebacteria have different capacity for adaptation on the skin than staphylococci. Most of Corynebacterium spp. expressed lack of proteinase, phospholipase, and saccharolytic enzymes activity. Corynebacteria were also more sensitive than Staphylococcus spp. to antimicrobial agents existing on human skin, especially to low pH. These characters can explain domination of Staphylococcus genera on healthy human skin. It can be suggested that within these two bacterial genus, there exists conceivable cooperation and reciprocal protection which results in their quantitative ratio. Such behavior must be considered as crucial for the stability of the population on healthy skin.

Species-specific sensitivity of coagulase-negative Staphylococci to single antibiotics and their combinations

The activity of beta-lactam antibiotics (oxacillin, cloxacillin, cephalotin), vancomycin, gentamicin and rifampicin applied in vitro individually and in combination against 37 nosocomial methicillin-resistant strains of coagulase-negative staphylococci (CNS) was assessed to demonstrate the heterogeneity of this group of bacteria and estimate the chance of the efficacy of such therapy. The strains belonged to four species: Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus cohnii, Staphylococcus hominis. They originated from a hospital environment and from the skin of medical staff of the intensive care unit of a paediatric ward at a university hospital. All strains were methicillin-resistant, according to CLSI standards, but individual strains differed in MIC(ox) values. Susceptibility to other tested antibiotics was also characteristic for the species. The increased susceptibility to antibiotics in combinations, tested by calculating the fractional inhibitory concentration (FIC) index, concerned 26 out of 37 investigated strains and it was a feature of a particular species. Combinations of vancomycin and cephalotin against S. epidermidis and oxacillin with vancomycin were significant, as well as cephalotin and rifampicin in growth inhibition of multiresistant S. haemolyticus strains.

[Influence of substances produced by lipophilic Corynebacterium CDC G1 ZMF 3P13 on the microorganisms inhabiting human skin]

Lipophilic species of Corynebacterium inhabiting skin as residents produces substances that can regulate the composition of natural flora. Research that was carried out concerned an influence of the substances produced by Corynebacterium CDC G1 ZMF 3P13 on the set of 22 bacterial strains (Staphylococcus spp., Corynebacterium spp., Propionibacterium spp.) mutually existing on the skin and the set of 6 Candida spp. isolated from patients. It was found out that the strain gives off into environment a mixture of substances with opposite effects. In the course of research an inhibiting substance (BLIS) was isolated with its evident effect on S. aureus, S. epidermidis, C. diphtheriae i Propionibacterium spp.

Staphylococcus cohnii hemolysins - isolation, purification and properties

A total 355 of Staphylococcus cohnii isolates from hospital environment, patients (newborns), medical staff and from non-hospital environment were tested for hemolytic activity. Ninety-one % of S. cohnii ssp. cohnii and 74.5 % S. cohnii ssp. urealyticus strains exhibited hemolysis synergistic to S. aureus ATCC 25923 strain. Crude preparations of hemolysins of both bacterial subspecies presented delta-hemolysin, but not alpha- and beta-toxin activity. Highly pure hemolysins were obtained by semipreparative SDS-PAGE or by organic solvent extraction from the freeze-dried crude preparations. Native-PAGE and 2D-PAGE showed their high heterogeneity. Molar masses of single hemolysin units estimated by the Tris-Tricine-SDS-PAGE were calculated as 3.47 kDa for S. cohnii ssp. cohnii and 3.53 kDa for S. cohnii ssp. urealyticus.

[Influence of contact with hospital environment on sensitivity to antibiotics of lipophilic strains of Corynebacterium residing on human skin]

Sensitivity of two groups of lipophilic corynebacteria strains of different species, which form stable residential flora on human skin, to therapeutically significant groups of antibiotic was compared. Strains were isolated from people who did not have any contact with hospital environment, and from doctors closely connected with hospital. It was shown that strains isolated from doctors, which were in fact not under antibiotic pressure, were five times more multiresistant whilst at the same time being resistant to antibiotics used only in hospital treatment.

[Production of antibacterial substances by resident corynebacteria isolated from human skin]

Coryneform bacteria, especially lipophilic species, form stable but not dominant population on a human skin. This position is probably controlled by secretion of bacteriocin-like substances, which act directly on coexisting bacteria. Among 118 investigated corynebacteria belonging to seven species/taxa and isolated from human skin, 90% possessed an ability to produce such substances. The spectrum of their activity was restricted to killing gram-positive bacteria, but along with corynebacteria it also covered cocci, with Staphylococcus aureus in this group. This feature was revealed better on low pH media (pH 5.6) and media with 1.5% NaCl for cocci, but on pH 7,4 for corynebacteria.

Hydrophobicity and biofilm formation of lipophilic skin corynebacteria

Lipophilic corynebacteria isolated as natural flora of human skin were examined. Among 119 assayed strains 94% presented a hydrophobic cell surface and 75.6% were able to form biofilms. These attributes, as well as aggregation in liquid media, were statistically connected with each other and promote the developing of biofilms on solid surfaces. This was characteristic of all the lipophilic Corynebacterium species found on human skin that were examined in this study. C. jeikeium and CDC group G2 strains dominated in this population, and they could be responsible for investigated features in the whole lipophilic skin bacterial population. These two groups are the most common coryneform bacteria isolated from nosocomial infections and these attributes most likely promote them to cause opportunistic infections.

Detection of methicillin resistance in hospital environmental strains of coagulase-negative staphylococci

The aim of this study was to evaluate methicillin resistance detection methods currently used when studying coagulase-negative staphylococci (CONS). The resistance to oxacillin of 142 strains from seven species of CoNS isolated from the Intensive Care Unit environments was tested. The methods used were: disc diffusion test with cefoxitin (FOX30) and oxacillin (OX1), oxacillin agar screen test with 6 mg/l of oxacillin (MHOXA), latex test for PBP2a (LA) and detection of mecA via PCR. One hundred and one isolates were methicillin-resistant in at least one of methods used, but only 74 were mecA-positive. Of the 68 mecA-negative strains: two were positive by OX1, the LA and MHOXA methods; three by the LA and MHOXA; and 22 only by OX1 test. Most of these strains were from the novobiocin-resistant CoNS group. The results obtained for all tested strains using FOX30 showed complete concordance with the presence of the mecA gene.

[Influence of testing conditions on the susceptibility results of Staphylococcus cohnii to beta-lactams]

The high occurence of coagulase-negative staphylococci among bacteria responsible for hospital infections is unquestioned. Studies on the poorly-known novobiocin-resistant, coagulase-negative Staphylococcus cohnii were undertaken. The possibilities of optimizing conditions for determination of susceptibility to beta-lactam antibiotics of this species were researched. In the case of S. cohnii the new cefoxitin test for detection of methicillin resistant strains, introduced by the National Reference Centre for Antibiotics in Poland was found as a good and of credible quality. It was also shown, that application in in vitro examination conditions stimulating the mechanisms of resistance to beta-lactam antibiotics, supplies credible results relating to their true susceptibility. The necessity of establishing individual conditions for susceptibility determination in different species of coagulase-negative staphylococci was suggested.

Opportunistic coryneform organisms--residents of human skin

Opportunistic infections are usually caused by endogenic flora originated from physiological flora. In this context we studied coryneform bacteria recovered from deeper layers of epidermis of the forehead (278 isolates) and the back (196 isolates) of healthy men. It was observed that coryneform bacteria are in dynamic equilibrium with coagulase-negative staphylococci and they amount 4,7% of resident aerobic flora. On the base of biological and metabolic features 49 different biotypes were indicated. Biotypes of lipophilic rods were the basic part of coryneform flora existing for long period. The most frequently isolated taxa were C. jeikeium (31%), CDC group G2 (23,4%), next in order CDC group G1 (11%) and C. afermentans ssp. lipophiluni (7%). These isolates were phenotypically differentiated. Nonlipophilic species did not play significant role in creating resident flora of the skin. The significance of coryneform bacteria in opportunistic infections is growing, especially in immunocompromissed patients. Isolated lipophilic taxa belong to these taxa coryneforms which are described in literature as the main etiologic factors of opportunistic infections.

Plasmids ofStaphylococcus cohnii isolated from the intensive-care unit

Numerous isolates of both subspecies of Staphylococcus cohnii were found in the environment of the intensive-care unit of a pediatric hospital. These isolates carried in their cells many plasmids, up to fourteen, of a wide range of sizes (< 2 to > 56 kb). Striking was the occurrence of large plasmids not very common in staphylococci. These were present in > 80% of S. cohnii isolates. Fifty-two different plasmid profiles were found in 79 investigated isolates belonging to S. cohnii ssp. cohnii and S. cohnii ssp. urealyticus. Isolates similar in plasmid profiles were grouped in antibiotic-resistance clusters established for 9 antibiotics (gentamicin, ciprofloxacin, clindamycin, erythromycin, tetracycline, chloramphenicol, mupirocin, trimethoprim-sulfamethoxazole, vancomycin) using the method of unweighted pair group mathematical averages (UPGMA). Many isolates were multiresistant to antibiotics and produced bacteriocins.

Bacteria forming a resident flora of the skin as a potential source of opportunistic infections

Along with progress of medicine, contribution that opportunistic bacteria make in nosocomial infections increases. Coagulase-negative staphylococci are these multiresistant strains which often cause this kind of infections. But more and more frequently other genera of bacteria are isolated. The main source of them is first and foremost the hospitalized patient's endogenous flora e.g. from their skin, because transmission of bacteria from this source is very effective. Analysis was concerned with bacteria that were recovered repeatedly from the skin of young, healthy men during period of five months. Composition of resident bacteria, after removing transients was evaluated. The number of microorganisms per 1 cm2 patients' skin was a constant value but different for each patient. Newly composed media enabled exact isolation and qualitative analysis of all groups of expected bacteria. Isolated microorganisms represented three main groups: sensitive to novobiocin staphylococci, microaerophilic rods from Propionibacterium genus and corynefonn bacteria. Aside from quantitative differences in total bacteria number, significant differences in contribution of aerobic and anaerobic flora living on patient skin were observed. A persistent although not predominant population occurring on the skin of all patients in similar number (average 2%), were coryneform bacteria. They mainly belonged to the Corynebacteriumn genus, and 84.7% of them were the lipophilic species. These bacteria deserve special attention because among such species isolated from nosocomial infections, multiple antibiotic resistance of unknown origin was described.

[Ability of Staphylococcus cohnii strains to adhere to epithelial cells and solid surfaces in the hospital environment]

Presented study describes abilities of staphylococci to adhere to exfoliated cheek and uroepithelial epithelium cells and to various surfaces such as plastics, glass and steel. The subject of the study were strains of Staphylococcus cohnii ssp. cohnii and Staphylococcus cohnii ssp. urealyticus isolated from Intensive Care Unit of Pediatric Hospital. Staphylococcus cohnii ssp.cohnii adhered in great number to epithelial cells. However, the adhesion differed by individual strains. We did not find relationship between slime production and adherence to epithelial cell. Most of investigated strains adhered closely to surfaces--especially of plastics and glass. This phenomenon was stronger in the presence of culture medium and phosphate buffer.

Evaluation of selected features of Staphylococcus cohnii enabling colonization of humans

Based on iron utilization, sensitivity to skin fatty acids, lipolytic and proteolytic activity the potential abilities of Staphylococcus cohnii strains to colonize humans were evaluated. The investigation included 60 strains that belong to both subspecies, viz. S. cohnii ssp. cohnii and S. cohnii ssp. urealyticus. Strains were isolated from different sources of the Intensive Care Unit and from non-hospital environment. Most of the strains were multiple antibiotic-resistant. Strains of both subspecies revealed a relatively low iron requirement. These strains were capable of utilizing iron bound in oxo acids and from host iron-binding proteins. S. cohnii ssp. urealyticus were more effective in iron uptake than S. cohnii ssp. cohnii. All investigated strains revealed sensitivity to skin fatty acids, but S. cohnii ssp. urealyticus strains were more resistant. Special features of strains of this subspecies promote colonization of humans.

Staphylococcus cohnii--resident of hospital environment: cell-surface features and resistance to antibiotics

Staphylococcus cohnii strains dominated in the environment of investigated hospitals. We isolated 420 strains of the species mainly from hospitals environments, but also from infants--Intensive Care Units patients, its medical staff and non-hospital environments. S. cohnii subspecies cohnii was seen to dominate (361 strains). Seventy seven percent of these strains expressed cell-surface hydrofobicity, most of them were slime producers (61%) and this feature was correlated with their methicillin resistance. Among S. cohnii ssp. cohnii strains isolated from ICU environment 90% were resistant to methicillin, 43% expressed high-level resistance to mupirocin and high percentages were resistant to many other antibiotics. These strains may constitute a dangerous reservoir of resistance genes in a hospital.

Predominant staphylococci in the intensive care unit of a paediatric hospital

Coagulase-negative staphylococci cause a significant number of infections, especially in immunocompromised patients, including premature neonates. Nosocomial strains present in the environment create a special risk.We studied staphylococci isolated from the intensive care unit of a paediatric teaching hospital over the period of six months in 1997. Biotyping and species identification were performed; resistance to methicillin and other beta-lactam antibiotics and patterns of resistance to antimicrobial agents were determined. Staphylococcus cohnii was the predominant species of 147 isolates of staphylococci recovered from the ward environment. Strains were resistant to several antibiotics and 97% were resistant to methicillin. In isolates from infants (72) methicillin-resistant strains of Staphylococcus epidermidis were predominant. Susceptibility to beta-lactams (penicillin, amoxycillin, amoxycillin-clavulanic acid and cephalosporins: cephalothin, cefuroxime and cefotaxime) showed differences between the two species. Some S. cohnii were susceptible to penicillin and amoxycillin despite methicillin-resistance. S. epidermidis were relatively susceptible to amoxycillin-clavulanic acid and cephalosporins. All strains investigated were susceptible to vancomycin, but nearly 30% demonstrated high-level resistance to mupirocin. The search for strains of the same origin showed clones belonging to S. epidermidis, S. hominis and S. saprophyticus but not S. cohnii.A large number of multiresistant, phenotypically different S. cohnii strains surviving in the ward environment may provide a reservoir of antimicrobial resistance genes.

Poly-beta-hydroxybutyrate in staphylococci

Staphylococci--chemoorganotrophic bacteria whose main habitats are human and animal organisms--can accumulate poly-beta-hydroxybutyrate (PHB) in their cells. The polymer is metabolized in endogenous turnovers preceding degradation of aminoacids, proteins and RNA. PHB depolymerase was not found in staphylococci but beta-hydroxybutyrate dehydrogenase was estimated, purified and characterized.