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A special morphogenetic wall defect and the subsequent activity of "murosomes" as the very reason for penicillin-induced bacteriolysis in staphylococci.

The actual reason for the penicillin-induced bacteriolysis of staphylococci was shown to be the "punching" of one or a few minute holes into the peripheral cell wall at predictable sites. These perforations were the result of the lytic activity of novel, extraplasmatic vesicular structures, located exclusively within the bacterial wall material, which we have named "murosomes". In untreated staphylococci the punching of holes into the peripheral wall is a normal process which follows cross wall completion and represents the first visible step of cell separation. Under penicillin, however, analogous holes are punched by the murosomes at sites of presumptive cell separation even if no sufficient cross wall material had been assembled before at this site (but had rather been deposited at other sites). Consequently, because of the internal pressure of the protoplast, lytic death is the inevitable result of this perforation of the protective peripheral wall. Hence, the real mechanism of penicillin-induced bacteriolysis in staphylococci is considered to be mainly the result of a special morphogenetic wall defect: bacteriolysis is taking place regularly when a cell separation process is no longer preceeded by sufficient cross wall assembly at the correct place. However, hypotheses which are based purely on some variations of overall biochemical processes like total wall enzyme activities or total wall synthesis are not regarded to be sufficient to explain this type of lytic death.

Bacteriolysis↗

Response of Escherichia coli to Beta-lactam antibiotics: effect of the concomitant presence of staphylococci exhibiting inducible Beta-lactamase activity.

The response to Beta-lactam antibiotics of mixed cultures of Escherichia coli and Staphylococcus epidermidis was studied in static culture and in an in vitro model which simulates the dynamic conditions in which bacteria are exposed to antibiotics in the treatment of urinary infection. In static cultures, the concomitant presence of staphylococci exhibiting inducible Beta-lactamase activity substantially reduced the efficacy of benzylpenicillin and ampicillin (but not cefuroxime) against E. coli. In the conditions of the bladder model some interference with the activity of Beta-lactam antibiotics by Beta-lactamase producing staphylococci was also demonstrated. Nevertheless, relatively modest doses of ampicillin were still able to suppress growth of susceptible E. coli for periods exceeding the normal interdose interval, even in the presence of enzyme-producing staphylococci.

Ampicillin↗

Increased oxacillin activity associated with glycopeptides in coagulase-negative staphylococci.

Vancomycin resistance in methicillin-resistant staphylococci presents a potential therapeutic problem. In order to understand the impact of low-level vancomycin resistance in coagulase-negative staphylococci, stepwise selection of vancomycin resistance was accomplished by growing Staphylococcus haemolyticus in culture media with increasing concentrations of vancomycin. A >40-fold increase in susceptibility to beta-lactam antibiotics was observed. No obvious alterations in the growth curve, the presence of the mecA gene, total DNA restriction fragment length polymorphism (RFLP), beta-lactamase production, or the crude protein fraction were detected in the Staphylococcus haemolyticus-derived clones when compared to the original isolate. The proportion of the oxacillin-heteroresistant population also remained similar. A comparable phenomenon occurred with the selection of Staphylococcus epidermidis exhibiting low-level resistance to vancomycin. Additionally, it was observed that clinical isolates of coagulase-negative staphylococci grown in the presence of sub-minimum inhibitory concentrations of either vancomycin or teicoplanin lost their high-level resistance to oxacillin. Checkerboard tests showed that the combination of vancomycin and oxacillin was synergistic for two isolates of Staphylococcus haemolyticus, two of four isolates of Staphylococcus epidermidis, and one isolate of Staphylococcus hominis.

Anti-Bacterial Agents↗

Antimicrobial activity of josamycin against erythromycin-resistant staphylococci as compared to roxythromycin and clarithromycin.

In an in vitro study 246 clinical isolates of erythromycin-resistant staphylococci from six hospitals in Austria were investigated for susceptibility to josamycin and other, newer macrolide antibiotics, e.g. roxithromycin and clarithromycin. 71 strains of Staphylococcus aureus showed an MIC > or = 4 mg/l and 100 strains of S. aureus showed an MIC > or = 256 mg/l. In addition, 25 strains of coagulase-negative staphylococci resistant to erythromycin at an MIC of > or = 4 mg/l were investigated. At an MIC of 2 mg/l 57% of the erythromycin-resistant strains of S. aureus were inhibited by josamycin, 25% by clarithromycin and 11.6% by roxithromycin. At an MIC of 2 mg/l 13.3% of erythromycin-resistant coagulase-negative staphylococci were inhibited by josamycin, 10.7% by clarithromycin and 9.3% by roxithromycin. This study suggests that josamycin is still active in vitro against more than 50% of erythromycin-resistant strains of S. aureus. This drug is also more active than roxithromycin and clarithromycin against erythromycin-resistant S. aureus.

Clarithromycin↗

Typing of coagulase-negative staphylococci by Southern hybridization of chromosomal DNA fingerprints using a ribosomal RNA probe.

Ribotyping consists of restriction endonuclease fingerprinting of ribosomal RNA (rRNA) genes visualized by Southern hybridization with an rRNA probe. This method was developed and compared with restriction endonuclease fingerprinting of chromosomal DNA for typing coagulase-negative staphylococci. Twenty-five American Type Culture Collection reference type strains and 53 clinical isolates were typed. Both methods clearly distinguished all 15 species of coagulase-negative staphylococci and most individual strains within each species. Except in the case of Staphylococcus warneri, ribotyping was most discriminating with the use of ClaI, one of eight endonucleases tested. HpaI and AvaI were more specific than ClaI for discrimination between strains of Staphylococcus warneri. The patterns produced by ribotyping were much simpler and thus easier to interpret than corresponding chromosomal fingerprints. However, ribotyping was slightly less discriminating. It is concluded that ribotyping offers an alternative method for molecular typing of coagulase-negative staphylococci. The application of both methods needs to be further evaluated in the clinical setting.

Bacterial Typing Techniques↗

Prevalence of Staphylococcus aureus and coagulase-negative staphylococci with decreased sensitivity to glycopeptides as assessed by determination of MICs.

The prevalence of staphylococci with decreased sensitivity to glycopeptides was assessed at a Paris hospital by determination of the MICs. The values obtained using the MIC method were compared to those obtained using the routine disk agar diffusion method. One hundred independently isolated strains were tested including 57 Staphylococcus aureus isolates and 43 coagulase-negative staphylococci (CNS). For all strains vancomycin MICs were less than or equal to 4 mg/l but for 5.3% of the Staphylococcus aureus isolates and 25.6% of the CNS isolates teicoplanin MICs were high (greater than or equal to 8 mg/l). Moreover, teicoplanin MICs did not correlate well with zone sizes. The MIC method is therefore recommended for evaluating the susceptibility of staphylococci to teicoplanin.

Anti-Bacterial Agents↗

Prevalence of antibiotic resistance among clinical isolates of methicillin-resistant staphylococci.

The prevalence of methicillin-resistant and multiply antibiotic-resistant staphylococci causing infections in hospitalized patients was studied over a two-year period. Among 122 clinically significant staphylococci, the prevalence of methicillin resistance was 66%, with a higher prevalence of Staphylococcus haemolyticus (85%) and Staphylococcus epidermidis (83%) observed than of Staphylococcus aureus (49%). Multiple antibiotic resistance was observed more frequently among coagulase-negative staphylococcus (52 to 70%) than among Staphylococcus aureus (17%). All strains of methicillin-resistant Staphylococcus aureus were susceptible to glycopeptide antibiotics and to trimethoprim-sulfamethoxazole, whereas approximately 50% of coagulase-negative staphylococci exhibited either moderate susceptibility or resistance to teicoplanin. For these latter strains, vancomycin remains the agent of choice, whereas teicoplanin cannot be recommended unless its efficacy is established by MIC determination.

Anti-Bacterial Agents↗

Distribution of coagulase-negative staphylococci, including the newly described species Staphylococcus schleiferi, in nosocomial and community acquired urinary tract infections.

Four hundred and four coagulase-negative staphylococci were isolated from 4905 urine specimens obtained from 4192 inpatients and outpatients. The distribution of the strains was as follows: 193 Staphylococcus epidermidis (47.8%), 171 Staphylococcus saprophyticus (42.3%), 29 Staphylococcus haemolyticus (7.2%), 5 Staphylococcus warneri (1.2%), 3 Staphylococcus schleiferi (0.7%), 2 Staphylococcus hominis (0.5%) and 1 Staphylococcus simulans (0.2%). All three Staphylococcus schleiferi strains were isolated from inpatients: a 64-year-old female, a 68-year-old male and a 3-month-old male with colony counts of 468,000 cfu/ml, 324,000 cfu/ml and 764,000 cfu/ml respectively. These findings show that among coagulase-negative staphylococci, Staphylococcus schleiferi, a newly described species of coagulase-negative staphylococci not previously reported as a uropathogen, may also cause hospital acquired urinary tract infection.

Aged↗

The role of glycosaminoglycan binding of staphylococci in attachment to eukaryotic host cells.

Attachment of microorganisms to host cells is believed to be a critical early step in microbial pathogenesis. The aim of the study was to determine the role of the known glycosaminoglycan (GAG) binding activity of Staphylococcus aureus and coagulase-negative staphylococci (CoNS) in their attachment to six different eukaryotic cell lines. Three staphylococcal species expressing GAG binding capacity-S. aureus, S. epidermidis, and S. hemolyticus-were chosen for investigation. Six different eukaryotic cell lines, endothelial HUVEC and EA. hy 926 cells, epithelial A549 and HeLa S3 cells, fibroblasts HEL Sp 12 and macrophages J774.A1, were included. A modified ELISA with biotinylated bacteria was used for estimating the adhesion of staphylococci to each of the cell lines. Our results showed that staphylococci adhered to each of the cell lines studied, although the binding of CoNS strains to epithelial cells was lower than to the other cells. The attachment to all cell types could be partially decreased by pretreatment of the bacteria with various polysulfated agents (highest inhibition was 60%), as well as by chlorate and heparitinase treatment of the cells. These observations may suggest that at least one mode of staphylococcal attachment utilizes GAG chains present on the surface of virtually all adherent cells.

Animals↗

Genomic diversity and resistance determinants of staphylococci from cow and buffalo milk.

BACKGROUND: Staphylococci are important mastitis pathogens in dairy animals and serve as reservoirs of antimicrobial resistance genes (ARGs) having zoonotic potential. Genomic characterization of resistant isolates is essential to understand their diversity, resistance mechanisms, and One Health implications. METHODS AND RESULTS: A total of 363 cow and buffalo milk samples-including 108 from animals with mastitis-were screened, yielding 98 staphylococcal isolates, comprising 20 Staphylococcus aureus and 78 coagulase-negative staphylococci (CoNS). Antimicrobial susceptibility testing revealed resistance to cefoxitin (CoNS: 21.7%; S. aureus: 10%), tetracycline (CoNS: 19.2%; S. aureus: 10%), erythromycin (CoNS:16.7%; S. aureus: 10%), gentamicin (CoNS: 10.2%; S. aureus: 10%) and fluoroquinolone (CoNS: 10.2%), while the majority were sensitive to chloramphenicol, cotrimoxazole (~ 95%, each), linezolid (~ 97%), and vancomycin (100%). Nineteen isolates, including two S. aureus, were cefoxitin-resistant, and eight carried the mecA gene. Whole genome sequencing of these eight isolates revealed genome sizes ranging from 2.27 to 2.78 MB, with the methicillin resistant S. aureus (MRSA, ERSST98) isolate possessing the largest genome and the highest rRNA copy number. Comparative genomic analysis revealed various SCCmec types along with an extensive array of resistance determinants, encompassing aminoglycosides, macrolides, tetracyclines, efflux systems, and heavy metals, underscoring the multifaceted resistance repertoire of these strains. Virulence profiling of ERSST98 demonstrated a broad arsenal of adhesins, toxins, and biofilm‑associated genes, highlighting its pathogenic capacity. Mobile genetic elements with diverse plasmid replicons and insertion sequence families further contributed to genomic plasticity. CONCLUSIONS: Collectively, this study underscores the genomic diversity of methicillin-resistant staphylococci from dairy animals with extensive resistance determinants and highlights their zoonotic relevance within One Health framework.

Animals↗

Coagulase-negative staphylococci as nosocomial pathogens in neonates. The role of host defense, artificial devices, and bacterial hydrophobicity.

In contrast to the well-established pathogen Staphylococcus aureus, the coagulase-negative staphylococci--formerly collectively called Staphylococcus epidermidis--were until recently regarded as harmless commensals. During the last two decades, however, the coagulase-negative staphylococci have clearly emerged as pathogens in patients who have artificial devices implanted, such as prosthetic heart valves, hip prostheses, and cerebrospinal fluid shunts, and in those with compromised host defenses such as premature neonates, cancer patients, and transplant recipients. Recently, an increasing incidence of septicemia due to coagulase-negative staphylococci was detected in our neonatal intensive care unit. More than 90 percent of cases occurred in premature infants of low birth weight (less than 2,500 g). All septicemic infants were receiving intravenous therapy, and total parenteral nutrition solutions had been administered to nearly 80 percent just before or during the septic episode. This led us to examine the role of host defense factors in neonates and the possible significance of bacterial surface characteristics in the pathogenesis of catheter-associated infections.

Adhesiveness↗

Native valve endocarditis due to coagulase-negative staphylococci. Clinical and microbiologic features.

Twenty-one patients with native valve endocarditis caused by coagulase-negative staphylococci were studied; 14 had pre-existing valvular or congenital heart disease. Although commonly subacute in presentation, complications of endocarditis were frequent: arterial emboli in five patients, new electrocardiographic conduction system abnormalities in nine, congestive heart failure in eight, annular or myocardial abscesses in five, and disruption of valve leaflets in three. Cures were achieved in 10 of 12 patients treated medically and seven of nine treated surgically. In microbiologic studies of 16 coagulase-negative staphylococci from patients with endocarditis, only eight were identified as Staphylococcus epidermidis. All isolates were susceptible to vancomycin. Antibiotic resistance (methicillin, four isolates; gentamicin, two isolates; rifampin, one isolate) was usually associated with nosocomial acquisition of endocarditis. Rather than representing contamination, coagulase-negative staphylococci in blood cultures may indicate life-threatening endocarditis. However, with careful attention to the selection of antibiotics for therapy and to the occurrence of heart failure due to intracardiac complications, treatment of this form of endocarditis is frequently successful. Organisms must always be tested for cryptic resistance to beta-lactam antibiotics. Valve replacement may be required frequently.

Anti-Bacterial Agents↗

Pathogenicity of different species of staphylococci in caprine udder.

Aseptic foremilk samples were collected from Finnish landrace goats. Ten different species of staphylococci, causing subclinical infections were detected. Twelve goats with persistent subclinical staphylococcal infection were followed on a monthly basis and compared with foremilk samples of nine goats suffering from clinical mastitis. Parameters of inflammation based on the activity of the California Mastitis Test (CMT). N-acetyl-beta-D-glucosaminidase (NAGase) and antitrypsin were determined from the milk. Staphylococci were further classified using the API STAPH system. On the basis of elevations of activities of CMT, NAGase and antitrypsin, Staphylococcus aureus was the most pathogenic in clinical and subclinical mastitis, S. hyicus showed only marginal pathogenicity. Subclinical infections were persistent and the infective organism was not always detected from milk by culture. The biochemical reactions of subclinical staphylococci seemed to vary within the same gland by time. Antitrypsin was most effective in differentiating between subclinical and clinical infection. A teat cistern puncture technique was found to be suitable for the goat.

Animals↗

Inhibition of thymidine uptake by staphylococci, a new method for the investigation of phagocytosis.

A radioassay employing (3H) thymidine, to measure inhibition of growth of Staphylococcus aures by human phagocytes is presented. The principle of this new method is that viable and dividing staphylococci take up thymidine more rapidly than white cells, so that whereas in control cultures containing staphylococci alone high counts per minute (cpm) are obtained within 90 min of incubation in test cultures both leucocytes and plasma from 25 normal subjects reduced the cpm, following ingestion and killing of staphylococci.

Blood Cell Count↗

Comparison of methods for routine separation of coagulase-negative staphylococci from micrococci isolated from sheep.

A total of 176 Gram-positive, catalase positive cocci strains, isolated from sheep were studied by different routine tests for the differentiation of staphylococci and micrococci, comparing their validity and usefulness. By glucose fermentation and growth in the anaerobic portion of thioglycolate 85 and 73.6% respectively of coagulase negative staphylococci were misclassified as Micrococcus spp. Susceptibility to lysostaphin was an adequate test for the differentiation of the strains. Atypical results in the production of acid from glycerol/erythromycin were obtained in 11.8% of the coagulase negative strains and 16.7% of micrococci. The combined use of the selective media furazolidone agar and Schleifer and Krämer medium resulted in a fast and useful separation of ovine staphylococci and micrococci. The bacteriolytic activity misclassified 32.2% of the coagulase negative strains.

Animals↗

Disk diffusion interpretive criteria for fusidic acid susceptibility testing of staphylococci by the National Committee for Clinical Laboratory Standards method.

Fusidic acid is used in many countries for the treatment of multiresistant staphylococcal infection, especially multiresistant Staphylococcus aureus infection (MRSA). We collected consecutive fusidic acid-resistant isolates of staphylococci from the routine laboratory over several years, and compared these strains with fusidic acid-susceptible staphylococci to establish interpretive criteria for disk diffusion testing by National Committee for Clinical Laboratory Standards (NCCLS) methods. The minimum inhibitory concentrations (MICs) and zone diameters for strains of S. aureus (n = 102), including MRSA, S. saprophyticus (n = 20) and other coagulase-negative staphylococci (n = 115) were determined by NCCLS agar dilution and disk diffusion tests using a 2.5-micrograms disk of fusidic acid. MICs were bimodally distributed. No isolates had MICs of 0.5 or 1 microgram/ml; thus, we chose these values to define strains of intermediate susceptibility. The error-rate-bounded method was used to determine interpretive zone diameters for disk testing. Interpretive zone diameter criteria were found to be: susceptible > or = 22 mm, intermediate 18-21 mm, and resistant < or = 17 mm. All S. saprophyticus were intrinsically resistant to fusidic acid (MIC > or = 2 micrograms/ml).

Anti-Bacterial Agents↗

Neuraminidase produces dose-dependent decrease of slime production and adherence of slime-forming, coagulase-negative staphylococci.

BACKGROUND: Slime is one of the important structures of certain bacterial strains involved in nonspecific adherence. This study was conducted to determine the role of neuraminidase on slime formation and adherence of slime-forming coagulase-negative staphylococci to inert surface. METHODS: Quantitative biofilm and qualitative bacterial adherence assays were performed with increasing concentrations of neuraminidase extracted from Clostridium perfringens-treated bacteria in polystyrene plates and polypropylene tubes. RESULTS: Slime production of slime-forming, coagulase-negative staphylococci was significantly decreased dose dependently at > or =100 mU/mL (p <0.001). Bacterial adherence to smooth surface was impeded at > or =100 mU/mL of neuraminidase treatment and adherence results were comparable with slime production assay results. CONCLUSIONS: Sialic acid may be a constituent molecule of slime and involved in bacterial adherence to inert surface. These results represent new insight into the mechanism of slime production and adherence of slime-forming, coagulase-negative staphylococci to inert surface.

Animals↗

A new test of disk-diffusion to help in staphylococci identification.

A modified carbohydrate fermentation test (MCFT) of disk-diffusion assay was performed using a peptone-free agar medium, in order to improve the identification of clinical staphylococci species. Results were compared with the standard method of carbohydrate fermentation in tubes (SCFT) containing methyl red broth. MCFT was able to identify correctly 12 different species of staphylococci from the ATCC collection and 646 clinical isolates. MCFT showed sensitivity between 91.6% and 100% and specificity between 99.6% and 100%, for the different carbohydrates studied. MCFT could replace the SCFT, with the evident advantage of reducing time for materials preparation. The method presented herein is easy to perform in clinical or research microbiology laboratories, because it can differentiate species of staphylococci.

Bacterial Typing Techniques↗