Activity of levofloxacin and ciprofloxacin on biofilms and planktonic cells of Stenotrophomonas maltophilia isolates from patients with device-associated infections.

The aim of this work was to compare the in vitro effects of levofloxacin and ciprofloxacin on pre-formed biofilms and planktonic populations of Stenotrophomonas maltophilia isolates from device-associated infections recovered over the period 2004-2008 at a university hospital in Argentina. For planktonic susceptibility studies, the minimum inhibitory concentrations (MICs) of fluoroquinolones were determined by the broth microdilution method. From the 32 isolates recovered, 84.4% were sensitive to levofloxacin and 43.8% were sensitive to ciprofloxacin. Biofilm susceptibility was evaluated by the minimum re-growth concentration (MRC) assay. Stenotrophomonas maltophilia isolates sensitive to fluoroquinolones according to their MICs were highly resistant according to the MRC values. Thus, currently used concentrations of fluoroquinolones cannot be used in monotherapy for eradication of a biofilm. Nevertheless, these agents could be used for the lock technique. Interestingly, for some isolates fluoroquinolone concentrations achievable during therapy caused a reduction in viable cells of 99% and promoted disruption of biofilms, evaluated by spectrophotometric and microscopic analysis. These results suggest that fluoroquinolones, particularly levofloxacin due to its better pharmacokinetic parameters, are candidates for synergy studies.

Biofilm formation by Stenotrophomonas maltophilia isolates from device-associated nosocomial infections / Formación de biopelículas por aislamientos de Stenotrophomonas maltophilia recuperados de infecciones nosocomiales asociadas al uso de dispositivos médicos

Medical devices are often colonized by bacteria which may cause severe infections. The aim of this work was to evaluate biofilm formation by S. maltophilia isolates from device-associated nosocomial infections. The 13 local isolates exhibited different capacities of biofilm formation on hydrophilic and hydrophobic surfaces. All isolates formed strong biofilms in polystyrene microplates, while strong, moderate or weak biofilms were detected in borosilicate (BS) or polypropylene (PP) tubes. The proficiency of biofilm formation was better evaluated by the level of crystal violet staining expressed relative to the final culture density. The microscopic analysis of biofilms formed on glass coverslips revealed the presence of a matrix of exopolysaccharides and microcolonies typical of biofilm architecture. Isolates with increased adhesion to BS showed larger microcolonies. According to our results, twitching correlated well with attachment to the three abiotic surfaces tested, while swimming only showed a slight correlation with biofilm formation on PP. Poor correlation was observed between cell surface hydrophobicity and biofilm formation. One of the highest biofilm-producing isolates adhered to urethral catheters of different materials, and exhibited an increased resistance to oxidative stress, one of the common stresses encountered by bacteria during the infection process due to the immune response.

El objetivo de este trabajo fue evaluar la formación de biopelículas por parte de aislamientos de Stenotrophomonas maltophilia. Los 13 aislamientos locales evaluados mostraron diferente capacidad de formar biopelículas en superficies hidrofílicas e hidrofóbicas. Todos ellos formaron biopelículas fuertes en microplacas de poliestireno (PS), mientras que se observaron biopelículas fuertes, moderadas o débiles en tubos de borosilicato (BS) o polipropileno (PP). La medida del cristal violeta unido a la biopelícula expresada en función de la densidad final de los cultivos permitió una mejor evaluación de la eficiencia de formación de biopelículas. El análisis microscópico de biopelículas formadas sobre cubreobjetos mostró la presencia de una matriz de exopolisacáridos y microcolonias típicas de la arquitectura de las biopelículas. Los aislamientos con mayor adhesión a BS mostraron microcolonias de mayor tamaño. La motilidad asociada a superficies ( twitching) presentó buena correlación con la adhesión a BS, PP y PS, mientras que la motilidad asociada a flagelos solo correlacionó ligeramente con la adhesión a PP. La correlación entre la hidrofobicidad de la superficie bacteriana y la formación de biopelículas fue escasa. Uno de los aislamientos productores de biopelículas fuertes evidenció capacidad de adhesión a catéteres uretrales de diferentes materiales y mayor resistencia al estrés oxidativo.

Biofilm formation by Stenotrophomonas maltophilia isolates from device-associated nosocomial infections.

Medical devices are often colonized by bacteria which may cause severe infections. The aim of this work was to evaluate biofilm formation by S. maltophilia isolates from device-associated nosocomial infections. The 13 local isolates exhibited different capacities of biofilm formation on hydrophilic and hydrophobic surfaces. All isolates formed strong biofilms in polystyrene microplates, while strong, moderate or weak biofilms were detected in borosilicate (BS) or polypropylene (PP) tubes. The proficiency of biofilm formation was better evaluated by the level of crystal violet staining expressed relative to the final culture density. The microscopic analysis of biofilms formed on glass coverslips revealed the presence of a matrix of exopolysaccharides and microcolonies typical of biofilm architecture. Isolates with increased adhesion to BS showed larger microcolonies. According to our results, twitching correlated well with attachment to the three abiotic surfaces tested, while swimming only showed a slight correlation with biofilm formation on PP. Poor correlation was observed between cell surface hydrophobicity and biofilm formation. One of the highest biofilm-producing isolates adhered to urethral catheters of different materials, and exhibited an increased resistance to oxidative stress, one of the common stresses encountered by bacteria during the infection process due to the immune response.

Identification of Bordetella pertussis virulence-associated outer membrane proteins.

Bordetella pertussis virulence-associated 30-, 32-, 90- and 95-kDa outer membrane proteins were purified and their N-terminal amino acid sequences were determined. The 30- and 32-kDa outer membrane proteins showed identity to the C-terminal region of the precursors of the serum resistance protein (BrkA) and the tracheal colonization factor, respectively. We confirmed the cleavage site of these precursors after N731 for BrkA and after N393 for tracheal colonization factor. Associated with the 32-kDa outer membrane protein, we found a new group of 36-kDa virulence-associated peptides. The 95-kDa outer membrane protein showed identity to Vag8. The 90-kDa outer membrane protein did not show homology with the described proteins. We report the N-termini sequence of Vir-90, a novel potential virulence factor.

Selección de variantes Bvg- de Bordetella pertussis / Selection of Bordetella pertussis Bvg- variants

Las cepas virulentas (Bvg+) de Bordetella pertussis expresan numerosos factores de virulencia. Estos factores están regulados por el locus bvg en respuesta a estímulos ambientales, a través del proceso reversible de modulación antigénica. A su vez, mutaciones en el locus bvg originan variantes avirulentas (Bvg-) que no expresan factores de virulencia en ninguna condición de cultivo. En este trabajo hemos seleccionado variantes espontáneas Bvg- de B. pertussis Tohama I y 10536, potencialmente útiles para el estudio de marcadores de virulencia, utilizando como medios selectivos Stainer-Scholte agarizado suplementado con 1 o/o de Casamino-acids (SSA-CAS) y Jones-Kendrick con 0,20 microgramos/ml de eritromicina (JK-Ery). Paralelamente hemos estudiado la eficiencia de recuperación de células de B. pertussis Tohama 1, 10536 y 40103 (cepas Bvg+) y de la cepa Bvg- 347 (control del fenotipo avirulento) en SSA-CAS y en Steiner-Scholte agarizado (SSA), y analizado el fenotipo de las células recuperadas a partir de ellos. Para la caracterización fenotípica se utilizaron los siguientes marcadores de fase virulenta: producción de hemólisis, producción de hemaglutininas y perfiles de proteínas de fracciones enriquecidas en membrana externa. Las tres cepas Bvg+ ensayadas mostraron diferente comportamiento en estos medios. B. pertussis Tohama 1 y 10646 no crecieron en SSA, mientras que la eficiencia de recuperación en el medio SSA-CAS fue inferior al 0,001 o/o, obteniéndose variantes Bvg- estables de la cepa Tohama 1, en cambio la cepa 10536 sufrió el fenómeno de modulación, ya que recuperó el fenotipo virulento al ser subcultivada en Bordel-Gengou. El medio JK-Ery permitió seleccionar variantes Bvg- estables de B. pertussis Tohama 1 y 10536. B. pertussis 40103 mostró alta eficiencia de recuperación en SSA y SSA-CAS y retuvo el fenotipo virulento en todos los medios ensayados. Por otra parte, B. pertussis 347, a pesar de ser avirulenta, presento una eficiencia de recuperación pobre en SSA y un crecimiento escaso en JK-Ery, corroborando que no todas las cepas Bv- adquieren la capacidad de crecer en medios que resultan inhibitorios para muchas cepas virulentas

Selección de variantes Bvg- de Bordetella pertussis / Selection of Bordetella pertussis Bvg- variants

Las cepas virulentas (Bvg+) de Bordetella pertussis expresan numerosos factores de virulencia. Estos factores están regulados por el locus bvg en respuesta a estímulos ambientales, a través del proceso reversible de modulación antigénica. A su vez, mutaciones en el locus bvg originan variantes avirulentas (Bvg-) que no expresan factores de virulencia en ninguna condición de cultivo. En este trabajo hemos seleccionado variantes espontáneas Bvg- de B. pertussis Tohama I y 10536, potencialmente útiles para el estudio de marcadores de virulencia, utilizando como medios selectivos Stainer-Scholte agarizado suplementado con 1 o/o de Casamino-acids (SSA-CAS) y Jones-Kendrick con 0,20 microgramos/ml de eritromicina (JK-Ery). Paralelamente hemos estudiado la eficiencia de recuperación de células de B. pertussis Tohama 1, 10536 y 40103 (cepas Bvg+) y de la cepa Bvg- 347 (control del fenotipo avirulento) en SSA-CAS y en Steiner-Scholte agarizado (SSA), y analizado el fenotipo de las células recuperadas a partir de ellos. Para la caracterización fenotípica se utilizaron los siguientes marcadores de fase virulenta: producción de hemólisis, producción de hemaglutininas y perfiles de proteínas de fracciones enriquecidas en membrana externa. Las tres cepas Bvg+ ensayadas mostraron diferente comportamiento en estos medios. B. pertussis Tohama 1 y 10646 no crecieron en SSA, mientras que la eficiencia de recuperación en el medio SSA-CAS fue inferior al 0,001 o/o, obteniéndose variantes Bvg- estables de la cepa Tohama 1, en cambio la cepa 10536 sufrió el fenómeno de modulación, ya que recuperó el fenotipo virulento al ser subcultivada en Bordel-Gengou. El medio JK-Ery permitió seleccionar variantes Bvg- estables de B. pertussis Tohama 1 y 10536. B. pertussis 40103 mostró alta eficiencia de recuperación en SSA y SSA-CAS y retuvo el fenotipo virulento en todos los medios ensayados. Por otra parte, B. pertussis 347, a pesar de ser avirulenta, presento una eficiencia de recuperación pobre en SSA y un crecimiento escaso en JK-Ery, corroborando que no todas las cepas Bv- adquieren la capacidad de crecer en medios que resultan inhibitorios para muchas cepas virulentas (AU)

Flagellin, a major protein present in SDS-PAGE profiles of Sarkosyl-OMP-enriched fractions from Bordetella bronchiseptica Bvg- or modulated Bvg+ strains.

The bvg or vir locus positively regulates the expression of many Bordetella virulence-associated determinants (encoded by vag genes), including cell envelope proteins, in response to environmental stimuli. On the other hand, several genes named vrg genes are negatively controlled by the bvg regulon (Knapp and Mekalanos, 1988). Flagellin is encoded by a vrg gene, which is expressed when the principal virulence factors are eliminated during antigenic modulation or in phase variants (Akerley et al., 1992). We have previously analyzed SDS-PAGE profiles of Sarkosyl-outer membrane protein (OMP)-enriched fractions from B. bronchiseptica Bvg- and modulated Bvg+ strains and reported a major band associated with the avirulent phenotype (Passerini de Rossi et al., 1995). In order to characterize this band we have purified flagellar filaments from Bvg- and modulated Bvg+ strains, and analyzed them by SDS-PAGE. These profiles revealed a single major band of 40 or 45 kDa depending on the strain. The N-terminal amino acid sequence of the putative flagellin expressed by BB7200a was identical over the first 21 residues analyzed to that of the flagellin from the modulated strain BB7865 reported by Akerley et al. (1992). Comparison of the SDS-PAGE profile of flagellar filaments with that of the OMP-enriched fraction of the corresponding strain showed that the flagellum-associated polypeptide had the same electrophoretic mobility as that of the characteristic band of the avirulent phenotype. Furthermore, this band was absent in the OMP-enriched fraction profile from a Bvg- strain subjected to a treatment that removes flagella. Our results indicate that the major protein observed in SDS-PAGE profiles of Sarkosyl-OMP-enriched fractions from B. bronchiseptica Bvg- and modulated Bvg+ strains corresponds to flagellin.

[Selection of Bvg- variants of Bordetella pertussis]. / Selección de variantes Bvg- de Bordetella pertussis.

Bordetella pertussis virulent strains (Bvg+) produce a wide array of virulence factors. The production of these factors is coordinately regulated by the locus bvg in response to environmental signals in a process known as antigenic modulation. Mutations in the bvg locus originate avirulent variants (Bvg-) that are unable to express virulence factors regardless of growth conditions. In this paper we have obtained spontaneous variants Bvg- of B. pertussis Tohama I and 10536, which would be useful for studying virulence markers, using the selective media Stainer-Scholte agar supplemented with 1% Casamino-acids (SSA-CAS) and Jones-Kendrick with 0.20 microgram of erythromycin per ml (JK-Ery). We have also studied the efficiency of plating of B. pertussis Tohama I, 10536 and 40103 cells (Bvg+ strains) and of Bvg- strain 347 (control of the avirulent phenotype) on SSA-CAS and Stainer-Scholte agar (SSA), and we have analyzed the phenotype of the cells recovered from these media. The bacterial phenotype was characterized by using the following virulence markers: hemolysis production, hemagglutinin production, and outer membrane protein (OMP) enriched profiles. The three Bvg+ strains showed different behaviour in these selective media. B. pertussis Tohama I and 10536 could not be recovered on SSA, whereas on SSA-CAS the efficiency of plating was poor, less than 0.001%, but nevertheless allowed the selection of stable Bvg- variants of Tohama I since the OMP profile of this stain did not change after subculture in Cyclodextrin liquid medium. By contrast, strain 10536 grown on SSA-CAS suffered the process of antigenic modulation since this strain recovered the virulent phenotype when it was subcultured in Bordet-Gengou. Stable Bvg- variants from Tohama I and 10536 were obtained on JK-Ery. On the other hand, Bvg+ strain 40103 showed a high efficiency of plating on SSA and SSA-CAS and retained the virulent phenotype in all the selective media. Bvg- strain 347, in spite of being an avirulen variant, showed a poor efficiency of plating in SSA and a scant growth in JK-Ery, in agreement with the findings of other investigators which suggest that not all avirulent strains posses the ability to grow on media that inhibit most of virulent strains.