Characterization of a novel staphylococcal cassette chromosome composite island from community-associated MRSA isolated in aged care facilities in Western Australia.

BACKGROUND: In Western Australia (WA), clonal complex 5, ST835, community-associated (CA) MRSA is isolated almost exclusively from aged care facilities. In WA four different staphylococcal cassette chromosome (SCC) mec (SCCmec) elements have been identified in this ST, indicating high genetic activity in the SCCmec region. OBJECTIVES: To investigate the SCC region of ST835 CA-MRSA WA MRSA-40 and determine the distribution of an SCCsorbitol element found within the region. RESULTS: The SCC region contained a composite island, SCCmecWA MRSA-40-CI, that was composed of three elements, ΨSCCpls, SCCsorbitol and SCCmecVT (5C2&5). This is the first time that a sorbitol operon has been reported in an SCC element. CONCLUSIONS: Generation of SCCmecWA MRSA-40-CI has involved multiple genetic events and recombination with CoNS has occurred during evolution of the SCC elements. While Staphylococcus aureus is renowned for its ability to utilize mobile genetic elements to disseminate antimicrobial resistance, the SCC region of WA MRSA-40 shows that this clone has also utilized SCC elements to acquire extra virulence and possibly adapt to a niche environment.

Staphylococcus aureus plasmids without mobilization genes are mobilized by a novel conjugative plasmid from community isolates.

OBJECTIVES: To describe a family of conjugative plasmids isolated from colonizing community Staphylococcus aureus and determine their ability to mobilize unrelated antimicrobial resistance/virulence plasmids, not encoding mobilization functions. METHODS: Plasmid pWBG749 was labelled with Tn551 (pWBG749e) to enable laboratory manipulation. Plasmid pWBG749e was conjugated into S. aureus of seven different lineages that harboured unrelated plasmids and mobilization experiments were performed. Plasmids were screened by EcoRI restriction and hybridization with probes prepared from unique pWBG749 conjugation genes. RESULTS: Conjugative plasmids pWBG745, pWBG748 and pWBG749 belong to the same conjugative-plasmid family as the vancomycin resistance plasmid pBRZ01. Plasmid pWBG749e mobilized five unrelated plasmids. Mobilized plasmid pWBG744 is a pIB485-family plasmid that was also found in international S. aureus. CONCLUSIONS: Plasmid pWBG749e can mobilize unrelated S. aureus plasmids whose means of dissemination have not previously been understood.

Population dynamics of methicillin-susceptible and -resistant Staphylococcus aureus in remote communities.

OBJECTIVES: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was first reported in remote regions of Western Australia (WA) in 1992 and is now the predominant MRSA isolated in the State. To gain insights into the emergence of CA-MRSA, 2146 people living in 11 remote WA communities were screened for colonization with S. aureus. METHODS: Antibiogram analysis, contour-clamped homogeneous electric field electrophoresis, multilocus sequence typing, Panton-Valentine leucocidin determinant detection and accessory genetic regulator typing were performed to characterize the isolates. MRSA was further characterized by staphylococcal cassette chromosome mec typing. RESULTS: The S. aureus population consisted of 13 clonal complexes and two Singleton lineages together with 56 sporadic isolates. Five lineages contained MRSA; however, these were not the predominant methicillin-susceptible S. aureus (MSSA) lineages. There was greater diversity amongst the MSSA while the MRSA appeared to have emerged clonally following acquisition of the staphylococcal cassette chromosome mec. Three MRSA lineages were considered to have been endemic in the communities and have subsequently become predominant lineages of CA-MRSA in the wider WA community. People colonized with MSSA tended to harbour clones of a different genetic lineage at each anatomical site while people colonized with MRSA tended to harbour clones of the same lineage at each site. Overall, the isolates were resistant to few antimicrobials. CONCLUSIONS: Although the evidence suggests that in WA CA-MRSA strains arose in remote communities and have now disseminated into the wider community, there is no evidence that they arose from the predominant MSSA clones in these communities.

Genetic lineages of community-associated methicillin-resistant Staphylococcus aureus in Kuwait hospitals.

Twenty-six community-associated methicillin-resistant Staphylococcus aureus (CAMSRA) isolates were characterized by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) and screened for accessory gene regulator (agr), capsular polysaccharide (cap), and Panton-Valentine leucocidin (PVL) genes. They exhibited five PFGE patterns (types A to E). The majority were PFGE type A (12 isolates) or type B (8 isolates). MLST showed that PFGE type A isolates belonged to sequence type 80 (ST80), while the PFGE type B isolates were ST30. The ST80 and ST30 clones contained agr allotype 3, cap type 8, and PVL. The results showed that two internationally recognized CAMRSA clones are dominant in Kuwait hospitals.

Difference spectroscopic characterisation of the cytochrome complement in Acanthocheilonema viteae.

(Dithionite-reduced) minus (ferricyanide-oxidised) difference spectra of 600 x g and 12,000 x g subcellular pellet fractions of adult male Acanthocheilonema viteae exhibited alpha-absorption maxima (296 K) attributable to Cyt c555, Cyt b562 and aa3 (600-605 nm). The gamma(Soret) maximum of both fractions was evident at 427 nm, with a shoulder at 432-434 nm. 600 x g and 12,000 x g pellet fractions of adult female and mixed-sex adult A. viteae exhibited similar absorption maxima. (Succinate-reduced)--(ferricyanide-oxidised) difference spectra of the 12,000 x g pellet fraction of mixed-sex adult A. viteae showed absorption maxima at 555 and 562 nm, 600 and 630 nm, suggesting the reduction of Cyt c555, Cyt b562, Cyt aa3 (600 nm) and an unidentified species (630 nm peak) Antimycin A (10(-6) M) induced the disappearance of the maxima at 555, 600 and 630 nm corresponding to Cyt c555, Cyt aa3 and the unidentified species; the maximum at 562 nm prevailed in the presence of antimycin A. These antimycin A induced changes can be cited as classical evidence for the functional involvement of these a, b and c type cytochromes in respiratory electron transport. (Dithionite reduced + CO)--(dithionite reduced) difference spectra suggest that adult A. viteae may have one or more CO-binding-species, one of which appears to be a low-spin-haemoprotein with a b-type or c-type haem, which has essentially an electron carrier function rather than a ligand binding function.

Strongyloides ratti: fumarate reductase and succinate dehydrogenase activities of infective larvae.

Submitochondrial particles prepared from axenised infective (L3) larvae of S. ratti (homogonic-strain) were assayed spectrophotometrically for fumarate reductase (FR) and succinate dehydrogenase (SDH) and their kinetic properties characterised. The S. ratti FR (pH 8.2; 37 degrees C) exhibited a maximum specific activity of 3.45 nmol (min)-1 (mg protein)-1 at a sodium fumarate concentration of 0.3 mM. Interestingly, the FR activity declined at fumarate concentrations greater than 0.3 mM. The mechanism of this unusual inhibitory effect requires further study. The S. ratti SDH (pH 8.2; 37 degrees C) showed a Vmax of 17.4 nmol (min)-1 (mg protein)-1; the Kmsucc was 0.5 mM. Although the SDH:FR ratio cannot predicate vectorial electron flow as would occur in vivo, an in vitro ratio of 5.04:1 was observed for SMPs derived from S. ratti L3 larvae.

An alternative protocol for the serial passage and maintenance of a homogonic strain of Strongyloides ratti in female Sprague-Dawley rats.

A method which does not involve the tedious use of watch glass coprocultures for obtaining filariform infective (L3) larvae of Strongyloides ratti from faecal pellets of infected Sprague-Dawley rats is described. The alternative method utilises Baermannization (18 h) of faecal pellets to yield rhabditiform (L1) larvae of S. ratti and their subsequent culture for 72 h at 19 degrees C in tissue-culture-flasks containing only dechlorinated tap water to yield infective filariform (L3) larvae. The yields and infectivity of the L3 larvae obtained from the two methods were essentially similar.

Strongyloides ratti: mitochondrial enzyme activities of the classical electron transport pathway in the infective (L3) larvae.

Submitochondrial particles prepared from S. ratti L3 larvae exhibited NADH-oxidase (NOX), NADH-ferricyanide reductase (NFR), NADH-cytochrome-c-reductase (NCR), succinate-cytochrome-c-reductase (SCR), and cytochrome-aa3-oxidase activities of 2.1 +/- 0.3, 8.9 +/- 1.3, 0.6 +/- 0.1., 1.0 +/- 0.2 and 1.2 +/- 0.3 nm min-1 mg protein-1 respectively, at 37 degrees C. The NCR and NOX activities were 39.3% and 23.5% of the NFR activity, suggesting the occurrence of a rate-limiting step or bifurcation of the respiratory electron transport (RET) pathway on the oxygen-side of RET-Complex I. The NCR activity was 50% that of cytochrome-aa3-oxidase activity which suggests partitioning of electron flow at the level of RET-Complex III and/or the quinone-function. Antimycin A and rotenone but not 2-thenoyl trifluoroacetone (TTFA) inhibited NCR activity, the EC50 values were 3.6 x 10(-6) M, 3.7 x 10(-7) M, respectively. SCR activity was inhibited by antimycin A (EC50 = 3.8 x 10(-6) M) and TTFA (EC50 = 2.8 x 10(-5) M) but not by rotenone. The results suggest that presence of classical and alternate RET-pathways in S. ratti L3 larvae.

The effect of electron transport (ET) inhibitors and thiabendazole on the fumarate reductase (FR) and succinate dehydrogenase (SDH) of Strongyloides ratti infective (L3) larvae.

The fumarate reductase (FR) and succinate dehydrogenase (SDH) activities of isolated submitochondrial particles (SMPs) prepared from axenised L3 larvae of S. ratti were characterised with respect to their response to a selected range of inhibitors. Rotenone (a specific inhibitor of electron transport Complex I) inhibited the S. ratti FR (EC50 = 3.0 x 10(-7) M) but not SDH. This strongly suggests that the S. ratti FR is functionally linked with the S. ratti ET-Complex I. 2-Thenoyltrifluoroacetone (TTFA, an inhibitor of ET-Complex II) inhibited FR (EC50 = 2.6 x 10(-5) M) and SDH (EC50 = 2.8 x 10(-5) M) with similar effectiveness. Sodium malonate (substrate analogue of succinate) had a greater affinity for SDH (EC50 = 6.8 x 10(-4) M), than FR (EC50 = 1.9 x 10(-2) M). Sodium fumarate was ca. 8-fold more effective in inhibiting the S. ratti FR (EC50 = 6.0 x 10(-4) M) than SDH (EC50 = 4.8 x 10(-3) M). The S. ratti FR was more sensitive to inhibition by thiabendazole (TBZ; EC50 = 4.6 x 10(-4) M) than SDH (EC50 > 1.0 x 10(-3) M), suggesting that one of the sites-of-action of TBZ to be the FR of S. ratti mitochondria. More potent inhibitors of S. ratti FR, if developed, may prove to be effective chemotherapeutic agents in the management of human strongloidiasis.

The response of intact Strongyloides ratti infective (L3) larvae to substrates and inhibitors of respiratory electron transport.

Live, intact third-stage larvae (L3s) of Strongyloides ratti in the absence of exogenous substrates consumed oxygen at a rate (E-QO2) of 181.8 +/- 12.4 ng atoms min-1 mg dry weight-1 at 35 degrees C. Respiratory electron transport (RET) Complex I inhibitor rotenone (2 microM) produced 33 +/- 6.5% inhibition of the E-QO2. Unusually the rotenone-induced inhibition was not relieved by 5 mM-succinate. The E-QO2 of intact L3s was refractory to RET Complex III inhibitor antimycin A at 2 microM; 4 microM-antimycin inhibited less than or equal to 10% of the E-QO2. The electron donor couple ascorbate/TMPD augmented the E-QO2 in the presence of rotenone (2 microM) and antimycin A (4 microM) by 110%. Azide (1 mM) stimulated the antimycin A refractory QO2 by 36.6 +/- 7.2% which was only partially inhibited by 1.0 mM-KCN (IC50 = 0.8 mM). The data suggest the presence of classical (CPW) and alternate (APW) electron transport pathways in S. ratti L3s.

Murine strongyloidiasis: the effects of cyclosporin A and thiabendazole administered singly and in combination.

A single Cyclosporin A (CsA) dose of 30 mg kg-1 given orally at day 4 post-infection (p.i.) to Sprague-Dawley rats infected with Strongyloides ratti, reduced the faecal larval count by 46.8 +/- 1.2%. CsA was equally effective when the same dose rate was administered subcutaneously at day 4 p.i., reducing the faecal larval count by 41.6 +/- 8.6%. Thiabendazole (TBZ) given orally at 5 or 10 mg kg-1 (single dose at day 4 p.i.) reduced the faecal larval counts by 57.1 +/- 4.1% and 69.0 +/- 9.6%, respectively. Orally administered CsA was less effective than 5 mg TBZ kg-1 (at day 4 p.i.) Co-administration of 5 mg TBZ kg-1 and CsA did not elicit synergy or additive efficacy, indicating that CsA did not antagonise the anti-strongyloides activity of TBZ. The data suggests that for patients with current, historical or serological evidence of strongyloidiasis, CsA may be used where immunosuppressive therapy is required for other concurrent reasons or when TBZ is contraindicated.

The efficacy of two electron transport inhibitors (720C80 and 993C76) on murine strongyloidiasis: a comparison with albendazole.

The clinical efficacy of albendazole (ABZ) in the treatment of chronic uncomplicated strongyloidiasis has been reported to be highly variable. In our murine model of strongyloidiasis a single oral dose of 5 and 10 mg kg-1 ABZ reduced (at day 4 post infection) the faecal larval count (FLC) by 54.2 +/- 12.5% and 81.5 +/- 10.2%, respectively. 100 mg kg-1 ABZ reduced the FLC by 100%. Two inhibitors of protozoan and filarial electron transport (720C80 and 993C76) inhibited the endogenous O2 consumption of intact infective (L3) larvae of S. ratti by > 50% at 2 x 10(-5) M in vitro, and reduced the FLC by 72 +/- 9.3% and 62.0 +/- 10.3% respectively in vivo, at a dose of 70 mg kg-1. These results suggest that compounds designed as selective inhibitors of protozoan electron transport have significant efficacy against murine strongyloidiasis and may prove useful in the management of human strongyloidiasis.

A new incompatibility group plasmid in Staphylococcus aureus.

The conjugative plasmid pWBG637 and its derivatives, pWBG636 and pWBG642, were tested for incompatibility against conjugative and non-conjugative plasmids in Staphylococcus aureus. They were compatible with other conjugative plasmids and plasmids of the 14 established incompatibility groups. They therefore define a new Incompatibility group 15.

Conjugal transfer of plasmid pWBG637 from Staphylococcus aureus to Staphylococcus epidermidis and Streptococcus faecalis.

Plasmids pWBG636 (GmR) and pWBG642 (EmR) derived from the conjugative plasmid pWBG637 were tested for ability to transfer conjugatively to Staphylococcus epidermidis, Streptococcus faecalis, Bacillus subtilis and Escherichia coli. Both plasmids transferred to S. epidermidis and Strept. faecalis but not to B. subtilis and E. coli. Once in S. epidermis and Strept. faecalis they were transferred back to S. aureus. Restriction endonuclease analysis showed that the plasmids were stably maintained in S epidermidis and Strept. faecalis.

Typing of methicillin-resistant Staphylococcus aureus with IS256.

A simple one-step procedure is described for specifically amplifying and labelling insertion element IS256 which is associated with the gentamicin-resistance transposon Tn4001. The product has been used to probe DNA digests of methicillin-resistant Staphylococcus aureus. The resulting restriction fragment length polymorphisms were found to be able to distinguish isolates which were indistinguishable by other typing methods. The probe also hybridised with methicillin-resistant Staphylococcus aureus which were isolated before the emergence of gentamicin resistance, demonstrating its usefulness in typing species other than those that are gentamicin-resistant.

Conjugative trimethoprim resistance in Staphylococcus aureus.

A multiply resistant Staphylococcus aureus isolate, WBG7410, harbours plasmids of 38, 26, 2.8, 2.4 and 1.9 kb and transfers trimethoprim and kanamycin resistance at high frequencies by conjugation. The transconjugants contained the 38-kb plasmid, pWBG707, and the 2.8-kb plasmid. Plasmid pWBG707 was shown to encode trimethoprim resistance, was conjugative and mobilised at high frequencies the 2.8-kb plasmid which presumably encodes kanamycin resistance. Plasmid pWBG707 was isolated mostly in the open circular form and analysis with EcoRI restriction endonuclease suggests that pWBG707 is a new conjugative plasmid distinct from the other conjugative plasmids reported in S. aureus.

Genetic analysis of methicillin-resistant Staphylococcus aureus from a Nigerian hospital.

Methicillin-resistant strains of Staphylococcus aureus isolated during 1985 and 1987 at a Nigerian hospital were compared by resistance profiles, plasmid analysis, and pulsed-field gel electrophoresis of chromosomal DNA. The results indicated that the isolates from the two periods were unrelated with regard to all three aspects. None of the isolates was similar to the classical MRSA nor to the epidemic MRSA of Australia or the UK. The MRSA isolated in 1985 had a similar plasmid to MRSA isolates from Singapore, but differed from them when compared by pulsed-field gel electrophoresis.

Transfer of resistance determinants from a multi-resistant Staphylococcus aureus isolate.

The clinical isolate Staphylococcus aureus WBG1024 was resistant to cadmium, benzyl penicillin, kanamycin, neomycin, streptomycin, tetracycline and trimethoprim and harboured a conjugative plasmid pWBG637 (34.5 kb) and non-conjugative plasmids of 23.8, 4.4, 2.8 and 1.9 kb. Transduction and mixed-culture transfer experiments demonstrated that the 4.4-kb plasmid (pWBG632) encoded resistance to tetracycline and the 23.8-kb plasmid (pWBG628) encoded resistance to cadmium, benzyl penicillin, kanamycin, neomycin and streptomycin. The conjugative plasmid pWBG637 was able to mobilise a further 4.4-kb plasmid (pWBG633) encoding streptomycin resistance and recombined with the multiresistance plasmid pWBG628 to produce transconjugantes of various resistance phenotypes.

Typing of Australian methicillin-resistant Staphylococcus aureus strains by pulsed field gel electrophoresis.

Twenty-six clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) collected from six Australian hospitals by a National Staphylococcal Study Group were examined by analysis of restriction fragment length polymorphisms (RFLPs) of chromosomal DNA with pulsed field gel electrophoresis. Digestion with the restriction endonuclease SmaI produced 13-17 bands of 7-700 kb. The digestion patterns were easily distinguished and isolates could be classified into 17 groups based on their RFLPs. Isolates giving a pattern associated with one group were from four hospitals in four different states. In another group, the isolates responsible were from three hospitals in two states and in a further group, the isolates were derived from two hospitals in different states. The remaining groups comprised only one member each. The method has promise for typing and studying the epidemiology of MRSA.

A new class of conjugative plasmid in Staphylococcus aureus.

Plasmid pWBG637, a Staphylococcus aureus conjugative plasmid having no known resistance phenotype, was compared with other conjugative plasmids in S. aureus by restriction endonuclease analysis, incompatibility testing and DNA-DNA hybridisation. It differed from the other conjugative plasmids on all three criteria and thus belongs to a new class of conjugative plasmids.