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Staphylococcus aureus phenotype switching: an effective bacterial strategy to escape host immune response and establish a chronic infection.

ABSTRACT: Staphylococcus aureus is a frequent cause for serious, chronic and therapy-refractive infections in spite of susceptibility to antibiotics in vitro. In chronic infections, altered bacterial phenotypes, such as small colony variants (SCVs), have been found. Yet, it is largely unclear whether the ability to interconvert from the wild-type to the SCV phenotype is only a rare clinical and/or just laboratory phenomenon or is essential to sustain an infection. Here, we performed different long-term in vitro and in vivo infection models with S. aureus and we show that viable bacteria can persist within host cells and/or tissues for several weeks. Persistence induced bacterial phenotypic diversity, including SCV phenotypes, accompanied by changes in virulence factor expression and auxotrophism. However, the recovered SCV phenotypes were highly dynamic and rapidly reverted to the fully virulent wild-type form when leaving the intracellular location and infecting new cells. Our findings demonstrate that bacterial phenotype switching is an integral part of the infection process that enables the bacteria to hide inside host cells, which can be a reservoir for chronic and therapy-refractive infections.

SUBMITTER: Tuchscherr L

PROVIDER: S-EPMC3395110 | biostudies-literature | 2011 Mar

REPOSITORIES: biostudies-literature

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Staphylococcus aureus phenotype switching: an effective bacterial strategy to escape host immune response and establish a chronic infection.

Tuchscherr Lorena L Medina Eva E Hussain Muzaffar M Völker Wolfgang W Heitmann Vanessa V Niemann Silke S Holzinger Dirk D Roth Johannes J Proctor Richard A RA Becker Karsten K Peters Georg G Löffler Bettina B

EMBO molecular medicine 20110126 3

Staphylococcus aureus is a frequent cause for serious, chronic and therapy-refractive infections in spite of susceptibility to antibiotics in vitro. In chronic infections, altered bacterial phenotypes, such as small colony variants (SCVs), have been found. Yet, it is largely unclear whether the ability to interconvert from the wild-type to the SCV phenotype is only a rare clinical and/or just laboratory phenomenon or is essential to sustain an infection. Here, we performed different long-term in ...[more]

PMID: 21268281

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Project description:Staphylococcus aureus is a human pathogen responsible for many antibiotic-resistant infections, for instance burn wound infections, which pose a threat to human life. Exploring possible synergy between various antimicrobial agents, like nanoparticles and plant natural products, may provide new weapons to combat antibiotic resistant pathogens. The objective of this study was to examine the potential of silver nanoparticles (AgNPs) to enhance the antimicrobial activity of selected naphthoquinones (NQs): plumbagin (PL), ramentaceone (RAM), droserone (DR), and 3-chloroplumbagin (3ChPL). We also attempted to elucidate the mechanism by which the AgNPs enhance the antimicrobial activity of NQs. We analyzed the interaction of AgNPs with bacterial membrane and its effect on membrane stability (TEM analysis, staining with SYTO9 and propidium iodide), as well as aggregation of NQs on the surface of nanoparticles (UV-Vis spectroscopy and DLS analysis). Our results demonstrated clearly a synergistic activity of AgNPs and three out of four tested NQs (FBC indexes ≤ 0.375). This resulted in an increase in their combined bactericidal effect toward the S. aureus reference strain and the clinical isolates, which varied in resistance profiles. The synergistic effect (FBC index = 0.375) resulting from combining 3ChPL with silver nitrate used as a control, emphasized the role of the ionic form of silver released from nanoparticles in their bactericidal activity in combination with NQs. The role of membrane damage and AgNPs-NQ interactions in the observed synergy of silver nanoparticles and NQs was also confirmed. Moreover, the described approach, based on the synergistic interaction between the above mentioned agents enables a reduction of their effective doses, thus significantly reducing cytotoxic effect of NQs toward eukaryotic HaCaT cells. Therefore, the present study on the use of a combination of agents (AgNPs-NQs) suggests its potential use as a possible strategy to combat antibiotic-resistant S. aureus.

Project description:Staphylococcus aureus causes invasive infections and easily acquires antibiotic resistance. Even antibiotic-susceptible S. aureus can survive antibiotic therapy and persist, requiring prolonged treatment and surgical interventions. These so-called persisters display an arrested-growth phenotype, tolerate high antibiotic concentrations, and are associated with chronic and recurrent infections. To characterize these persisters, we assessed S. aureus recovered directly from a patient suffering from a persistent infection. We show that host-mediated stress, including acidic pH, abscess environment, and antibiotic exposure promoted persister formation in vitro and in vivo. Multiomics analysis identified molecular changes in S. aureus in response to acid stress leading to an overall virulent population. However, further analysis of a persister-enriched population revealed major molecular reprogramming in persisters, including down-regulation of virulence and cell division and up-regulation of ribosomal proteins, nucleotide-, and amino acid-metabolic pathways, suggesting their requirement to fuel and maintain the persister phenotype and highlighting that persisters are not completely metabolically inactive. Additionally, decreased aconitase activity and ATP levels and accumulation of insoluble proteins involved in transcription, translation, and energy production correlated with persistence in S. aureus, underpinning the molecular mechanisms that drive the persister phenotype. Upon regrowth, these persisters regained their virulence potential and metabolically active phenotype, including reduction of insoluble proteins, exhibiting a reversible state, crucial for recurrent infections. We further show that a targeted antipersister combination therapy using retinoid derivatives and antibiotics significantly reduced lag-phase heterogeneity and persisters in a murine infection model. Our results provide molecular insights into persisters and help explain why persistent S. aureus infections are so difficult to treat.

Dataset Information

Staphylococcus aureus phenotype switching: an effective bacterial strategy to escape host immune response and establish a chronic infection.

Publications

Staphylococcus aureus phenotype switching: an effective bacterial strategy to escape host immune response and establish a chronic infection.

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