Virulence factors among Staphylococcus lugdunensis are associated with infection sites and clonal spread

  • N. Giormezis
  • F. Kolonitsiou
  • A. Makri
  • A. Vogiatzi
  • M. Christofidou
  • E. D. Anastassiou
  • I. Spiliopoulou
Article
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Abstract

Staphylococcus lugdunensis has emerged as a significant human pathogen, with distinct clinical and microbiological characteristics. Our goal was to identify the virulence factors in S. lugdunensis recovered from infected patients of two Greek hospitals during a six-year period (2008–2013). A collection of 38 S. lugdunensis was tested for biofilm formation, antimicrobial susceptibility, clonal distribution, virulence factors (ica operon, fbl, atlL, vwbl, slush) and antibiotic resistance genes (mecA, ermC) carriage. Strains were classified into pulsotypes by pulsed-field gel electrophoresis (PFGE) of SmaI DNA digests. The majority (22) was isolated from skin and soft tissue infections (SSTIs), nine from deep-sited infections (DSIs), including three bacteraemias and seven from prosthetic device-associated infections (PDAIs). All isolates were oxacillin-susceptible, mecA-negative and fbl-positive. The highest resistance rate was detected for ampicillin (50 %), followed by erythromycin and clindamycin (18.4 %). Fourteen isolates (36.8 %) produced biofilm, whereas 26/38 (68.4 %) carried the ica operon. Biofilm formation was more frequent in isolates from PDAIs. Thirty-six strains (94.7 %) carried atlL and 31 (81.6 %) carried vwbl, whereas slush was detected in 15 (39.5 %). PFGE revealed a low level of genetic diversity: strains were classified into seven pulsotypes, with two major clones (C: 22 and D: nine strains). Type C strains recovered from all infection sites prevailed in biofilm formation and ermC carriage, whereas type D strains associated with SSTIs and DSIs carried more frequently vwbl, slush or both genes. Despite susceptibility to antimicrobials, the clonal expansion and carriage of virulence factors, combined with biofilm-producing ability, render this species an important pathogen that should not be ignored.

Keywords

Linezolid Teicoplanin Daptomycin PFGE Type High Resistance Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Notes

Acknowledgements

We thank Anastasia Spiliopoulou MD, PhD for her assistance in collecting the isolates. The Ethics Committee of the University Hospital of Patras approved this study and waived the need for informed consent (approval no.: 316). Part of this work was presented as a poster presentation at the 24th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2014), May 2014, Barcelona, Spain.

Funding

This research was supported by funding from the National Staphylococcal Reference Laboratory, Greece, under the scientific responsibility of I.S. and E.D.A. (grant C954, Hellenic Centre for Disease Control and Prevention, HCDCP/KEELPNO).

Conflict of interest

Nothing to declare.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • N. Giormezis
    • 1
    • 2
  • F. Kolonitsiou
    • 1
    • 2
  • A. Makri
    • 3
  • A. Vogiatzi
    • 3
  • M. Christofidou
    • 1
  • E. D. Anastassiou
    • 1
    • 2
  • I. Spiliopoulou
    • 1
    • 2
  1. 1.Department of Microbiology, School of MedicineUniversity of PatrasRion, PatrasGreece
  2. 2.National Reference Laboratory for StaphylococciPatrasGreece
  3. 3.Laboratory of MicrobiologyGeneral Children Hospital PentelisAthensGreece

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