BackgroundThe ability of biofilm formation seems to play an essential role in the virulence of coagulase-negative staphylococci (CNS). The most clearly characterized component of staphylococcal biofilms is the polysaccharide intercellular adhesin (PIA) encoded by the icaADBC operon. Biofilm production was studied in 80 coagulase-negative staphylococci (CNS) strains isolated from clinical specimens of newborns with infection hospitalized at the Neonatal Unit of the University Hospital, Faculty of Medicine of Botucatu, and in 20 isolates obtained from the nares of healthy individuals without signs of infection. The objective was to compare three phenotypic methods with the detection of the icaA, icaD and icaC genes by PCR.FindingsAmong the 100 CNS isolates studied, 82% tested positive by PCR, 82% by the tube test, 81% by the TCP assay, and 73% by the CRA method. Using PCR as a reference, the tube test showed the best correlation with detection of the ica genes, presenting high sensitivity and specificity.ConclusionsThe tube adherence test can be indicated for the routine detection of biofilm production in CNS because of its easy application and low cost and because it guarantees reliable results with excellent sensitivity and specificity.

Coagulase-negative staphylococci (CNS) species identification is

Infections caused by the genus Staphylococcus are of great importance for human health. Staphylococcus species are divided into coagulase‐positive staphylococci, represented by S. aureus, a pathogen that can cause infections of the skin and other organs in immunocompetent patients, and coagulase‐negative staphylococci (CNS) which comprise different species normally involved in infectious processes in immunocompromised patients or patients using catheters. Oxacillin has been one of the main drugs used for the treatment of staphylococcal infections; however, a large number of S. aureus and CNS isolates of nosocomial origin are resistant to this drug. Methicillin resistance is encoded by the mecA gene which is inserted in the SCCmec cassette. This cassette is a mobile genetic element consisting of five different types and several subtypes. Oxacillin‐resistant strains are detected by phenotypic and genotypic methods. Epidemiologically, methicillin‐resistant S. aureus strains can be divided into five large pandemic clones, called Brazilian, Hungarian, Iberian, New York/Japan and Pediatric. The objective of the present review was to discuss aspects of resistance, epidemiology, genetics and detection of oxacillin resistance in Staphylococcus spp., since these microorganisms are increasingly more frequent in Brazil.

Coagulase-negative staphylococci (CNS) are among the main responsible agents for mastitis in sheep. Cure rates can be reduced due to several causes, such as those related to virulence factors presented by microorganisms. This study aims at characterizing the virulence and resistance factors to antimicrobial agents in different CNS species isolated from sheep milk. After collecting milk samples, the samples were analyzed and the CNS species were identified. After identification, the susceptibility-sensitivity profile was examined using the disk diffusion technique for 10 antimicrobial agents. The DNA was extracted to detect the presence of the mecA gene, biofilm (icaADBC, bap, and bhp) and toxin genes (sea, seb, sec, sed, tst, and luk-PV) by PCR. Samples carrying toxin genes had their expression assessed using the reverse-transcription PCR technique. The biofilm production was assessed using the adherence method on a polystyrene plate. One hundred twelve CNS samples were isolated, 53 (47.3%) from animals with subclinical mastitis and 59 (52.7%) from healthy animals. Drugs tested have shown to be efficient for most CNS samples. The largest resistance percentage of CNS was found for the penicillin (17.0%) and tetracycline (10.7%) and 4 samples carried the mecA gene. As for the biofilm genes, the icaADBC operon was found in 10 (8.9%) samples, the bap gene was found in 16 (14.3%), and the bhp gene was found in 3 (2.7%). In addition, 69 (61.6%) samples produced biofilm. The survey of toxin genes has shown that 70 (62.5%) samples showed some toxin-encoding gene. However, none of the samples has expressed any of the genes from those toxins studied.

Within the genus Staphylococcus, S. aureus, a coagulase-positive species which produces a series of other enzymes and toxins, is the most widely known and has frequently been implicated in the etiology of a series of infections and intoxications in man and animals, while coagulase-negative staphylococci (CNS) have been considered to be saprophytic or rarely pathogenic (21).Before the 1970s, reports of infections caused by CNS were rare, with these bacteria being recognized by clinicians and microbiologists as contaminants of clinical samples (22). However, this detection, widely used for clinical diagnosis, has posed a challenge regarding the role that these microorganisms play in infectious processes.CNS are currently known to be essentially opportunistic microorganisms that take advantage of numerous organic situations to produce severe infections (22)(23)(24)(25)(26). The emergence of CNS as etiological agents might also be the result of the recognition of this group as opportunistic pathogens and of the increasing use of invasive procedures such as intravascular catheters and prostheses in immunocompromised patients, and in intensive treatment, premature children, patients with neoplasia and transplant patients (22).Several virulence factors are responsible for the symptoms and severity of infections caused by S. aureus. These factors include hemolysins α, β, γ and δ, leukocidin, exfoliative toxins A and B, and a group of Abstract: The detection of staphylococcal enterotoxins is decisive for the confirmation of an outbreak and for the determination of the enterotoxigenicity of strains. Since the recognition of their antigenicity, a large number of serological methods for the detection of enterotoxins in food and culture media have been proposed. Since immunological methods require detectable amounts of toxin, molecular biology techniques represent important tools in the microbiology laboratory. In the present study, polymerase chain reaction (PCR) was used to identify genes responsible for the production of enterotoxins and toxic shock syndrome toxin 1 (TSST-1) in S. aureus and coagulase-negative staphylococci (CNS) isolated from patients and the results were compared with those obtained by the reverse passive latex agglutination (RPLA) assay. PCR detection of toxin genes revealed a higher percentage of toxigenic S. aureus strains (46.7%) than the RPLA method (38.3%). Analysis of the toxigenic profile of CNS strains showed that 26.7% of the isolates produced some type of toxin, and one or more toxin-specific genes were detected in 40% of the isolates. These results suggests the need for further studies in order to better characterize the pathogenic potential of CNS and indicate that attention should be paid to the toxigenic capacity of this group of microorganisms.

Aims:  The objective of this study was to investigate the detection of SEE, SEG, SEH and SEI in strains of Staphylococcus aureus and coagulase‐negative staphylococci (CNS) using RT‐PCR. Methods and Results:  In this study, 90 Staph. aureus strains and 90 CNS strains were analysed by PCR for the detection of genes encoding staphylococcal enterotoxins (SE) E, G, H and I. One or more genes were detected in 54 (60%) Staph. aureus isolates and in 29 (32·2%) CNS isolates. Staphylococcus epidermidis was the most frequently isolated CNS species (n = 64, 71·1%), followed by Staphylococcus warneri (n = 8, 8·9%) and other species (Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus lugdunensis, Staphylococcus simulans, Staphylococcus saprophyticus and Staphylococcus xylosus: n = 18, 20%). The genes studied were detected in Staph. epidermidis, Staph. warneri, Staph. haemolyticus, Staph. hominis, Staph. simulans and Staph. lugdunensis. The highest frequency of genes was observed in Staph. epidermidis and Staph. warneri, a finding indicating differences in the pathogenic potential between CNS species and highlighting the importance of the correct identification of these micro‐organisms. RT‐PCR used for the detection of mRNA revealed the expression of SEG, SEH and/or SEI in 32 (59·3%) of the 90 Staph. aureus isolates, whereas expression of some of these genes was observed in 10 (34·5%) of the 90 CNS isolates. Conclusions:  Staphylococcus epidermidis was the most toxigenic CNS species. Among the other species, only Staph. warneri and Staph. lugdunensis presented a positive RT‐PCR result. PCR was efficient in confirming the toxigenic capacity of Staph. aureus and CNS. Significance and Impact of the Study:  This study permitted to confirm the toxigenic capacity of CNS to better characterize the pathogenic potential of this group of micro‐organisms. In addition, it permitted the detection of SEG, SEH and SEI, enterotoxins that cannot be detected by commercially available immunological methods.

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Although no longer recommended by the Clinical Laboratory Standards Institute, we observed some cases in which only the oxacillin disc-diffusion test detected resistance. The discrepancy between phenotypic tests and mecA is probably due to heterogeneity and borderline resistance.