S. aureus Colonization, Biofilm Production, and Phage Susceptibility in Peritoneal Dialysis Patients

Abstract

Peritonitis caused by Staphylococcusaureus is of major importance in peritoneal dialysis (PD) patients due to its great virulence profile and biofilm formation ability. Bacteriophages are a potential tool to treat peritonitis resulting from biofilm-associated infections. We screened S. aureus colonization in 71 PD patients from the nasal cavity, groin, and PD exit-site regions and analyzed clinical outcomes in these patients. We performed biofilm-formation testing of different strains and compared the isolates of one patient to detect phenotypic differences in S. aureus. Phage cocktails were used to detect S. aureus in vitro susceptibility. An adaptation procedure was performed in cases of bacterial resistance. Around 30% of PD patients (n = 21) were found to be S. aureus carriers; from these, a total of 34 S. aureus strains were isolated, of which 61.8% (n = 21) produced a strong biofilm. Phenotypic differences in strain biofilm production were detected in eight patients out of ten. All strains were sensitive to commonly used antibiotics. Broadly positive phage lytic activity (100%) was observed in six cocktails out of seven, and bacterial resistance towards phages was overcome using adaptation. Overall phages showed a promising in vitro effect in biofilm-forming S. aureus strains.

Correlation Between Biofilm-Formation and the Antibiotic Resistant Phenotype in Staphylococcus aureus Isolates: A Laboratory-Based Study in Hungary and a Review of the Literature

“… 94 Biofilm-formation in S. aureus is genetically mediated by the regulatory genetic locus staphylococcal accessory regulator ( sarA ); this controls two pathways – namely the intracellular adhesin ( ica ) operon and accessory gene regulator ( agr ) regulated pathways – both of which have been suggested as determinants of the extent of biofilm-formation in these bacteria. 95 , 96 The product of the genes of the ica operon ( icaADBC ) are the IcaA and IcaD transferase membrane proteins; these proteins have important roles in the biosynthesis of PIA (polysaccharide intercellular adhesion protein; or poly-β-1,6-N-acetylglucosamine [PNAG]), which is a major component of staphylococcal biofilms. 97 Although our study did not demonstrate pronounced differences among the biofilm-producing capabilities of the locally collected MSSA and MRSA isolates, there have been studies offering possible biological explanations to this phenomenon.…”

Use of Phage Cocktail BFC 1.10 in Combination With Ceftazidime-Avibactam in the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Femur Osteomyelitis—A Case Report

“…Safe and potent use of BFC 1.10 has previously been demonstrated in the local and systemic treatment of P. aeruginosa and S. aureus infections ( 9 , 18 , 19 ). Phage susceptibility was assessed using the spot test on double-layer trypticase soy agar (TSA) plates with BFC 1.10 concentration of 10 7 PFU/ml for each phage ( 20 ).…”

Staphylococcus aureus Isolated from the Oral Cavity: Phage Susceptibility in Relation to Antibiotic Resistance

“…Recent studies have shown that, similar to antibiotic resistance, bacteria can also develop resistance to bacteriophages [ 7 ]. In such cases, bacteriophage cocktails or phage-antibiotic combinations seem to be effective therapeutic options [ 8 , 9 , 10 ]. Phage-antibiotic combinations appear as the most realistic alternative to inefficient antibiotic therapy.…”