Subscribe to RSS
DOI: 10.4103/0974-2727.72159
Comparative Study for the Presence of Enterococcal Virulence Factors Gelatinase, Hemolysin and Biofilm Among Clinical and Commensal Isolates of Enterococcus Faecalis
Source of Support: NilABSTRACT
Background: Biofilm production, gelatinase and hemolysin are the potential virulence factors of Enterococci. Gelatinase and hemolysin producing strains of Enterococcus faecalis have been shown to cause severe infections in animal models. Biofilm production has been shown to enhance the persistence of E. faecalis in urinary bladder and other medical indwelling devices infections.
Aims: To compare the presence of gelatinase, hemolysin and biofilm formation among clinical and commensal isolates and to study the co-relation between virulence factors with respect to different clinical specimens.
Settings and Design: During the study period of 2 years from July 2004 to July 2006, 200 clinical isolates from nosocomial infections and 100 commensal isolates of E. faecalis were taken for the study.
Materials and Methods: The clinical and commensal isolates were tested for the presence of gelatinase, hemolysin and biofilm and compared. The presence of these virulence factors among different clinical isolates was also studied.
Materials and Methods: Viral citrullinated peptide (VCP) and Epstein-Barr nuclear antigen (EBNA-1) peptide were commercially prepared and antibodies to these were determined in 25 patients of ERA, 40 disease control patients constituting 25 rheumatoid arthritis (RA), 7 systemic lupus erythematosus (SLE), 2 scleroderma, 1 spondyloarthritis (SpA), 1 juvenile rheumatoid arthritis (JRA), 1 osteoarthritis (OA), 1 psoriatic arthritis (PsA), 1 undifferentiated arthritis (UA), and 1 gout and 25 healthy controls (HCs) were taken for comparison. In-house ELISA was established for both the antibodies while cyclic citrullinated peptide (CCP) antibody was detected by commercial ELISA kit.
Statistical Analysis: Chi-square and likelihood ratio analysis were carried out using SSPS version 5.1 software.
Results: Results: The clinical isolates produced 39, 16.5 and 32.5% of gelatinase, hemolysin and biofilm, respectively, as compared to 31, 19 and 16% produced by the commensal isolates, respectively. Endotracheal tube infection, urinary tract infection, umbilical catheter tip infected isolates produced 60.8, 86.6 and 100% biofilm, respectively.
Conclusion: Significant difference in the production of biofilm (P<0.001) was noted between clinical and commensal isolates. Organism isolated from medically indwelling devices produced high amount of biofilm, confirming its role in colonization and causing nosocomial infections.
Publication History
Article published online:
29 January 2020
© 2010.
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
REFERENCES
- 1 Tendulkar PM, Baghdayan AS, Shankar N. Pathogenic Enterococci: New developments in the 21st Century. Cell Mol Life Sci 2003;60:2622-36.
- 2 Vergis EN, Shankar N, Chow JW, Hayden MK, Snydman DR, Zervos MJ, et al. Association between the presence of Enterococcal virulence factors gelatinase, haemolysin and enterococcal surface protein and mortality among patients with bacteremia due to Enterococcus faecalis. Clin Infect Dis 2002;35:570-5.
- 3 Hancock LE, Gilmore MS. Pathogenicity of Enterococci. In: Fischetti V, Novick R, Ferretti J, Portnoy D, Rood J, editors,. Gram positive pathogens. Washington DC:Am Soc Microbiol 2000;251-8.
- 4 Garsin AD, Sifri CD, Mylonakis E, Qin X, Singh KV, Murray BE, et al. A simple model host for identifying gram positive virulence factors. Proc Natl Acad Sci U S A 2001;98:10892-7.
- 5 Jett BD, Huycke MM, Gilmore MS. Virulence of Enterococci. Clin Microbiol Rev 1994;7:462-78.
- 6 Nallapareddy SR, Qin X, Weinstock GM, Hook M, Murray BE. Enterococcus faecalis adhesion, Ace mediates attachment to extracellular matrix proteins collagen type IV and laminin as well as collagen Type I. Infect Immun 2000;68:5218-24.
- 7 Sartingen S, Rozdzinski E, Muscholl-Silberhorn A. Aggregation substances increases adherence and internalization but not translocation of Enterococcus faecalis through different intestinal epithelial cells invitro. Infect Immun 2000;68:6044-7.
- 8 Hass W, Shepard BD, Gilmore MS. Two-component regulator of Enterococcus faecalis cytolysin responds to quorum-sensing autoinduction. Nature 2002;415:84-7.
- 9 Huycke MM, Abrams V, Moore DR. Enterococcus faecalis produces extracellular superoxide and hydrogen peroxide that damages colonic epithelial cell DNA. Carcinogenesis 2002;23:529-6.
- 10 Upadhyaya PG, Ravikumar KL, Umapathy BL. Review of virulence factors of Enterococcus: An emerging nosocomial pathogen. Indian J Med Microbiol 2009;27:301-5.
- 11 Coque TM, Patterson JE, Steckleberg JM, Murray BE. Incidence of hemolysin, gelatinase, and aggregation substance among Enterococci isolated from patients with endocarditis and other infections and from feces of hospitalized and community-based persons. J Infect Dis 1995;171:1233-9.
- 12 Jett BD, Jensen HG, Nordquist RE, Gilmore MS. Contribution of the pAD1-encoded cytolysin to the severity of experimental Enterococcus faecalis endophthalmitis. Infect Immun 1992;60:2445-52.
- 13 Ike Y, Hashimoto H, Clewell DB. Hemolysin of Streptococcus faecalis subspecied zymogenes contributes to virulence in mice. Infect Immun 1984;45:528-30.
- 14 Shankar V, Baghdayan AS, Huycke MM, Lindahl G, Gilmore MS. Infection-derived Enterococcus faecalis strains are enriched in esp, a gene encoding a novel surface protein. Infect Immun 1999;67:193-200.
- 15 Chow JW, Thal LA, Perri MB, Vazquez JA, Donabedian SM, Clewell DB. Plasmid-associated hemolysin and aggregation substance production contribute to virulence in experimental enterococcal endocarditis. Antimicrob Agents Chemother 1993;37:2474-7.
- 16 Ross PW. Streptococcus and Enterococcus. In: Collee JG, Fraser AG, Marmion BP, Simmons A, editors. Practical medical microbiology. New Delhi: Curchill Livingstone; 2006. p. 263-73.
- 17 Jayanthi S, Ananthasubramanian N, Appalaraju B. Assessment of pheromone response in biofilm forming clinical isolates of high level gentamycin resistant Enterococcus faecalis. Indian J Med Microbiol 2008;23:248-51.
- 18 Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing, M100-S16. Wayne, PA: CLSI; 2006.
- 19 Gilmore MS, Huycke MM, Daniel FS. Multidrug-resistant Enterococci. The nature of the problem and an agenda for the future. Emerg Infect Dis 1998;4:239-49.