Prevalence of IS256 among Ica-Positive and Biofilm Non-Producing Staphylococcus epidermidis Clinical Isolates
AbstractBackground: S. epidermidis is one of predominant members of human normal microflora, however it may be the main cause of nosocomial infections related to medical devices put into the body and thus the biofilm formation is a main route for pathogenesis which is affected by icaADBC operon. In this study, the prevalence of IS256 sequence among ica-positive and biofilm non-producer clinical isolates of S. epidermidis was investigated. Methods: In this study, 100 clinical isolates of S. epidermidis were collected from different infections. The IS256 sequence, icaADBC operon and biofilm formation by microtiter plate assay were evaluated among them. The antibiotic susceptibility of these isolates was done with disc diffusion by using cefoxitin, ciprofloxacin, erythromycin, gentamycin, oxacillin and tetracycline discs. Results: Of 100 isolates, 18 (18%) were ica operon-positive from which 18%, 14%, 16% and 17% contained icaA, icaD, icaB and icaC genes, respectively. Moreover, 14 of 18 (77.77%) ica-positive isolates amplified the IS256 gene. The biofilm formation by microtiter plate assay showed that 18 (18%) isolates were strong biofilm producers, 21 (21%) produced intermediate level biofilm and 14 (14%) and 47 (47%) isolates were weak and non-biofilm producers, respectively. in the antibiotic susceptibility test, the majority of isolates were resistant to oxacillin and lowest resistance was against ciprofloxacin.Conclusion: The statistical analysis with p<0.05 exhibited that there was a reverse relation between biofilm production and the insertion of IS256, and in fact the higher prevalence of IS256 among isolates, the biofilm formation declined. Data showed that amongst most of ica-positive isolates, the IS256 was detected and therefore other genetic factors affect the expression of this operon.
Büttner H, Dietrich M, Holger R. Structural basis of Staphylococcus epidermidis biofilm formation: mechanisms and molecular interactions. Front Cell Infect Microbiol 2015; 5: 14.
El Farran CA, Sekar A, Balakrishnan A, et al. Prevalence of biofilm- producing Staphylococcus epidermidis in the healthy skin of individuals in Tamil Nadu, India. Indian J Med Microbiol 2013; 31(1): 19-23.
Mirzaee M, Najar-Peerayeh S, Behmanesh M, et al. Detection of Intracellular Adhesion (ica) Gene and Biofilm Formation Staphylococcus aureus isolates from Clinical Blood Cultures. J Med Bacteriol 2014; 3(1, 2): 1-7.
Revdiwala S, Rajdev BM, Mulla S. Characterization of bacterial etiologic agents of biofilm formation in medical devices in critical care setup. Crit Care Res Pract 2012; 2012: 945805.
Stepanović S, Vuković D, Ježek Pand, et al. Influence of dynamic conditions on biofilm formation by staphylococci. Eur J Clin Microbiol Infect Dis 2001; 20(7): 502-504.
O'gara JP, Humphreys H. Staphylococcus epidermidis biofilms: importance and implications. J Med Microbiol 2001; 50(7): 582-7.
Archer NK, Mazaitis MJ, Costerton JW, et al. Staphylococcus aureus biofilms: properties, regulation, and roles in human disease. Virulence 2011; 2(5): 445-459.
Loessner I, Dietrich K, Dittrich D and et al. Transposase-dependent formation of circular IS256 derivatives in Staphylococcus epidermidis and Staphylococcus aureus. J Bacteriol 2002; 184(17): 4709-14
Mirzaee M, Najar-Peerayeh S, Behmanesh M, et al. Relationship between adhesin genes and biofilm formation in vancomycin-intermediate Staphylococcus aureus clinical isolates. Curr microbiol. 2015; 70: 665–670.
Mirzaee M, Najar Peerayeh S, Behmanesh M, et al. Biofilm formation and presence of ica genes in Staphylococcus aureus isolated from intensive care unit. J Mazandaran Univ Med Sci 2014; 24(115): 43-51.
Mirzaee M, Najar Peerayeh S, Ghasemian A-M. Detection of icaABCD genes and biofilm formation in clinical isolates of methicillin resistant Staphylococcus aureus. Iran J Pathol 2014; 9(4): 257-62.
Meriem L, Hafida H, Kaotar N, Samia B, Imene M, Ibtissem KT, et al. Detection of biofilm formation, icaADBC gene and investigation of toxin genes in Staphylococus spp. strain from dental unit waterlines, University Hospital Center (UHC) Tlemcen Algeria. African J Microbiol Res 2014; 8(6): 559-65.
Ninin E, Caroff N, Espaze E, Maraillac J, Lepelletier D, Milpied N, et al. Assessment of ica operon carriage and biofilm production in Staphylococcus epidermidis isolates causing bacteraemia in bone marrow transplant recipients. Clin Microbiol Infect 2006; 12(5): 446-52.
Cafiso V, Bertuccio T, Santagati M, Campanile F, Amicosante G, Perilli M, et al. Presence of the ica operon in clinical isolates of Staphylococcus epidermidis and its role in biofilm production. Clin Microbiol Infect 2004; 10(12): 1081-8.
Rahimi F and Karimi S. Biofilm Producing Staphylococcus epidermidis strains isolated from clinical samples in Tehran, Iran. Clin Infect Dis 2016; 11(3): e33343.
Eftekhar F, Mirmohamadi Z. Evaluation of biofilm production by Staphylococcus epidermidis isolates from nosocomial infections and skin of healthy volunteers. Int J Med Medical 2009; 1(10): 438-41.
Otto M, editor. Molecular basis of Staphylococcus epidermidis infections. Semin Immunopathol 2012; 34(2): 201-14.
Koskela A, Nilsdotter Å, Persson L and et al. Prevalence of the ica operon and insertion sequence IS256 among Staphylococcus epidermidis prosthetic joint infection isolates. Eur J Clin Microbiol Infect Dis 2009; 28(6): 655-60.
Liduma I, Tracevska T, Bers U and et al. Phenotypic and genetic analysis of biofilm formation by Staphylococcus epidermidis. Medicina 2012; 48(6): 305-9.
Cafiso V, Bertuccio T, Santagati M, et al. Presence of the ica operon in clinical isolates of Staphylococcus epidermidis and its role in biofilm production. Clin Microbiol Infect 2004; 10(12): 1081-8.
Hennig S, Ziebuhr W. Characterization of the transposase encoded by IS256, the prototype of a major family of bacterial insertion sequence elements. J Bacteriol 2010; 192(16): 4153-63.
Handke L, Conlon K, Slater S, and et al. Genetic and phenotypic analysis of biofilm phenotypic variation in multiple Staphylococcus epidermidis isolates. J Med Microbiol 2004; 53(5): 367-74.
De Silva G, Kantzanou M, Justice A, et al. The ica operon and biofilm production in coagulase-negative staphylococci associated with carriage and disease in a neonatal intensive care unit. J Cin Microbiol 2002; 40(2): 382-8.
Otto M. Staphylococcus epidermidis the 'accidental' pathogen. Nature Rev Microbiol. 2009; 7(8): 555-67.
De Silva G, Kantzanou M, Justice A, et al. The ica operon and biofilm production in coagulase-negative staphylococci associated with carriage and disease in a neonatal intensive care unit. J Clin Microbiol 2002; 40(2): 382-8.
Hennig S, Ziebuhr W. Characterization of the transposase encoded by IS256, the prototype of a major family of bacterial insertion sequence elements. J Bacteriol 2010; 192(16): 4153-63
Hennig S, Ziebuhr W. A transposase-independent mechanism gives rise to precise excision of IS256 from insertion sites in Staphylococcus epidermidis. J Bacteriol 2008; 190(4): 1488-90.
Arciola CR, Baldassarri L, Montanaro L. Presence of icaA and icaD Genes and slime production in a collection of Staphylococcal strains from catheter-associated infections. J Clin Microbiol 2001; 39(6): 2151-6.
Cho S-H, Naber K, Hacker J, et al. Detection of the icaADBC gene cluster and biofilm formation in Staphylococcus epidermidis isolates from catheter-related urinary tract infections. Int J Antimicrob Agents 2002; 19(6): 570-5.
Rciola CR, Campoccia D, Gamberini S, et al. Search for the insertion element IS256 within the ica locus of Staphylococcus epidermidis clinical isolates collected from biomaterial-associated infections. Biomaterials 2004; 25(18): 4117-25.