Analysis of the Genotype and Virulence of
Staphylococcus epidermidis
Isolates from Patients with Infective Endocarditis
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Published:2008-11
Issue:11
Volume:76
Page:5127-5132
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ISSN:0019-9567
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Container-title:Infection and Immunity
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language:en
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Short-container-title:Infect Immun
Author:
Monk Alastair B.1, Boundy Sam1, Chu Vivian H.2, Bettinger Jill C.3, Robles Jaime R.4, Fowler Vance G.2, Archer Gordon L.15
Affiliation:
1. Departments of Internal Medicine 2. Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710 3. Pharmacology and Toxicology, School of Medicine 4. Department of Pharmacy, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia 23298 5. Microbiology and Immunology
Abstract
ABSTRACT
Staphylococcus epidermidis
is one of the most common causes of infections of prosthetic heart valves (prosthetic valve endocarditis [PVE]) and an increasingly common cause of infections of native heart valves (native valve endocarditis [NVE]). While
S. epidermidis
typically causes indolent infections of prosthetic devices, including prosthetic valves and intravascular catheters,
S. epidermidis
NVE is a virulent infection associated with valve destruction and high mortality. In order to see if the differences in the course of infection were due to characteristics of the infecting organisms, we examined 31
S. epidermidis
NVE and 65 PVE isolates, as well as 21 isolates from blood cultures (representing bloodstream infections [BSI]) and 28 isolates from nasal specimens or cultures considered to indicate skin carriage. Multilocus sequence typing showed both NVE and PVE isolates to have more unique sequence types (types not shared by the other groups; 74 and 71%, respectively) than either BSI isolates (10%) or skin isolates (42%). Thirty NVE, 16 PVE, and a total of 9 of the nasal, skin, and BSI isolates were tested for virulence in
Caenorhabditis elegans
. Twenty-one (70%) of the 30 NVE isolates killed at least 50% of the worms by day 5, compared to 1 (6%) of 16 PVE isolates and 1 (11%) of 9 nasal, skin, or BSI isolates. In addition, the
C. elegans
survival rate as assessed by log rank analyses of Kaplan-Meier survival curves was significantly lower for NVE isolates than for each other group of isolates (
P
< 0.0001). There was no correlation between the production of poly-β(1-6)-
N
-acetylglucosamine exopolysaccharide and virulence in worms. This study is the first analysis suggesting that
S. epidermidis
isolates from patients with NVE constitute a more virulent subset within this species.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Immunology,Microbiology,Parasitology
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