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Journal of Clinical Microbiology, December 2004, p. 5614-5619, Vol. 42, No. 12
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.12.5614-5619.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Detection of Virulence-Associated Genes Not Useful for Discriminating between Invasive and Commensal Staphylococcus epidermidis Strains from a Bone Marrow Transplant Unit

Holger Rohde,1* Matthias Kalitzky,1 Nicolaus Kröger,2 Stefanie Scherpe,1 Matthias A. Horstkotte,1 Johannes K.-M. Knobloch,1 Axel R. Zander,2 and Dietrich Mack1,3

Institut für Infektionsmedizin,1 Zentrum für Knochenmarktransplantation, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany,2 Medical Microbiology and Infectious Diseases, The Clinical School, University of Wales Swansea, Swansea, United Kingdom3

Received 21 April 2004/ Returned for modification 22 June 2004/ Accepted 22 July 2004

Because of their biofilm-forming capacity, invasive Staphylococcus epidermidis isolates, which cause the majority of nosocomial catheter-related bloodstream infections (BSIs), are thought to be selected at the time of catheter insertion from a population of less virulent commensal strains. This fact allows the prediction that invasive and contaminating strains can be differentiated via detection of virulence-associated genes. However, the hospital environment may pave the way for catheter-related infections by promoting a shift in the commensal bacterial population toward strains with enhanced virulence. The distribution of virulence-associated genes (icaADBC, aap, atlE, bhp, fbe, embp, mecA, IS256, and IS257), polysaccharide intercellular adhesin synthesis, and biofilm formation were investigated in S. epidermidis strains from independent episodes of catheter-related BSIs in individuals who have received bone marrow transplantation (BMT). The results were compared with those obtained for commensal S. epidermidis isolates from hospitalized patients after BMT and from healthy individuals, respectively. The clonal relationships of the strains were investigated by pulsed-field gel electrophoresis. icaADBC, mecA, and IS256 were significantly more prevalent in BSI isolates than in commensal isolates from healthy individuals. However, the prevalence of any of the genes in clonally independent, endogenous commensal strains from BMT patients did not differ from that in invasive BSI strains. icaADBC and methicillin resistance, factors important for the establishment of catheter-related infections, already ensure survival of the organisms in their physiological habitat in the hospital environment, resulting in a higher probability of contamination of indwelling medical devices with virulent S. epidermidis strains. The dynamics of S. epidermidis populations reveal that detection of icaADBC and mecA is not suitable for discriminating invasive from contaminating S. epidermidis strains.

* Corresponding author. Mailing address: Institut für Infektionsmedizin, Zentrum für Klinisch-Theoretische Medizin, Martinistraße 52, 20246 Hamburg, Germany. Phone: 0049 40 42803 3147. Fax: 0049 40 42803 4881. E-mail: rohde{at}uke.uni-hamburg.de.

Journal of Clinical Microbiology, December 2004, p. 5614-5619, Vol. 42, No. 12
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.12.5614-5619.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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