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Quantifying the Cytotoxicity of Staphylococcus aureus Against Human Polymorphonuclear Leukocytes
Published on: January 3, 2020
Hemolytic activity and antibiotic resistance profiles of Staphylococcus aureus isolates from clinical patients
Yen-Hsi Lai1, Chih-Chen Kao1,2, Min Yi Wong1
1Division of Thoracic and Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Taiwan.
Abstract:
Staphylococcus aureus is a common human pathogen that can cause vascular and skin infections, and patients undergoing hemodialysis are particularly susceptible to vascular access infections caused by S. aureus. Hemolysins are important virulence factors, and antibiotic resistance poses challenges for treatment. In this study, S. aureus isolates were collected from hemodialysis patients with vascular access, such as arteriovenous grafts, tunneled-cuffed catheters, and arteriovenous fistulas, as well as from non-vascular access infection (VAI) patients. The hemolytic phenotype and eight antibiotic susceptibility of these isolates were tested, and PCR was used to detect hemolysin (hla, hlb, hld, and hlgC/B) and antibiotic resistance genes (accA-aphD, tetM, and tetK). The results showed that methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) isolates exhibited only β- and γ-hemolytic phenotypes. The hla and hld genes were the most frequently detected hemolysin genes, whereas hlb was the least common. Over 80% of both MRSA and MSSA isolates exhibited resistance to ampicillin, with multidrug resistance observed more frequently in MRSA. Distinct antibiotic resistance gene patterns were observed in MRSA and MSSA isolates. Despite these differences in gene patterns, no obvious differences were found between VAI and non-VAI patients, or between MRSA and MSSA isolates. These findings provide a better understanding of the hemolytic characteristics and antibiotic susceptibility of S. aureus isolates collected from hemodialysis and non-hemodialysis patients, contributing to more targeted and effective treatment strategies.IMPORTANCEStaphylococcus aureus is a common human pathogen, and dialysis patients are at higher risk of infection compared to the general population because this bacterium can colonize medical devices and vascular access catheters. Among its various virulence factors, hemolysins play a crucial role by damaging host cells and helping the bacteria evade immune defenses. The widespread use of antibiotics has led to the emergence of antibiotic-resistant S. aureus, especially methicillin-resistant S. aureus, further complicating treatment. This study aims to investigate the types of hemolysins, the distribution of hemolysin and antibiotic resistance genes, and antibiotic resistance patterns in S. aureus isolates from patients with vascular access-related and non-vascular access infections, providing a reference for infection control and treatment strategies.
Insights
Staphylococcus aureus infections in dialysis patients show specific hemolysin gene patterns and high ampicillin resistance. Methicillin-resistant S. aureus (MRSA) exhibited more multidrug resistance, but no clear differences were found between vascular access and non-vascular access infection groups.
Area of Science:
- Clinical microbiology and infectious diseases
- Molecular epidemiology of bacterial pathogens
- Antimicrobial resistance mechanisms
Background:
- Staphylococcus aureus is a significant pathogen, particularly in hemodialysis patients due to vascular access devices.
- Hemolysins are key virulence factors, while antibiotic resistance complicates treatment strategies.
- Dialysis patients face elevated infection risks from S. aureus colonization of medical devices.
Purpose of the Study:
- To investigate hemolytic phenotypes and antibiotic resistance gene profiles of S. aureus isolates from hemodialysis patients.
- To compare S. aureus isolates from vascular access infections (VAI) versus non-VAI patients.
- To analyze differences between methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) isolates.
Main Methods:
- Collection of S. aureus isolates from hemodialysis patients with and without VAI.
- Phenotypic testing for hemolysis and antibiotic susceptibility to eight antibiotics.
- Polymerase chain reaction (PCR) for detecting hemolysin genes (hla, hlb, hld, hlgC/B) and resistance genes (accA-aphD, tetM, tetK).
Main Results:
- All S. aureus isolates displayed beta- and gamma-hemolytic phenotypes.
- hla and hld were the most common hemolysin genes; hlb was least common.
- Over 80% of MRSA and MSSA isolates were ampicillin-resistant; MRSA showed higher multidrug resistance. Distinct resistance gene patterns were observed between MRSA and MSSA, but not between VAI and non-VAI groups.
Conclusions:
- S. aureus isolates from hemodialysis patients possess specific hemolysin profiles and significant antibiotic resistance.
- While MRSA strains exhibit higher multidrug resistance, VAI status did not correlate with distinct gene patterns.
- Findings aid in understanding S. aureus virulence and resistance, informing targeted treatment and infection control for dialysis patients.

