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. 2020 Sep 7;9(9):582.
doi: 10.3390/antibiotics9090582.

S. aureus Colonization, Biofilm Production, and Phage Susceptibility in Peritoneal Dialysis Patients

Karlis Racenis  1   2 , Juta Kroica  1 , Dace Rezevska  1 , Lauris Avotins  1 , Edgars Skuditis  1 , Anna Popova  1   2 , Ilze Puide  2   3 , Viktorija Kuzema  2   3 , Aivars Petersons  2   3
Affiliations

S. aureus Colonization, Biofilm Production, and Phage Susceptibility in Peritoneal Dialysis Patients

Karlis Racenis et al. Antibiotics (Basel). .

Abstract

Peritonitis caused by Staphylococcusaureus is of major importance in peritoneal dialysis (PD) patients due to its great virulence profile and biofilm formation ability. Bacteriophages are a potential tool to treat peritonitis resulting from biofilm-associated infections. We screened S. aureus colonization in 71 PD patients from the nasal cavity, groin, and PD exit-site regions and analyzed clinical outcomes in these patients. We performed biofilm-formation testing of different strains and compared the isolates of one patient to detect phenotypic differences in S. aureus. Phage cocktails were used to detect S. aureus in vitro susceptibility. An adaptation procedure was performed in cases of bacterial resistance. Around 30% of PD patients (n = 21) were found to be S. aureus carriers; from these, a total of 34 S. aureus strains were isolated, of which 61.8% (n = 21) produced a strong biofilm. Phenotypic differences in strain biofilm production were detected in eight patients out of ten. All strains were sensitive to commonly used antibiotics. Broadly positive phage lytic activity (100%) was observed in six cocktails out of seven, and bacterial resistance towards phages was overcome using adaptation. Overall phages showed a promising in vitro effect in biofilm-forming S. aureus strains.

Keywords: S. aureus; biofilm; peritoneal dialysis; phage adaptation; phage therapy; phenotypic trait.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Biofilm production capability on microtiter plate of the 34 clinical isolates of S. aureus and negative control (NC). Bars represent mean values of OD (measured at wavelength of 570 nm). Differences between one suspect S. aureus strain capability in biofilm formation were analyzed using T test and Mann–Whitney U Test for two strain analyses, and one-way ANOVA and Kruskal–Wallis test for three strain analysis and are expressed as p-values.
Figure 2
Figure 2
Lytic activity of seven commercial bacteriophage cocktails against Staphylococcus aureus reference strain ATCC 15923 before and after bacteriophage adaptation. (1) Staphylococcal Bacteriophage (Eliava); (2) Pyo Bacteriophage (Eliava); (3) Ses Bacteriophage (Eliava); (4) Fersisi Bacteriophage (Eliava); (5) Enko Bacteriophage (Eliava); (6) Intesti Bacteriophage (Eliava); (7) Pyobacteriophag Bacteriophage (Microgen). (A) Lytic activity before adaptation procedure. (1) R (−), resistant or no lysis; (2–4) PL (++), partial lysis; (5) IP (+), individual plaques; (6, 7) PL (++), partial lysis. (B) Lytic activity after adaptation procedure. (1) CL (+++), confluent lysis; (2) PL (++), partial lysis; (3, 4) CL (+++), confluent lysis; (5) PL (++), partial lysis; (6, 7) CL (+++), confluent lysis.
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