Comment on: Staphylococcus aureus bacteremia (SAB) with associated S. aureus bacteriuria (SABU) as a predictor of complications and mortality

Identification and evaluation of a novel peptide binding to the cell surface of Staphylococcus aureus

Identification of short peptides that serve as specific ligands to biological materials such as microbial cell surfaces has major implications in better understanding the molecular recognition of cell surfaces. In this study we screened a commercially available random phage-display library against Staphylococcus aureus cells and identified peptides specifically binding to the bacteria. A synthetic peptide (SA5-1) representing the consensus sequence (VPHNPGLISLQG) of the bacteria-binding peptide was evaluated for its binding potential against S. aureus. Dot-blot, immunoblot assay and ELISA results revealed the SA5-1 peptide to be highly specific to S. aureus. The SA5-1 peptide binding was optimal between pH 6.0 and 8.0. Nanogold Transmission Electron Microscopy demonstrated that the SA5-1 binds to the outer membrane surface of S. aureus. Diagnostic potential of the SA5-1 peptide was evaluated in human platelet samples spiked with S. aureus and specific detection of the bacteria by biotinylated-SA5-1 and streptavidin-conjugated fluorescent quantum dots. Fluorometry results indicated that the peptide was able to detect ∼100 organisms per ml in a spiked biological sample providing a proof-of-concept towards potential of this peptide as a S. aureus diagnostic tool that can be of use in different detection platforms.

Clinical significance of Staphylococcus aureus bacteriuria in a nationwide study of adults with S. aureus bacteraemia

OBJECTIVES

To evaluate the clinical significance of Staphylococcus aureus bacteriuria (SABU) in adults with S. aureus bacteraemia (SAB).

METHODS

All individuals ≥18 years old diagnosed with SAB in Iceland between December 1st 2003 and November 30th 2008 were retrospectively identified. Data was collected from medical records. Concomitant SABU was defined as growth of S. aureus in a urine sample taken within 24 h of the index blood culture.

RESULTS

SABU was seen in 27 of 166 (16.3%) SAB patients having urine cultured before administration of antibiotics, but after excluding those with SAB of urinary tract origin SABU was seen in 16 of 152 (10.5%). In this latter cohort SABU was independently associated with having endocarditis (RR 6.68; 95% CI 1.53-17.3) and admission to intensive-care unit (RR 2.84; 95% CI 1.25-4.44), while for having complicated SAB the RR was 1.56 (95% CI 0.96-1.80). No correlation was seen with mortality or relapse rates.

CONCLUSIONS

SABU appears to be secondary to SAB in some cases while it is the primary infection causing SAB in others. In patients with SAB of non-urinary tract origin SABU should probably be regarded as distant haematogenous seeding and a marker of deep tissue dissemination, thus affecting general management and treatment duration.