Phage typing of Pseudomonas aeruginosa

Identification and biosynthesis of thymidine hypermodifications in the genomic DNA of widespread bacterial viruses

Certain viruses of bacteria (bacteriophages) enzymatically hypermodify their DNA to protect their genetic material from host restriction endonuclease-mediated cleavage. Historically, it has been known that virion DNAs from the Delftia phage ΦW-14 and the Bacillus phage SP10 contain the hypermodified pyrimidines α-putrescinylthymidine and α-glutamylthymidine, respectively. These bases derive from the modification of 5-hydroxymethyl-2'-deoxyuridine (5-hmdU) in newly replicated phage DNA via a pyrophosphorylated intermediate. Like ΦW-14 and SP10, the Pseudomonas phage M6 and the Salmonella phage ViI encode kinase homologs predicted to phosphorylate 5-hmdU DNA but have uncharacterized nucleotide content [Iyer et al. (2013) Nucleic Acids Res 41:7635-7655]. We report here the discovery and characterization of two bases, 5-(2-aminoethoxy)methyluridine (5-NeOmdU) and 5-(2-aminoethyl)uridine (5-NedU), in the virion DNA of ViI and M6 phages, respectively. Furthermore, we show that recombinant expression of five gene products encoded by phage ViI is sufficient to reconstitute the formation of 5-NeOmdU in vitro. These findings point to an unexplored diversity of DNA modifications and the underlying biochemistry of their formation.

Transmission of urinary bacterial strains between patients with indwelling catheters--nursing in the same room and in separate rooms compared

Despite lack of supporting scientific data it has been suggested that patients with an indwelling urinary catheter (IUC) should be nursed in separate rooms to reduce the risk of cross-infection. We conducted a one-month case-control study of nursing home patients with an IUC and bacteriuria, 20 nursed together pairwise and 20 in separate rooms, by weekly urine cultures and typing of the bacterial isolates. The transmission rate of urinary strains between patients was three times higher within rooms (5/9 possible transmissions) than between rooms (9/53 possible transmissions, P = 0.02). The study thus supported nursing IUC patients in separate rooms.

Morphology of Pseudomonas aeruginosa typing phages of the Lindberg set

Eighteen phages were studied by electron microscopy. They belonged to eight morphotypes representing the Myoviridae, Siphoviridae and Podoviridae families of tailed phages. Twelve phages were members of known species and six phages belonged to three new species. Results correlated closely with serological and DNA-DNA hybridization data. Induced and non-induced propagating bacteria were investigated for lysogeny. All strains produced R-type pyocins, phage-like particles or inhibitory reactions. The identity of typing phages should be controlled periodically.

Purification and properties of an S-type pyocin, pyocin AP41

Pyocin AP41, a protease-sensitive bacteriocin produced by Pseudomonas aeruginosa PAF41, was purified to a homogeneous state and characterized. The molecular weight of this pyocin was about 95,000 as determined by the combination of gel filtration and sedimentation velocity analysis. This pyocin was a complex of two kinds of polypeptides. Highly purified preparations showed two protein bands on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and their apparent molecular weights were 90,000 and 6,000 to 7,000, respectively. Two proteins could be separated by gel filtration in the presence of 6 M urea. Amino acid compositions of these components were determined. The large component had pyocin activity similar to the complex, whereas the small component did not. Sensitive cells were killed by this pyocin only under growing conditions and with single-hit kinetics. The pyocin-treated cells lysed in about 30 min with concomitant production of their resident pyocins or phages. The induced production of resident pyocins caused by pyocin AP41 depended on a recA gene function.

Attempts to control clothes-borne infection in a burn unit, 2. Clothing routines in clinical use and the epidemiology of cross-colonization

Previous investigations have shown that cross-contamination in a burn unit is mainly clothes-borne. New barrier garments have been designed and tried experimentally. The aim of the present study was to investigate the effects of different clothing routines on cross-contamination. In a long-term study, the rates and routes of colonizations with Staphylococcus aureus, Streptococcus groups A, B, C, F, and G and Pseudomonas aeruginosa were examined. The exogenous colonization rates were, with S. aureus 77%, with Streptococcus species 52% and with Ps. aeruginosa 32%. The colonization rate with Ps. aeruginosa was higher in patients with larger burns. Patients dispersed Streptococcus and Ps. aeruginosa as well as S. aureus into the air of their rooms in considerable amounts, but dispersers were not more important as sources of cross-colonization than non-dispersers. In comparison of clothing routines, there was no difference in overall colonization rates. The newly designed barrier garment that was made from apparently particle-tight material did not reduce the transfer of bacteria from patient to patient. A less rigid routine than that previously used did not increase the risk of cross-contamination. A thorough change of barrier dress after close contact nursing delayed the first exogenous S. aureus colonization from day 6 to day 14 after admission. This routine might be recommended for clinical use. Otherwise, methods must be developed for adequate selection of materials intended for barrier garments.

Attempts to control clothes-borne infection in a burn unit, 3. An open-roofed plastic isolator or plastic aprons to prevent contact transfer of bacteria

An open-roofed plastic isolator was built in a single patient isolation room in a burn unit. It was designed to prevent contact contamination only, as this had been shown to be the important route of cross-colonization in the unit. To exclude any possible effect on airborne transfer of bacteria, the isolator was first examined by means of an airborne particle tracer of the same size as bacteria-carrying particles. Such experiments indicated that the isolator might prevent some transfer out of but not into the isolator. This was not confirmed in simulated nursing experiments nor in a patient study, where the air counts of bacteria were practically the same inside and outside the isolator wall. Two patients only were nursed in the isolator. Both patients acquired exogenous colonizations from other patients, one with Ps. aeruginosa and the other with S. aureus. Nursing in the isolator was difficult and staff-demanding. In simulated nursing experiments, plastic aprons and gauntlets as the only protective measures against contact contamination gave as much protection to a mock patient as did the isolator. S. aureus were released from nurses' clothes more easily during work with the isolator than in open nursing with aprons and gauntlets. In conclusion, the isolator did not seem to be a realistic alternative to impermeable clothes such as plastic aprons as a means of preventing clothes-borne cross-contamination between burn patients.

Isolation care of infection-prone burn patients

An experimental and clinical study of spread of colonisation between burn patients, and their susceptibility to infection, was performed. Burn patients' polymorphonuclear neutrophil granulocytes (PMN) functioned poorly, particularly during the second week after injury which coincided with maximum growth of bacteria in the burn wound. Patients with large burns often dispersed S. aureus and Ps. aeruginosa but also beta-hemolytic Streptococcus to the air of their rooms. Airborne transfer of these bacteria was practically eliminated by nursing in single isolation rooms with plenum ventilation. In such rooms, cross-contamination was carried mainly via clothes. Patients with small burns sometimes were important sources of such contamination although they dispersed little bacteria to the air. A thorough change of barrier dress after close contact nursing delayed the first exogenous S. aureus colonisation until after the time of greatest impairment in PMN functions. A further reduction in cross-contamination would be possible with barrier garments impermeable to fluids and bacteria on points of contact, as shown in experiments with plastic apron as protective dress. Measurements of penetration through fabrics of particles suspended in air, commercially used, did not correlate to the performance of garments made from the fabrics in experimental nursing and clinical use. Bacteria were shown to penetrate fabrics through rubbing, particularly when wet where the microcolonies present on the cloth were separated into smaller units. An instrument was designed which measured such penetration, and was used to select fabrics for barrier garments. Tightly fitting barrier garments increased the disperal of bacteria from clothes worn underneath them. The wearing of barrier garments should therefore be restricted to close contact nursing. An open-roofed plastic patient isolator was designed and built. It did not appreciably reduce cross-contamination and gave psychological and practical problems. It seemed not to be a realistic alternative to better protective garments in isolation rooms.

Pyocin typing of Pseudomonas aeruginosa: a simplified method

A simplified method has been devised for typing Pseudomonas aeruginosa by pyocin production. Pyocins are produced as strains grow overnight in Trypticase soy broth (without glucose) plus 1% potassium nitrate. Because P. aeruginosa can use nitrate instead of oxygen as a terminal electron acceptor, mechanical shaking is not necessary, nor is induction by mitomycin C. Pyocins can now be produced in screw-cap tubes in a water bath or incubator. A total of 250 strains were tested as possible pyocin indicators, which included 60 strains already used in pyocin-typing systems. The final set contained 18 indicators which were chosen because (i) they had clear positive or clear negative reactions, thus eliminating reactions difficult to read, (ii) they had few zones due to bacteriophage lysis, and (iii) they were most sensitive in differentiating clinical isolates of P. aeruginosa. The final typing method was tested in several studies and the results were clear; thus definitive epidemiological conclusions could be made. Because it is simple to perform and easily automated, the new method should have application in many hospitals; however, it should be used only in carefully planned epidemiological studies. The method and its application are described in detail, and some pitfalls are discussed.

Typing of Pseudomonas aeruginosa: comparison of the phage procedure with the pyocine technique

Two hundred and sixty strains of Pseudomonas aeruginosa were isolated from patients of the Asaf Harofe Government Hospital. The strains were typed by phage technique and 64 of them were also typed according to pyocine sensitivity. The two methods proved complementary, and reduced the number of untypable strains. Phage typing was performed with both routine test dilution (RTD) and more concentrated phage suspensions. The most reliable results were obtained at 100 RTD.

Epidemiology of pseudomonas aeruginosa in a burn hospital: evaluation of serological, bacteriophage, and pyocin typing methods

In a retrospective study 36 cultures of Pseudomonas aeruginosa, isolated from patients with fatal Pseudomonas burn wound sepsis and from burned patients with nonfatal P. aeruginosa infections, were used to evaluate the consistency and reliability of serological, phage, and pyocin typing as epidemiological tools. Frequency distributions of positive reactions were analyzed by a computer in a 3-way chi-square test, and a high degree of consistency was demonstrated for each method. From these data, 75% of the cultures were differentiated by serological, 90% by phage, and 100% by pyocin typing. There was no significant difference among organisms isolated from fatal cases of burn wound sepsis and organisms from patients with nonfatal infections (chi(2) = 0.3418; P = 0.9870). The combined typing system was a sensitive and reliable epidemiological tool for intraspecific differentiation of P. aeruginosa.

Epidemiological fingerprinting of Pseudomonas aeruginosa by the production of and sensitivity of pyocin and bacteriophage

A new method has been devised to trace cross-infection by Pseudomonas aeruginosa. Unknown strains growing logarithmically in liquid media were treated with mitomycin C to induce the liberation of pyocin and phage. The lysates were then tested against 27 selected indicator strains, and the zones of clearing were differentiated as to killing by pyocin or lysis by phage. Twenty-four standard pyocin-phage lysates were then applied to each of the unknowns, and the sensitivity pattern was recorded. Thus, an "epidemiological fingerprint" consisting of 51 operational characteristics was established for each isolate. Organisms from the same source had identical or similar fingerprints, but organisms from different origins could easily be distinguished. Pyocin production, pyocin sensitivity, and phage production were found to be stable genetic characters; however, spontaneous mutations in phage sensitivity were frequently encountered. The epidemiological fingerprint has proven to be a sensitive tool in establishing the identity or dissimilarity of unknown strains. This method has been of great value in tracing the epidemiology of P. aeruginosa in the hospital environment. Each of the 157 P. aeruginosa strains tested has been typable by this method.