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Articles by Andrew M. Edwards in JoVE

Other articles by Andrew M. Edwards on PubMed

Genetic Relatedness and Phenotypic Characteristics of Treponema Associated with Human Periodontal Tissues and Ruminant Foot Disease

Treponema have been implicated recently in the pathogenesis of digital dermatitis (DD) and contagious ovine digital dermatitis (CODD) that are infectious diseases of bovine and ovine foot tissues, respectively. Previous analyses of treponemal 16S rDNA sequences, PCR-amplified directly from DD or CODD lesions, have suggested relatedness of animal Treponema to some human oral Treponema species isolated from periodontal tissues. In this study a range of adhesion and virulence-related properties of three animal Treponema isolates have been compared with representative human oral strains of Treponema denticola and Treponema vincentii. In adhesion assays using biotinylated treponemal cells, T. denticola cells bound in consistently higher numbers to fibronectin, laminin, collagen type I, gelatin, keratin and lactoferrin than did T. vincentii or animal Treponema isolates. However, animal DD strains adhered to fibrinogen at equivalent or greater levels than T. denticola. All Treponema strains bound to the amino-terminal heparin I/fibrin I domain of fibronectin. 16S rDNA sequence analyses placed ovine strain UB1090 and bovine strain UB1467 within a cluster that was phylogenetically related to T. vincentii, while ovine strain UB1466 appeared more closely related to T. denticola. These observations correlated with phenotypic properties. Thus, T. denticola ATCC 35405, GM-1, and Treponema UB1466 had similar outer-membrane protein profiles, produced chymotrypsin-like protease (CTLP), trypsin-like protease and high levels of proline iminopeptidase, and co-aggregated with human oral bacteria Porphyromonas gingivalis and Streptococcus crista. Conversely, T. vincentii ATCC 35580, D2A-2, and animal strains UB1090 and UB1467 did not express CTLP or trypsin-like protease and did not co-aggregate with P. gingivalis or S. crista. Taken collectively, these results suggest that human oral-related Treponema have broad host specificity and that similar control or preventive strategies might be developed for human and animal Treponema-associated infections.

Carcinoembryonic Antigen-related Cell Adhesion Molecule (CEACAM)-binding Recombinant Polypeptide Confers Protection Against Infection by Respiratory and Urogenital Pathogens

The human-specific pathogens Neisseria meningitidis, N. gonorrhoea, Haemophilus influenzae and Moraxella catarrhalis share the property of targeting the carcinoembryonic antigen (CEA)-related cell adhesion molecules (CEACAMs) expressed on human epithelia. CEACAMs are signalling receptors implicated in cell adhesion and regulation of several physiological functions. Their targeting by pathogens can lead to tissue invasion. Although the CEACAM-binding ligands of the bacteria are structurally diverse, they target a common site on the receptor. We have generated a recombinant polypeptide that blocks the interactions of the mucosal pathogens with human epithelial cells and antibodies against it inhibit M. catarrhalis interactions with the receptor. As such, it is a potential antimicrobial agent to prevent infection via a strategy unlikely to promote bacterial resistance and a vaccine candidate against M. catarrhalis. In addition, it could serve more widely as a novel research tool and as a potential therapeutic agent in CEACAM-based physiological disorders.

Binding Properties and Adhesion-mediating Regions of the Major Sheath Protein of Treponema Denticola ATCC 35405

There is growing evidence that a number of oral Treponema species, in particular Treponema denticola, are associated with the progression of human periodontal disease. The major sheath (or surface) protein (Msp) of T. denticola is implicated in adhesion of bacteria to host cells and tissue proteins and is likely to be an important virulence factor. However, the binding regions of the Msp are not known. We have purified from Escherichia coli recombinant Msp (rMsp) polypeptides corresponding to the following: full-length Msp (rMsp) minus 13 N-terminal amino acid (aa) residues, an amino-terminal fragment (rN-Msp, 189 aa residues), a 57-aa residue segment from the central region (rV-Msp), and a C-terminal fragment (rC-Msp, 272 aa residues). rMsp (530 aa residues) bound to immobilized fibronectin, keratin, laminin, collagen type I, fibrinogen, hyaluronic acid, and heparin. The N- and V-region polypeptides, but not rC-Msp, also bound to these substrates. Binding of rMsp to fibronectin was targeted to the N-terminal heparin I/fibrin I domain. Antibodies to the N-region or V-region polypeptides, but not antibodies to the rC-Msp fragment, blocked adhesion of T. denticola ATCC 35405 cells to a range of host protein molecules. These results suggest that the N-terminal half of Msp carries epitopes that are surface exposed and that are involved in mediating adhesion. Binding of rMsp onto the cell surface of low-level fibronectin-binding Treponema isolates conferred a 10-fold increase in fibronectin binding. This confirms that Msp functions autonomously as an adhesin and raises the possibility that phenotypic complementation of virulence functions might occur within mixed populations of Treponema species.

Fusobacterium Nucleatum Transports Noninvasive Streptococcus Cristatus into Human Epithelial Cells

Analysis of human buccal epithelial cells frequently reveals an intracellular polymicrobial consortium of bacteria. Although several oral bacteria have been demonstrated to invade cultured epithelial cells, several others appear unable to internalize. We hypothesized that normally noninvasive bacteria may gain entry into epithelial cells via adhesion to invasive bacteria. Fusobacterium nucleatum is capable of binding to and invading oral epithelial cells. By contrast, Streptococcus cristatus binds weakly to host cells and is not internalized. F. nucleatum and S. cristatus coaggregate strongly via an arginine-sensitive interaction. Coincubation of KB or TERT-2 epithelial cells with equal numbers of F. nucleatum and S. cristatus bacteria led to significantly increased numbers of adherent and internalized streptococci. F. nucleatum also promoted invasion of KB cells by other oral streptococci and Actinomyces naeslundii. Dissection of fusobacterial or streptococcal adhesive interactions by using sugars, amino acids, or antibodies demonstrated that this phenomenon is due to direct attachment of S. cristatus to adherent and invading F. nucleatum. Inhibition of F. nucleatum host cell attachment and invasion with galactose, or fusobacterial-streptococcal coaggregation by the arginine homologue l-canavanine, abrogated the increased S. cristatus adhesion to, and invasion of, host cells. In addition, polyclonal antibodies to F. nucleatum, which inhibited fusobacterial attachment to both KB cells and S. cristatus, significantly decreased invasion by both species. Similar decreases were obtained when epithelial cells were pretreated with cytochalasin D, staurosporine, or cycloheximide. These studies indicate that F. nucleatum may facilitate the colonization of epithelial cells by bacteria unable to adhere or invade directly.

Influence of Moderate Dehydration on Soccer Performance: Physiological Responses to 45 Min of Outdoor Match-play and the Immediate Subsequent Performance of Sport-specific and Mental Concentration Tests

To determine whether moderate water loss (approximately 1.5-2% of body mass (BM)) represents a significant impairment to soccer match-play and the related fitness variables.

Streptococcus Pyogenes Pili Promote Pharyngeal Cell Adhesion and Biofilm Formation

Group A Streptococcus (GAS, Streptococcus pyogenes) is a Gram-positive human pathogen responsible for several acute diseases and autoimmune sequelae that account for half a million deaths worldwide every year. GAS infections require the capacity of the pathogen to adhere to host tissues and assemble in cell aggregates. Furthermore, a role for biofilms in GAS pathogenesis has recently been proposed. Here we investigated the role of GAS pili in biofilm formation. We demonstrated that GAS pilus-negative mutants, in which the genes encoding either the pilus backbone structural protein or the sortase C1 have been deleted, showed an impaired capacity to attach to a pharyngeal cell line. The same mutants were much less efficient in forming cellular aggregates in liquid culture and microcolonies on human cells. Furthermore, mutant strains were incapable of producing the typical three-dimensional layer with bacterial microcolonies embedded in a carbohydrate polymeric matrix. Complemented mutants had an adhesion and aggregation phenotype similar to the wild-type strain. Finally, in vivo expression of pili was indirectly confirmed by demonstrating that most of the sera from human patients affected by GAS-mediated pharyngitis recognized recombinant pili proteins. These data support the role of pili in GAS adherence and colonization and suggest a general role of pili in all pathogenic streptococci.

Revisiting Lévy Flight Search Patterns of Wandering Albatrosses, Bumblebees and Deer

The study of animal foraging behaviour is of practical ecological importance, and exemplifies the wider scientific problem of optimizing search strategies. Lévy flights are random walks, the step lengths of which come from probability distributions with heavy power-law tails, such that clusters of short steps are connected by rare long steps. Lévy flights display fractal properties, have no typical scale, and occur in physical and chemical systems. An attempt to demonstrate their existence in a natural biological system presented evidence that wandering albatrosses perform Lévy flights when searching for prey on the ocean surface. This well known finding was followed by similar inferences about the search strategies of deer and bumblebees. These pioneering studies have triggered much theoretical work in physics (for example, refs 11, 12), as well as empirical ecological analyses regarding reindeer, microzooplankton, grey seals, spider monkeys and fishing boats. Here we analyse a new, high-resolution data set of wandering albatross flights, and find no evidence for Lévy flight behaviour. Instead we find that flight times are gamma distributed, with an exponential decay for the longest flights. We re-analyse the original albatross data using additional information, and conclude that the extremely long flights, essential for demonstrating Lévy flight behaviour, were spurious. Furthermore, we propose a widely applicable method to test for power-law distributions using likelihood and Akaike weights. We apply this to the four original deer and bumblebee data sets, finding that none exhibits evidence of Lévy flights, and that the original graphical approach is insufficient. Such a graphical approach has been adopted to conclude Lévy flight movement for other organisms, and to propose Lévy flight analysis as a potential real-time ecosystem monitoring tool. Our results question the strength of the empirical evidence for biological Lévy flights.

Scavenger Receptor Gp340 Aggregates Group A Streptococci by Binding Pili

Group A streptococci (GAS) are the most frequent cause of bacterial pharyngitis. The first obstacle to GAS colonization of the pharynx is saliva. As well as forming a physical barrier, saliva contains components of innate and acquired immunity. Previous work has shown that saliva induces bacterial aggregation, which may serve as a clearance mechanism. As the aggregation of some oral streptococci in saliva is mediated by long proteinaceous appendages, we hypothesized that pili of GAS might behave similarly. Wild-type GAS M1 strain SF370 aggregated in saliva, while pilus-defective mutants did not. Similarly, heterologous expression of diverse GAS pili on the surface of Lactococcus lactis induced aggregation in saliva, while control strains were unaffected. Further studies revealed that aggregating bacteria bound salivary component gp340. Purified gp340 aggregated wild-type GAS and L. lactis expressing GAS pili, but not control strains. GAS pilus-defective mutants were abrogated in gp340 binding and aggregation. Furthermore, gp340-mediated aggregation reduced bacterial adhesion to human epithelial cells, suggesting a role in host defence.

Using Likelihood to Test for Lévy Flight Search Patterns and for General Power-law Distributions in Nature

1. Ecologists are obtaining ever-increasing amounts of data concerning animal movement. A movement strategy that has been concluded for a broad variety of animals is that of Lévy flights, which are random walks whose step lengths come from probability distributions with heavy power-law tails. 2. The exponent that parameterizes the power-law tail, denoted micro, has repeatedly been found to be within the Lévy range of 1 < micro

Dehydration: Cause of Fatigue or Sign of Pacing in Elite Soccer?

Numerous studies have suggested that dehydration is a causal factor to fatigue across a range of sports such as soccer; however, empirical evidence is equivocal on this point. It is also possible that exercise-induced moderate dehydration is purely an outcome of significant metabolic activity during a game. The diverse yet sustained physical activities in soccer undoubtedly threaten homeostasis, but research suggests that under most environmental conditions, match-play fluid loss is minimal ( approximately 1-2% loss of body mass), metabolite accumulation remains fairly constant, and core temperatures do not reach levels considered sufficiently critical to require the immediate cessation of exercise. A complex (central) metabolic control system which ensures that no one (peripheral) physiological system is maximally utilized may explain the diversity of research findings concerning the impact of individual factors such as dehydration on elite soccer performance. In consideration of the existing literature, we propose a new interpretative pacing model to explain the self-regulation of elite soccer performance and, in which, players behaviourally modulate efforts according to a subconscious strategy. This strategy is based on both pre-match (intrinsic and extrinsic factors) and dynamic considerations during the game (such as skin temperature, thirst, accumulation of metabolites in the muscles, plasma osmolality and substrate availability), which enables players to avoid total failure of any single peripheral physiological system either prematurely or at the conclusion of a match. In summary, we suggest that dehydration is only an outcome of complex physiological control (operating a pacing plan) and no single metabolic factor is causal of fatigue in elite soccer.

Inspiratory Muscle Training and Endurance: a Central Metabolic Control Perspective

The efficacy of inspiratory muscle training (IMT) has been the subject of considerable controversy in terms of whether it is beneficial to endurance athletes and because a convincing physiological rationale has not been identified to explain its mechanism of action. Early studies suggested that IMT was an ineffectual intervention for gains in either maximal aerobic power or endurance-specific performance. More rigorous recent research supports the observation that maximal aerobic power is not receptive to IMT; however, closer evaluation of both early and contemporary research indicates that responses to endurance-specific performance tests are sensitive to IMT. As the aim of endurance training is to improve endurance performance rather than maximal aerobic power, it is plausible that IMT may be useful in specific performance-related circumstances. Performance adaptations following IMT appear to be connected with posttraining reports of attenuated effort sensations, but this common observation has tended to be overlooked by researchers in preference for a reductionist explanation. This commentary examines the pertinent research and practical performance implications of IMT from the holistic perspective of complex central metabolic control.

The Invisible Niche: Weakly Density-dependent Mortality and the Coexistence of Species

Weakly density-dependent effects, characterized by fractional scaling exponents close to one, are rarely studied in the ecological literature. Here, we consider the effect of an additional weakly density-dependent term on a simple competition model. Our investigation reveals that weak density-dependence opens up an "invisible niche". This niche does not constitute a new mechanism for coexistence, but is a previously unexplored consequence of known mechanisms. In the invisible niche a weaker competitor can survive at very low density. Coexistence thus requires large habitat size. Such niches, if found in nature, would have a direct impact on species-area laws and species-abundance curves and should therefore receive more attention.

Influence of Crank Length on Cycle Ergometry Performance of Well-trained Female Cross-country Mountain Bike Athletes

The aim of this study was to determine the differential effects of three commonly used crank lengths (170, 172.5 and 175 mm) on performance measures relevant to female cross-country mountain bike athletes (n = 7) of similar stature. All trials were performed in a single blind and balanced order with a 5- to 7-day period between trials. Both saddle height and fore-aft position to pedal axle distance at a crank angle of 90 degrees was controlled across all trials. The laboratory tests comprised a supra-maximal (peak power-cadence); an isokinetic (50 rpm) test; and a maximal test of aerobic capacity. The time to reach supra-maximal peak power was significantly (P < 0.05) shorter in the 170 mm (2.57 +/- 0.79 s) condition compared to 175 mm (3.29 +/- 0.76 s). This effect represented a mean performance advantage of 27.8% for 170 mm compared to 175 mm. There was no further inter-condition differences between performance outcome measurements derived for the isokinetic (50 rpm) maximum power output, isokinetic (50 rpm) mean power output or indices of endurance performance. The decreased time to peak power with the greater rate of power development in the 170 mm condition suggests a race advantage may be achieved using a shorter crank length than commonly observed. Additionally, there was no impediment to either power output produced at low cadences or indices of endurance performance using the shorter crank length and the advantage of being able to respond quickly to a change in terrain could be of strategic importance to elite athletes.

Staphylococcus Aureus Host Cell Invasion and Virulence in Sepsis is Facilitated by the Multiple Repeats Within FnBPA

Entry of Staphylococcus aureus into the bloodstream can lead to metastatic abscess formation and infective endocarditis. Crucial to the development of both these conditions is the interaction of S. aureus with endothelial cells. In vivo and in vitro studies have shown that the staphylococcal invasin FnBPA triggers bacterial invasion of endothelial cells via a process that involves fibronectin (Fn) bridging to alpha(5)beta(1) integrins. The Fn-binding region of FnBPA usually contains 11 non-identical repeats (FnBRs) with differing affinities for Fn, which facilitate the binding of multiple Fn molecules and may promote integrin clustering. We thus hypothesized that multiple repeats are necessary to trigger the invasion of endothelial cells by S. aureus. To test this we constructed variants of fnbA containing various combinations of FnBRs. In vitro assays revealed that endothelial cell invasion can be facilitated by a single high-affinity, but not low-affinity FnBR. Studies using a nisin-inducible system that controlled surface expression of FnBPA revealed that variants encoding fewer FnBRs required higher levels of surface expression to mediate invasion. High expression levels of FnBPA bearing a single low affinity FnBR bound Fn but did not invade, suggesting that FnBPA affinity for Fn is crucial for triggering internalization. In addition, multiple FnBRs increased the speed of internalization, as did higher expression levels of FnBPA, without altering the uptake mechanism. The relevance of these findings to pathogenesis was demonstrated using a murine sepsis model, which showed that multiple FnBRs were required for virulence. In conclusion, multiple FnBRs within FnBPA facilitate efficient Fn adhesion, trigger rapid bacterial uptake and are required for pathogenesis.

How Does Staphylococcus Aureus Escape the Bloodstream?

Staphylococcus aureus is a major cause of bacteraemia, which frequently leads to infective endocarditis, osteomyelitis, septic arthritis and metastatic abscess formation. The development of these secondary infections is due to bacterial dissemination from the blood into surrounding tissues and is associated with significantly increased morbidity and mortality. Despite the importance of S. aureus extravasation in disease progression, there is relatively little understanding of the molecular mechanisms by which this pathogen crosses the endothelial barrier and establishes new sites of infection. Recent work has identified a number of putative routes by which S. aureus can escape the bloodstream. In this article we review these new developments and set them in the context of strategies used by other established pathogens to traverse cellular barriers.

Acute Nonhypothermic Exposure to Cold Impedes Motor Skill Performance in Video Gaming Compared to Thermo-neutral and Hot Conditions

The study examined whether or not acute exposure to unfamiliar hot or cold conditions impairs performance of highly skilled coordinative activities and whether prior physical self-efficacy beliefs were associated with task completion. Nineteen volunteers completed both Guitar Hero and Archery activities as a test battery using the Nintendo Wii console in cold (2 degrees C), neutral (20 degrees C), and hot (38 degrees C) conditions. Participants all completed physical self-efficacy questionnaires following experimental familiarization. Performances of both Guitar Hero and Archery significantly decreased in the cold compared with the neutral condition. The cold trial was also perceived as the condition requiring both greater concentration and effort. There was no association between performance and physical self-efficacy. Performance of these coordinative tasks was compromised by acute (nonhypothermic) exposure to cold; the most likely explanation is that the cold condition presented a greater challenge to attentional processes as a form of environmental distraction.

Staphylococcus Aureus Keratinocyte Invasion is Dependent Upon Multiple High-affinity Fibronectin-binding Repeats Within FnBPA

Staphylococcus aureus is a commensal organism and a frequent cause of skin and soft tissue infections, which can progress to serious invasive disease. This bacterium uses its fibronectin binding proteins (FnBPs) to invade host cells and it has been hypothesised that this provides a protected niche from host antimicrobial defences, allows access to deeper tissues and provides a reservoir for persistent or recurring infections. FnBPs contain multiple tandem fibronectin-binding repeats (FnBRs) which bind fibronectin with varying affinity but it is unclear what selects for this configuration. Since both colonisation and skin infection are dependent upon the interaction of S. aureus with keratinocytes we hypothesised that this might select for FnBP function and thus composition of the FnBR region. Initial experiments revealed that S. aureus attachment to keratinocytes is rapid but does not require FnBRs. By contrast, invasion of keratinocytes was dependent upon the FnBR region and occurred via similar cellular processes to those described for endothelial cells. Despite this, keratinocyte invasion was relatively inefficient and appeared to include a lag phase, most likely due to very weak expression of α(5)β(1) integrins. Molecular dissection of the role of the FnBR region revealed that efficient invasion of keratinocytes was dependent on the presence of at least three high-affinity (but not low-affinity) FnBRs. Over-expression of a single high-affinity or three low-affinity repeats promoted invasion but not to the same levels as S. aureus expressing an FnBPA variant containing three high-affinity repeats. In summary, invasion of keratinocytes by S. aureus requires multiple high-affinity FnBRs within FnBPA, and given the importance of the interaction between these cell types and S. aureus for both colonisation and infection, may have provided the selective pressure for the multiple binding repeats within FnBPA.

Assessing Lévy Walks As Models of Animal Foraging

The hypothesis that the optimal search strategy is a Lévy walk (LW) or Lévy flight, originally suggested in 1995, has generated an explosion of interest and controversy. Long-standing empirical evidence supporting the LW hypothesis has been overturned, while new models and data are constantly being published. Statistical methods have been criticized and new methods put forward. In parallel with the empirical studies, theoretical search models have been developed. Some theories have been disproved while others remain. Here, we gather together the current state of the art on the role of LWs in optimal foraging theory. We examine the body of theory underpinning the subject. Then we present new results showing that deviations from the idealized one-dimensional search model greatly reduce or remove the advantage of LWs. The search strategy of an LW with exponent μ = 2 is therefore not as robust as is widely thought. We also review the available techniques, and their potential pitfalls, for analysing field data. It is becoming increasingly recognized that there is a wide range of mechanisms that can lead to the apparent observation of power-law patterns. The consequence of this is that the detection of such patterns in field data implies neither that the foragers in question are performing an LW, nor that they have evolved to do so. We conclude that LWs are neither a universal optimal search strategy, nor are they as widespread in nature as was once thought.

Overturning Conclusions of Lévy Flight Movement Patterns by Fishing Boats and Foraging Animals

A surprisingly diverse variety of foragers have previously been concluded to exhibit movement patterns known as Lévy flights, a special type of random walk. These foragers range in size from microzooplankton in experiments to fishermen in the Pacific Ocean and the North Sea. The Lévy flight conclusion implies that all the foragers have similar scale-free movement patterns that can be described by a single dimensionless parameter, the exponent micro of a power-law (Pareto) distribution. However, the previous conclusions have been made using methods that have since been shown to be problematic: inaccurate techniques were used to estimate micro, and the power-law distribution was usually assumed to hold without testing any alternative hypotheses. Therefore, I address the open question of whether the previous data still support the Lévy flight hypothesis, and thus determine whether Lévy flights really are so ubiquitous in ecology. I present a comprehensive reanalysis of 17 data sets from seven previous studies for which Lévy flight behavior had been concluded, covering marine, terrestrial, and experimental systems from four continents. I use the modern likelihood and Akaike weights approach to test whether simple alternative models are more supported by the data than Lévy flights. The previously estimated values of the power-law exponent micro do not match those calculated here using the accurate likelihood approach, and almost all of them lie outside of the likelihood-based 95% confidence intervals. Furthermore, the original power-law Lévy flight model is overwhelmingly rejected for 16 out of the 17 data sets when tested against three other simple models. For one data set, the data are consistent with coming from a bounded power-law distribution (a truncated Lévy flight). For three other data sets, an exponential distribution corresponding to a simple Poisson process is suitable. Thus, Lévy flight movement patterns are not the common phenomena that was once thought, and are not suitable for use as ecosystem indicators for fisheries management, as has been proposed.

Self-pacing in Interval Training: a Teleoanticipatory Approach

The aim of the present study was to investigate whether the concurrent use of Rating of Perceived Exertion (RPE) and a new Perceived Readiness (PR) scale facilitates optimal interval training performance outcomes. Eleven competitive male runners completed outdoor interval track-running trials at a pre-set RPE. The PR scale was used to facilitate self-determined recovery, while minimum heart rate (HR) and work to rest ratio (WR) strategies were used as comparative conditions. Duplicate PR trial performances were similar but intercondition comparisons identified that the HR trial was significantly slower than both WR and PR conditions. There was no difference in performance between WR and PR, but recoveries for both PR trials were significantly shorter than for WR. Since the aim of interval training is to sustain performance with the shortest possible recovery time, the concurrent use of RPE and PR scales appears to be a useful psychophysiological technique to self- determine both work and rest in interval training.

Methicillin Resistance Reduces the Virulence of Healthcare-Associated Methicillin-Resistant Staphylococcus Aureus by Interfering With the Agr Quorum Sensing System

The difficulty in successfully treating infections caused by methicillin-resistant Staphylococcus aureus (MRSA) has led to them being referred to as highly virulent or pathogenic. In our study of one of the major healthcare-associated MRSA (HA-MRSA) clones, we show that expression of the gene responsible for conferring methicillin resistance (mecA) is also directly responsible for reducing the ability of HA-MRSA to secrete cytolytic toxins. We show that resistance to methicillin induces changes in the cell wall, which affects the bacteria's agr quorum sensing system. This leads to reduced toxin expression and, as a consequence, reduced virulence in a murine model of sepsis. This diminished capacity to cause infection may explain the inability of HA-MRSA to move into the community and help us understand the recent emergence of community-associated MRSA (CA-MRSA). CA-MRSA typically express less penicillin-binding protein 2a (encoded by mecA), allowing them to maintain full virulence and succeed in the community environment.

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