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Distinct phenotypic and genomic signatures underlie contrasting pathogenic potential of Staphylococcus epidermidis clonal lineages

Abstract

Background: Staphylococcus epidermidis is a common skin commensal that has emerged as a pathogen in hospitals, mainly related to medical devices-associated infections. Noteworthy, infection rates by S. epidermidis have the tendency to rise steeply in next decades together with medical devices use and immunocompromized population growth. Staphylococcus epidermidis population structure includes two major clonal lineages (A/C and B) that present contrasting pathogenic potentials. To address this distinction and explore the basis of increased pathogenicity of A/C lineage, we performed a detailed comparative analysis using phylogenetic and integrated pangenome-wide-association study (panGWAS) approaches and compared the lineages's phenotypes in in vitro conditions mimicking carriage and infection. Results: Each S. epidermidis lineage had distinct phenotypic signatures in skin and infection conditions and differed in genomic content. Combination of phenotypic and genotypic data revealed that both lineages were well adapted to skin environmental cues. However, they appear to occupy different skin niches, perform distinct biological functions in the skin and use different mechanisms to complete the same function: lineage B strains showed evidence of specialization to survival in microaerobic and lipid rich environment, characteristic of hair follicle and sebaceous glands; lineage A/C strains showed evidence for adaption to diverse osmotic and pH conditions, potentially allowing them to occupy a broader and more superficial skin niche. In infection conditions, A/C strains had an advantage, having the potential to bind blood-associated host matrix proteins, form biofilms at blood pH, resist antibiotics and macrophage acidity and to produce proteases. These features were observed to be rare in the lineage B strains. PanGWAS analysis produced a catalog of putative S. epidermidis virulence factors and identified an epidemiological molecular marker for the more pathogenic lineage. Conclusion: The prevalence of A/C lineage in infection is probably related to a higher metabolic and genomic versatility that allows rapid adaptation during transition from a commensal to a pathogenic lifestyle. The putative virulence and phenotypic factors associated to A/C lineage constitute a reliable framework for future studies on S. epidermidis pathogenesis and the finding of an epidemiological marker for the more pathogenic lineage is an asset for the management of S. epidermidis infections.

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Distinct phenotypic and genomic signatures underlie contrasting pathogenic potential of Staphylococcus epidermidis clonal lineages

Author: Espadinha, Diana,Sobral, Rita G.,Mendes, Catarina Inês,Méric, Guillaume,Sheppard, Samuel K.,Carrico, Joao Andre,de Lencastre, Hermínia,Miragaia, Maria
Publisher: Frontiers
Year: 2019
Source: https://repositorio.ulisboa.pt/bitstream/10451/49912/1/Staphylococcus_epidermidis.pdf
micb-10-01971 Augus 27, 2019 Time: 12:8 # 1
ORIGINAL RESEARCH
published: 27 Augus 2019
doi: 10.3389/ micb.2019.01971
Edi ed by:
Ludmila Chis ose do a,
Uni e si y o Washing on,
Uni ed S a es
Re iewed by:
Ka s en Becke ,
Uni e si y o Müns e , Ge many
Vas i Chaudh y,
Uni e si y o Tübingen, Ge many
*Co espondence:
Ma ia Mi agaia
[email p o ec ed]
Special y sec ion:
This a icle was submi ed o
E olu iona y and Genomic
Mic obiology,
a sec ion o he jou nal
F on ie s in Mic obiology
Recei ed: 02 Ap il 2019
Accep ed: 12 Augus 2019
Published: 27 Augus 2019
Ci a ion:
Espadinha D, Sob al RG,
Mendes CI, Mé ic G, Sheppa d SK,
Ca iço JA, de Lencas e H and
Mi agaia M (2019) Dis inc Pheno ypic
and Genomic Signa u es Unde lie
Con as ing Pa hogenic Po en ial
o S aphylococcus epide midis Clonal
Lineages. F on . Mic obiol. 10:1971.
doi: 10.3389/ micb.2019.01971
Dis inc Pheno ypic and Genomic
Signa u es Unde lie Con as ing
Pa hogenic Po en ial o
S aphylococcus epide midis Clonal
Lineages
Diana Espadinha1,2, Ri a G. Sob al3, Ca a ina Inês Mendes4, Guillaume Mé ic5,
Samuel K. Sheppa d5,6, João A. Ca iço4, He mínia de Lencas e2,7 and Ma ia Mi agaia1*
1Labo a o y o Bac e ial E olu ion and Molecula Epidemiology, Ins i u o de Tecnologia Química e Biológica An ónio Xa ie ,
Uni e sidade No a de Lisboa, Oei as, Po ugal, 2Labo a o y o Molecula Gene ics, Ins i u o de Tecnologia Química e
Biológica An ónio Xa ie , Uni e sidade No a de Lisboa, Oei as, Po ugal, 3Labo a o y o Molecula Mic obiology o Bac e ial
Pa hogens, UCIBIO/REQUIMTE, Faculdade de Ciências e Tecnologia, Uni e sidade No a de Lisboa, Cos a de Capa ica,
Po ugal, 4Molecula Mic obiology and In ec ion Uni , Ins i u o de Medicina Molecula , Faculdade de Medicina de Lisboa,
Uni e sidade de Lisboa, Lisbon, Po ugal, 5The Milne Cen e o E olu ion, Uni e si y o Ba h, Ba h, Uni ed Kingdom,
6MRC CLIMB Conso ium, Ba h, Uni ed Kingdom, 7Labo a o y o Mic obiology and In ec ious Diseases, The Rocke elle
Uni e si y, New Yo k, NY, Uni ed S a es
Backg ound: S aphylococcus epide midis is a common skin commensal ha has
eme ged as a pa hogen in hospi als, mainly ela ed o medical de ices-associa ed
in ec ions. No ewo hy, in ec ion a es by S. epide midis ha e he endency o ise
s eeply in nex decades oge he wi h medical de ices use and immunocomp omized
popula ion g ow h. S aphylococcus epide midis popula ion s uc u e includes wo
majo clonal lineages (A/C and B) ha p esen con as ing pa hogenic po en ials.
To add ess his dis inc ion and explo e he basis o inc eased pa hogenici y o
A/C lineage, we pe o med a de ailed compa a i e analysis using phylogene ic and
in eg a ed pangenome-wide-associa ion s udy (panGWAS) app oaches and compa ed
he lineages’s pheno ypes in in i o condi ions mimicking ca iage and in ec ion.
Resul s: Each S. epide midis lineage had dis inc pheno ypic signa u es in skin and
in ec ion condi ions and di e ed in genomic con en . Combina ion o pheno ypic and
geno ypic da a e ealed ha bo h lineages we e well adap ed o skin en i onmen al
cues. Howe e , hey appea o occupy di e en skin niches, pe o m dis inc biological
unc ions in he skin and use di e en mechanisms o comple e he same unc ion:
lineage B s ains showed e idence o specializa ion o su i al in mic oae obic and lipid
ich en i onmen , cha ac e is ic o hai ollicle and sebaceous glands; lineage A/C s ains
showed e idence o adap ion o di e se osmo ic and pH condi ions, po en ially allowing
hem o occupy a b oade and mo e supe icial skin niche. In in ec ion condi ions, A/C
s ains had an ad an age, ha ing he po en ial o bind blood-associa ed hos ma ix
p o eins, o m bio ilms a blood pH, esis an ibio ics and mac ophage acidi y and o
p oduce p o eases. These ea u es we e obse ed o be a e in he lineage B s ains.
PanGWAS analysis p oduced a ca alog o pu a i e S. epide midis i ulence ac o s and
iden i ied an epidemiological molecula ma ke o he mo e pa hogenic lineage.
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
Conclusion: The p e alence o A/C lineage in in ec ion is p obably ela ed o a
highe me abolic and genomic e sa ili y ha allows apid adap a ion du ing ansi ion
om a commensal o a pa hogenic li es yle. The pu a i e i ulence and pheno ypic
ac o s associa ed o A/C lineage cons i u e a eliable amewo k o u u e s udies on
S. epide midis pa hogenesis and he inding o an epidemiological ma ke o he mo e
pa hogenic lineage is an asse o he managemen o S. epide midis in ec ions.
Keywo ds: S. epide midis, pan genome, GWAS, clonal lineages, pa hogen, commensal
BACKGROUND
S aphylococcus epide midis is one o he mos abundan
commensal bac e ia o heal hy human skin and mucosa. This
o ganism has eme ged in ecen decades as an impo an
oppo unis ic pa hogen, being he main cause o nosocomial
in ec ions associa ed o indwelling medical de ices such as
pe iphe al o cen al in a enous ca he e s (CVCs) (O o, 2009).
In ec ions by S. epide midis usually occu due o a b each in he
skin ba ie esul ing om he inse ion o he medical de ices,
allowing S. epide midis o pene a e he hos issues.
The p og ession o in ec ion a e skin pene a ion depends
on he abili y o S. epide midis o apidly change om a
commensal o a pa hogenic s a e. As skin commensals,
S. epide midis su i e and g ow unde nu ien limi a ion,
a a low empe a u e (<37◦C) and pH (∼4.5–6.4) (Schmid-
Wend ne and Ko ing, 2006) and a di e se osmo ic p essu es
esul ing om he p oduc ion/e apo a ion o swea and
luc ua ions in en i onmen al humidi y (Wilson, 2005).
Fu he mo e, hey ha e o cope wi h cell desquama ion, and
oxida i e s ess esul ing om UV exposu e (Kammeye and
Lui en, 2015). Once in he bloods eam, upon skin ba ie
b each, he en i onmen al landscape changes d ama ically
and S. epide midis suddenly ace a nu ien - ich and alkaline
en i onmen wi h a highe empe a u e, p o-in lamma o y
molecules and eac i e oxygen species (ROS) gene a ed by
immune cells (Aki a e al., 2006;Weiss and Schaible, 2015) and
e en ual an ibio ic p essu e (Cio u e al., 2017). Howe e , he
ac o s o S. epide midis ha con ibu e o he ansi ion om
heal h o disease s a e a e no comple ely unde s ood.
One o he ac o s hough o be c ucial o ansi ion om
skin o blood is he o ma ion o bio ilms on he su ace o
medical de ices, which can be composed o a mesh o p o eins,
exopolysaccha ides and ex acellula DNA (Qin e al., 2007;
O o, 2009). These bio ilms can con e p o ec ion agains he
hos immune sys em (Vuong e al., 2004) and esis ance o
an ibio ics (Fa be e al., 1990;Kha do i e al., 1995;Singh
e al., 2010), making in ec ions ex emely di icul o ea (O o,
2009). O he mechanisms ha ha e been shown o be impo an
o S. epide midis pa hogenici y include he abili y o e ade
human inna e immuni y, namely h ough p ocesses in ol ed in
esis ance o an imic obial pep ides (AMP) (Cheung e al., 2010).
Besides he ica ope on, which is di ec ly in ol ed in bio ilm
o ma ion (Heilmann e al., 1996) and he inse ion sequence
IS256, shown o modula e bio ilm o ma ion and an ibio ic
esis ance (Kozi skaya e al., 2004), o he i ulence ac o s
ha e been p oposed. These include he p ima y a achmen o
hos ex acellula ma ices and in e cellula agg ega ion, oxins,
p o eases and lipases, all sugges ed o be implica ed in in asi e
po en ial (O o, 2012).
Whole genome sequence analysis (Conlan e al., 2012;Me ic
e al., 2015) has shown ha he S. epide midis popula ion
was composed o wo main phylogene ic clus e s: lineage A/C,
con aining mos o he isola es om coloniza ion and in ec ion
and lineage B, comp ising mainly coloniza ion isola es. In spi e
o hei clinical ele ance, he ac o s associa ed o he success
o A/C s ains, bo h as colonize s and pa hogens, a e no
ully unde s ood.
He e we hypo hesize ha he success o A/C s ains as
colonize s and as pa hogens is associa ed wi h an inc eased
abili y o adap o en i onmen al cons ain s imposed by bo h
coloniza ion and in ec ion s a es. To add ess his, we analyzed he
genomes o ep esen a i e isola es om A/C and B clus e s and
cha ac e ized hei pheno ypic ai s in condi ions ha mimic he
coloniza ion and in ec ion scena ios.
RESULTS AND DISCUSSION
S. epide midis Popula ion S uc u e Is
Composed o Two Clus e s Wi h
Di e en Pa hogenic Po en ial
In p e ious s udies we ha e cha ac e ized a collec ion o 1714
S. epide midis om di e en isola ion da es, geog aphic and
clinical o igins (Mi agaia e al., 2007;Rolo e al., 2012). Based on
mul ilocus sequence yping (MLST) da a we selec ed a collec ion
o 83 isola es ha ep esen he di e si y o s ains in e ms o
gene ic backg ounds (71 sequence ypes, be ween 1996 and 2001).
To unde s and how isola es o di e en o igins we e ela ed, we
gene a ed a pan genome based on he anno a ed genomes om
82 S. epide midis s ains unde s udy (one genome was excluded
om he genomic analysis due o possible con amina ion, see
Ma e ials and Me hods) and compa ed he genomic con en o
he s ains acco ding o hei isola ion sou ce. The pangenome
ob ained had a o al size o 5.0 Mbp wi h 31.3% o GC con en ,
encoding a o al o 6682 genes. F om hese, app oxima ely one
hi d (n= 1653) comp ised he co e genome (p esen in all
s ains in his s udy), wi h he emainde (5029) comp ising
he accesso y genome. Gene accumula ion cu es ha plo pan
genome size as a unc ion o he numbe o genomes sequenced,
sugges an open pan genome ha is cha ac e is ic o popula ions
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
FIGURE 1 | Maximum-likelihood ee o he 82 S. epide midis s ains. The ee was gene a ed by RaxML (S ama akis e al., 2012) embedded in Gubbins (C ouche
e al., 2015), based on he co e gene alignmen wi h emo al o he ecombining egions. In blue a e depic ed he coloniza ion isola es, in ed he in ec ion isola es
and in g ay a e he isola es o which no epidemiological in o ma ion was a ailable. (A–C) Co espond o S. epide midis clonal clus e s, acco ding o Me ic e al.
(2015).
ha unde go equen ho izon al gene ans e (HGT) (Me ic
e al., 2015) (Supplemen a y Figu e S1).
Phylogene ic econs uc ion, based on he Maximum-
likelihood (ML) ee de i ed om he co e genome co ec ed
o ecombining egions, con i med ha he S. epide midis
popula ion is di ided in o h ee clus e s (Figu e 1). Consis en
wi h p e ious s udies (Me ic e al., 2015), Clus e s A (66%) and
C (6%) we e joined in a single clus e and we e analyzed oge he
in u he analysis. The emainde o he isola es belonged o
clus e B (28%). The A/C clus e con ained mainly nosocomial
isola es (n= 49/59, 83%) whe eas he B clus e con ained a highe
p opo ion o isola es om heal hy people in he communi y
(n= 13/23, 56%) (p= 0.0007), con i ming p e ious indings
by Conlan e al. (2012) o a much smalle and geog aphically
delimi ed isola e collec ion. A/C clus e isola es almos equally
o igina ed om in ec ion (n= 28/59, 47%) and coloniza ion
(n= 31/59, 53%) sou ces, while B clus e isola es we e mos ly
om coloniza ion (17/23, 70%) (p= 0.127) e en hough his
di e en dis ibu ion did no each s a is ical signi icance. These
esul s sugges ha al hough bo h A/C and B s ains a e ca ied
asymp oma ically, A/C s ains a e, appa en ly, mo e implica ed
in in ec ion e en s. This obse a ion is co obo a ed by mul iple
s udies whe ein S. epide midis om in ec ion we e in hei
majo i y om A/C clus e (which comp ises clonal complex 2 as
de ined by MLST) (Mi agaia e al., 2007;Wide s om e al., 2009;
Go don e al., 2012;Hellma k e al., 2013;Che i i e al., 2014).
E idence o he Clonal Dissemina ion o
A/C Clus e Isola es
An impo an cha ac e is ic o some oppo unis ic pa hogens is
he abili y o dissemina e in di e en hos s and en i onmen s.
This can lead o b oad dis ibu ion o closely ela ed s ains.
The mean numbe o SNP di e ences be ween he co e genomes
o A/C and B clus e s was 39889, which co espond o 1.6%
o he a e age genome size o S. epide midis. Wi hin each
clus e , he a e age numbe o SNPs was simila o s ains
o clus e B (a e age numbe o SNP di e ences = 16786,
anging be ween 31 and 36796) and o s ains o clus e A/C
(a e age numbe o SNP di e ences = 17696 nucleo ides, anging
be ween 1 and 37617). The lowe numbe o di e ences (<100
SNPs) we e ound be ween 11 pai s o A/C isola es and only
one pai in clus e B, sugges ing ha A/C isola es a e mo e
clonal han B isola es. Fu he mo e, hese pai s included isola es
om di e en coun ies, isola ed ei he om he hospi al o
he communi y, demons a ing he dissemina ion o his clus e
h ough hese se ings.
In con as wi h o he known nosocomial pa hogens,
including S. au eus (Ruimy e al., 2009;G undmann e al., 2010),
we ound no e idence o geog aphic clus e ing in S. epide midis,
since each b anch in he ML ee, co esponding ei he o A/C
o B clus e s (conside ing a maximum o 50 SNPs di e ence),
con ained isola es om mul iple coun ies (see Supplemen a y
Table S1). Fu he mo e, he e we e eigh pai s o s ains om
di e en coun ies ha , wi h one excep ion, belonged o he
A/C clus e ha di e ged in less han 100 SNPs and ha we e
isola ed wi hin he same yea . This was he case o s ains om
Denma k and Po ugal (68 SNPs; DEN161, 966N), Denma k
and Iceland (60 SNPs; DEN116, ICE122) and A gen ina and
Hunga y (17 SNPs; AGT24, HUR105), among o he s (see
Supplemen a y Table S1). These examples sugges ex ensi e and
apid geog aphic dissemina ion o s ains belonging o he A/C
clus e , likely p omo ed by skin- o-skin con ac be ween a ele s.
This is consis en wi h p e ious s udies ha hypo hesized b oad
geog aphic dissemina ion o his species (Mi agaia e al., 2002;
Wide s om e al., 2006).
E idence o Ecological Isola ion and
Dis inc Biological Func ions o A/C and
B Clus e s
The success o a bac e ial clone may be in luenced by i s
capaci y o adap o di e en en i onmen s and his is equen ly
accomplished by he acquisi ion o exogenous gene ic elemen s
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
(Uhlemann e al., 2012;Wal he e al., 2018), which will compose
he accesso y genome. To assess di e ences in gene con en o he
wo S. epide midis clus e s, we analyzed and quan i ied accesso y
genome a ia ion. The ma ix o p esence/absence o all he
genes in he genomes is ep esen ed in Supplemen a y Table
S2. The majo i y o A/C and B pan genomes was composed
o accesso y genes (A/C: 74%, 3723/5029; B: 67%, 3381/5029).
Among his accesso y genome, 1648 genes we e exclusi e o A/C
clus e and hese genes a ied in equency om 93% o 2% and
1306 genes we e exclusi e o clus e B and anged om 100 o 4%,
sugges ing high genome plas ici y and clus e -speci ic unc ions.
The numbe o accesso y genes sha ed be ween s ains o he
same clus e (3723 in A/C and 3381 genes in B) is 1.8–1.6 highe
han he numbe o genes sha ed be ween he wo clus e s (2075
genes). This di e ence could be due o he exis ence o a ba ie o
gene ic ans e be ween hem. Howe e , in con as o S. au eus,
his appa en ly low equency o gene ic ans e is no e iden ly
associa ed wi h he p esence o Res ic ion/Modi ica ion (R-M)
sys ems (Wald on and Lindsay, 2006;Co aglia e al., 2010)
and/o he clus e ed egula ly in e spaced sho palind omic
epea s (CRISPR) (Ma a ini and Son heime , 2008). The e
was no clea associa ion o a hsdR/hsdM sys em o any o he
clus e s and cas and csm genes we e equally dis ibu ed among
s ains o he wo clus e s [A/C: 12% and B: 17% (p>0.05)]
(Supplemen a y Table S2). An al e na i e explana ion o he
lowe le el o gene ic exchange be ween he clus e s, in his
appa en ly ecombinogenic species (Mi agaia e al., 2007;Me ic
e al., 2015), migh be he exis ence o opism o each o
hese lineages o speci ic skin niches (G ice e al., 2009;Oh
e al., 2014) ha could ha e lead o some ecological isola ion o
he wo gene ic clus e s. Ac ually, skin mic obio a composi ion
was p e iously shown o a y acco ding o he en i onmen al
cha ac e is ics o he skin ecological niche sampled (Cos ello
e al., 2009;G ice e al., 2009). To es he hypo hesis o
ecological isola ion we ha e examined he se en MLST genes,
which cons i u e a good ep esen a ion o he co e genes, ei he
in e ms o genome dis ibu ion and gene ic di e si y (Gomes
e al., 2005;Mi agaia e al., 2007). Da a showed an appa en
allelic seg ega ion, whe e a oE gene p esen ed no common alleles
be ween he clus e s and he emaining genes (a cC, g ,mu S,
py R, pi,yqiL), comp ising be ween 11 and 20 alleles, had a
maximum o wo alleles sha ed by he wo clus e s.
Fu he mo e, we looked o genes ha we e signi ican ly
associa ed o each clus e using a pan genome wide-associa ion
app oach, ha sco es genes o associa ions wi h speci ic
epidemiological ea u es. In pa icula , 166 genes we e iden i ied
o ha e a s ong posi i e associa ion (Benjamini–Hochbe g
p<0.05) wi h clus e A/C (see Supplemen a y Table S3)
and 244 genes wi h a s ong associa ion wi h clus e B (see
Supplemen a y Table S4). Tables 1,2include he genes among
hese, which ha e unc ions ha we e ei he p esen exclusi ely in
one o he clus e s o ha we e p esen in bo h bu in signi ican ly
di e en equencies. S ains o he A/C clus e we e en iched
o genes in ol ed in p ocesses such as bio ilm o ma ion and
adhesion o hos ma ix p o eins, p o eolysis, esis ance o
an ibio ics and adap a ion o low pH. Con e sely, s ains om
clus e B we e en iched o genes in ol ed in he de oxi ica ion
o o ma e and o maldehyde, oxida i e s ess esponse, hos
in e ac ion h ough ype VII sec e ion sys em, lipid me abolism
and cell wall biosyn hesis. This is consis en wi h S. epide midis
clus e s A/C and B pe o ming dis inc biological unc ions and
possibly occupying di e en skin niches.
S. epide midis o A/C and B Clus e s
Ha e Adap ed o Skin En i onmen
Condi ions Using Di e en S a egies
Skin is he i s ba ie o he human body agains ex e nal
agg essions and con ains molecules ha de i e om he
me abolism o skin cells and ou mic obio a, bu also om
he en i onmen (Wilson, 2005). On he skin, S. epide midis
ha e o deal wi h nu ien limi a ion, ha sh and a iable
en i onmen al condi ions and mechanic s esses. Pe spi a ion
is one o he cen al con ibu o s o he composi ion o
skin milieu and a majo physiological unc ion ha assis s
in he mo egula ion, skin su ace hyd a ion and immune
de ense. Pe spi a ion is composed mainly o wa e , bu
con ains se e al o he me aboli es ha con ibu e o i s
mul iple unc ions, such as an imic obial pep ides (AMP),
immunoglobulins, na u al mois u izing ac o s (lac a e,
u ea, elec oly es, amino acids), i amins, me als and sal s
(Wilson, 2005).
To unde s and i he S. epide midis clus e s di e in hei
abili y o adap o skin we ha e compa ed hei abili y o g ow and
p oduce bio ilm in condi ions ha mimic he skin en i onmen
(acidic pH and inc eased sal concen a ions). Mo eo e , we
looked in mo e de ail o he genes ha we e associa ed by he
pan genomic wide-associa ion app oach o each lineage and ha
could p o ide an ad an age in he skin en i onmen al condi ions.
G ow h and Bio ilm Fo ma ion a Acidic pH
S aphylococcus epide midis belonging o A/C clus e appea o
ha e a dis inc i e abili y o adap o he wo acidic pH alues
es ed (pH 4.5 and pH 5.5), as s ains om he A/C clus e
eached, in a e age, highe cell densi ies in s a iona y phase
(∼12% highe in bo h cases) and p esen ed ei he a g ea e
(pH4.5: µA/C= 0.335; µB= 0.274, p= 0.043) o simila a e age
g ow h a e (pH 5.5: µA/C= 0.626; µB= 0.594, p= 0.273)
when compa ed o s ains om he B clus e (see Figu e 2A
and Table 3). Addi ionally, s ains belonging o he A/C clus e
we e associa ed o a gene in ol ed in he a ginine deiminase
me abolism (a cD, an a ginine/o ni hine an ipo e ) (see Table 1)
usually ca ied by he a ginine ca abolic mobile elemen (ACME).
Al hough a genomic copy o a cD gene wi h a simila unc ion
is known o be ubiqui ous in he S. epide midis genome, his
ex a copy oge he wi h he emaining a c ope on wi hin ACME
was p e iously sugges ed o be impo an o pH homeos asis in
S. epide midis and o con ibu e o addi ional ole ance o low-pH
in communi y-associa ed S aphylococcus au eus USA300 clone
(Thu low e al., 2013;Lindg en e al., 2014). O he unc ions
associa ed o A/C clus e s ains ha can e en ually con ibu e
o he obse ed inc eased g ow h a e is he la in-con aining
oxido educ ase (YwqN), he YdjH suga kinase; and he hexose-
6-phospha e:phospha e an ipo e (UhpT) (Pa k e al., 2015),
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
TABLE 1 | Genes posi i ely associa ed o clus e A/C (Benjamini–Hochbe g p<0.05 and OR >1).
Pu a i e unc ions Gene anno a ion Func ional anno a ion F equency in
clus e A/C %
F equency in
clus e B %
Hyd olysis g oup_1452 Pu a i e hyd olase 92 35
Adhesion and Bio ilm sd F Se ine-aspa a e epea -con aining p o ein F 68 9
sd I Pu a i e su ace p o ein 63 9
icaA∗∗ Poly-be a-1,6-N-ace yl-D-glucosamine
syn hase
37 4
icaB∗∗ Poly-be a-1,6-N-ace yl-D-glucosamine
N-deace ylase
37 4
icaC∗∗ Pu a i e poly-be a-1,6-N-ace yl-D-glucosamine
expo p o ein
37 4
icaD∗∗ Poly-be a-1,6-N-ace yl-D-glucosamine
syn hesis
37 4
icaR∗∗ Bio ilm ope on icaADBC HTH- ype nega i e
ansc ip ional egula o
37 4
Nickel and Cobal up ake nm R∗HTH- ype ansc ip ional egula o Nm R 37 0
A ginine deiminase a cD∗∗ A ginine/o ni hine an ipo e 55 4
Penicillin esis ance blaI Penicillinase ep esso 68 17
blaZ Be a-lac amase 60 22
Coppe esis ance mco∗∗ Mul icoppe oxidase mco 68 30
P o eolysis splF∗∗ Se ine p o ease SplF 78 35
Ca bohyd a e me abolism gno∗∗ Glucona e 5-dehyd ogenase 62 22
ywqN∗∗ Pu a i e NAD(P)H-dependen FMN-con aining
oxido educ ase YwqN
37 4
ydjH∗Pu a i e suga kinase YdjH 37 4
g oup_1735 Hexose-6-phospha e:phospha e an ipo e
uhpT
34 0
Thiamine up ake hiQ Thiamine impo ATP-binding p o ein ThiQ 80 30
Cys eine biosyn hesis cysL HTH- ype ansc ip ional egula o CysL 88 43
∗Only one gene/allele o ha unc ion and unc ion is exclusi e in clus e ; ∗∗Only one gene/allele o ha unc ion and is en iched in he clus e bu he unc ion is no
exclusi e in clus e .
which lead ei he o he p oduc ion o educing powe (NADH)
o he biosyn hesis o majo cell componen s o o he escue o
al e na i e suga sou ces.
The wo g oups could no be dis inguished by hei
abili y o p oduce bio ilm a pH 5.5 (ODA/C= 1.538 s.
ODB= 1.536, p= 0.994), since almos all s ains, i espec i e
o hei gene ic backg ound, p oduced bio ilm in his condi ion,
sugges ing ha bio ilm is impo an o he g ow h o
his commensal a he su ace o he skin (see Table 3
and Figu e 2C).
G ow h in Osmo ic S ess Condi ions
The be e capaci y o he s ains om he A/C clus e o
wi hs and pe spi a ion, osmo ic s ess and desicca ion condi ions
equen ly imposed a he skin su ace was appa en om hei
capaci y o g ow a sodium chlo ide concen a ions cha ac e is ic
o he skin (0.15M NaCL) (Schi ek e al., 2001) and in
high salini y s ess (2M NaCl) (P ice-Whelan e al., 2013).
Whe eas a a physiological concen a ion (0.15M NaCl), s ains
om clus e A/C and B had equi alen a e age g ow h a es
(µA/C= 0.701 s. µB= 0.670, p= 0.411) (see Table 3), a
osmo ic s ess condi ions (2M NaCl), he medium g ow h a e
o A/C clus e s ains was signi ican ly highe (µA/C= 0.339
s. µB= 0.298, p= 0.011; see Figu e 2B). Fu he mo e, hey
showed a much sho e lag phase (A/C: 361 min s. B: 404 min),
and eached highe inal ODs (14% highe ) (see Table 3). The
esul s sugges ha , in con as o S. epide midis s ains o B
clus e , s ain om A/C clus e a e well adap ed o a ange o
salini y concen a ions sugges ing imp o ed su i al in a b oade
ange o niches.
We ound ha di e en genes indi ec ly in ol ed on esis ance
o osmo ic s ess we e speci ically associa ed o ei he clus e
A/C o B. This is he case o genes which we e associa ed o
A/C clus e ha a e in ol ed in he p oduc ion o polysaccha ide
in e cellula adhesion (PIA) (icaADBCR ope on), which h ough
he p oduc ion o bio ilm induce p o ec ion agains as
osmo ic changes by dec easing he a e o wa e loss and
ehyd a ion (Robe son and Fi es one, 1992;de Go au e al.,
2009) (see Table 1). Fu he mo e, genes associa ed o B clus e
ha could induce osmop o ec ion include hose in ol ed in:
pep idoglycan c oss-linking (dacA - a pbp4 homolog, yodJ)
ha p o ides ex a igidi y o he bac e ial cell wall (Wyke
e al., 1981;Loskill e al., 2014); and he up ake o manni ol
(m lA, m lR), a known osmoly e (Ke s e al., 1996;Zahid
e al., 2015). The absence o m lD, esponsible o manni ol
deg ada ion, sugges s ha s ains o B clus e use manni ol
mainly as an osmoly e a he han as a ca bon o ene gy sou ce
(da Cos a e al., 1998).
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
TABLE 2 | Genes posi i ely associa ed o clus e B (Benjamini–Hochbe g p<0.05 and OR >1).
Pu a i e unc ions Gene
anno a ion
Func ional anno a ion F equency in
clus e B %
F equency in
clus e A/C %
Fo ma e de oxi ica ion g oup_862
g oup_863
Pu a i e o ma e dehyd ogenase
Pu a i e o ma e dehyd ogenase
91
22
0
0
Fo maldehyde
assimila ion/de oxi ica ion
hxlR_1 HTH- ype ansc ip ional ac i a o HxlR 22 0
Coppe esis ance cueR∗HTH- ype ansc ip ional egula o 22 0
Oxida i e s ess
esponse
g oup_3122
(c O)∗∗(?)
Glycosyl-4,40-diaponeu ospo enoa e
acyl ans e ase
22 0
c P∗∗ Diapolycopene oxygenase 22 0
c Q∗∗ 4,40-diaponeu ospo enoa e glycosyl ans e ase 22 0
c M∗∗ Dehyd osqualene syn hase 22 0
c N∗∗ Dehyd osqualene desa u ase 22 0
Hos -in e ac ion and
Vi ulence
esaA∗ESAT-6 sec e ion accesso y ac o 65 0
esaB∗ESAT-6 sec e ion accesso y ac o 65 0
essC∗∗ ESAT-6 sec e ion machine y p o ein 65 0
esxA∗ESAT-6 sec e ion sys em ex acellula p o ein A 65 0
essB∗∗
g oup_2414∗∗
ESAT-6 sec e ion machine y p o ein ESAT-6
sec e ion machine y p o ein
39
30
0
0
yezG_1
yezG_2
yezG_3
yezG_5
Pu a i e an i oxin
Pu a i e an i oxin
Pu a i e an i oxin
Pu a i e an i oxin
52
48
43
26
0
0
0
2
Ca bohyd a e
me abolism
eA∗T ehalose-6-phospha e hyd olase 26 0
m lR∗T ansc ip ional egula o M lR 22 0
m lA∗PTS sys em manni ol-speci ic EIICB
componen
22 0
Lipid me abolism g oup_3907∗NADP-dependen 7-alpha-hyd oxys e oid
dehyd ogenase
48 0
Benzoa e deg ada ion ligI∗2-py one-4,6-dica baxyla e hyd olase 26 0
T anspo sys ems g oup_1444 ABC anspo e ATP-binding p o ein Na A 43 0
Cell wall biosyn hesis dacAD-alanyl-D-alanine ca boxypep idase DacA 39 2
yodJ∗∗∗ Pu a i e ca boxypep idase YodJ 35 2
T ansposable elemen s bin3_3 Tn552 DNA-in e ase 43 0
in - n Tn916 ansposase In -Tn 87 34
∗Only one gene/allele o ha unc ion and unc ion is exclusi e in clus e ; ∗∗Mo e han one gene/allele o ha unc ion bu unc ion is exclusi e in clus e ; ∗∗∗Only one
gene/allele o ha unc ion and is en iched in he clus e bu he unc ion is no exclusi e in clus e .
Al hough s ains o bo h clus e s ca y genes ha a e
associa ed o esis ance o osmo ic s ess, o e all, he p ocesses
used by s ains o he A/C clus e appea o be mo e e icien
han hose o s ains om he B clus e , as illus a ed by i s highe
g ow h a e in i o.
Gene ic T ai s Associa ed o E asion o Skin Inna e
Immuni y
Skin is con inuously exposed o commensal mic oo ganisms
and challenged o de end he human body om in asion by
pa hogens. To deal wi h his ex ensi e mic obial exposu e, skin
issues p oduce an imic obial pep ides (AMPs) and ee a y
acids ha a ge he bac e ial cell wall o cell memb ane s uc u es
(Kenny e al., 2009;Gallo and Hoope , 2012). To su i e, bac e ia
ha e de eloped mul iple s a egies, including he p oduc ion o
ca o enoid pigmen s ha p o ec om ee a y acids and he
inac i a ion o AMPs by p o eolysis.
We ound ha s ains belonging o he B clus e mo e
commonly con ained he ope on in ol ed in s aphyloxan hin
biosyn hesis (c OPQMN) ha was desc ibed o con e esis ance
o ee a y acids p oduced by skin cells (Chambe lain
e al., 1991). The p oduc ion o he ca o enoid was con i med
pheno ypically o he g oup o i e s ains ca ying his ope on
h ough he obse a ion o p oduc ion o a yellow colo by
colonies g own on aga g ow h medium. O he pigmen s had
been ound o be syn hesized by S. epide midis (Ogo, 1985), bu
his is he i s ime ha s aphyloxan hin ope on is desc ibed in
his species. We also ound a se ine-p o ease (SplF) posi i ely
associa ed o s ains om clus e A/C (Table 1). S aphylococcal
p o eases ha e al eady been implica ed in he mechanism o
de ense agains he human inna e immune sys em, as some
o hese p o eases ha e he abili y o clea e and inac i a e
human AMPs, namely de mcidin (Lai e al., 2007) and LL-37
(Siep awska-Lupa e al., 2004) ha a e p oduced by epi helial cells
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
FIGURE 2 | Pe o mance o clus e A/C and B s ains in he g ow h and bio ilm assays. (A) A e age g ow h a es o A/C and B s ains g own in liquid medium a pH
4.5; (B) A e age g ow h a es o A/C and B s ains g own in liquid medium wi h 2M NaCl; (C) A e age bio ilm o ma ion capaci y o A/C and B s ains a pH 5.5;
(D) A e age bio ilm o ma ion capaci y o A/C and B s ains a pH 7.
and al hough his could be he case also o S. epide midis SplF,
his has ye o be p o en. Al oge he , he esul s sugges ha bo h
S. epide midis o A/C and B clus e a e equipped o e ade he hos
immune sys em and ha could be a majo ad an age o su i al
in bo h skin and blood.
In e ac ion Wi h he Hos and Pa hogens
Commensal bac e ia a e in cons an in e ac ion wi h he
su ounding en i onmen and he hos . Sec e ion sys ems a e
cen al elemen s in hese in e ac ions bu ha e been in es iga ed
mos ly om he pe spec i e o pa hogen-hos in e ac ions.
Recen da a sugges ha hese sys ems may play a ole in
mu ualis ic ela ionships be ween bac e ia and he hos (Sil e
e al., 2007) o in media ion o bac e ial in e ac ions (Basle
e al., 2013). We ound ha S. epide midis s ains belonging o
B clus e we e associa ed o genes ela ed o ype VII sec e ion
sys em (T7SS) (Lai e al., 2007). In pa icula , all he conse ed
T7SS s uc u al genes (esaA, esaB, essA, essB, essC) we e co-
loca ed in he ch omosome. Mo eo e , he e was conside able
s ain- o s ain a ia ion in he numbe and ype o sec e ed
oxin/an i oxin-homologs downs eam his ope on (see Table 2).
T7SS we e p e iously desc ibed in S. epide midis and we e
p oposed o sec e e an inhibi o y oxin agains P opionibac e ium
acnes (Ch is ensen e al., 2016), ano he common commensal o
he skin. Ye , in S. au eus, he unc ions o T7SS a e b oade ,
in ol ing no only in aspecies compe i ion (Cao e al., 2016), bu
also pe sis ence and pa hogenici y (Bu s e al., 2008;Kneupe
e al., 2014;Ko ea e al., 2014). The iden i ica ion o a T7SS
in S. epide midis belonging o B clus e is consis en wi h he
hypo hesis ha S. epide midis o clus e B and P opionibac e ium
may sha e a simila niche in he skin.
S. epide midis Gene ic Con en Re lec s
Adap a ion o An h opogenic Ac i i ies
P e ious s udies ha e shown ha human skin composi ion is
also de ined by ou daily ou ines (Bouslimani e al., 2015),
including ac i i ies ha imply equen con ac wi h he skin,
like hygiene habi s and he applica ion o skin ca e p oduc s
and clo hing. Mo eo e , swea has been conside ed o long
as a cleanse , allowing he exc e ion o oxic subs ances ha
could ha e been abso bed due o acu e o ch onic exposu e o
con amina ed en i onmen (ai , wa e , ood) o o consumed
p oduc s. We ound ha S. epide midis o ei he A/C o
B clus e we e associa ed o six loci ela ed o he up ake,
de oxi ica ion o egula ion o me aboli es (glucona e, ehalose,
coppe , and o maldehyde) ha acco ding o he Human
Me abolome Da abase1(Wisha e al., 2018) a e p esen in
he skin issues and ha a e known o be simul aneously
p esen in he composi ion o ood, pha maceu ical p oduc s,
de e gen s/disin ec an s and/o cosme ics (see Tables 1,2).
Deg ada ion o Suga and Suga De i a i es
Genes in ol ed in he deg ada ion o suga s o suga de i a i es,
namely ehalose ( eA) and glucona e (gno), we e associa ed wi h
B and A/C clus e s espec i ely, sugges ing ha s ains om he
wo clus e s use hese al e na i e suga s as ca bon and ene gy
1www.hmdb.ca
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
TABLE 3 | Pe o mance o clus e A/C and clus e B s ains in skin and
blood condi ions.
Condi ions es ed Clus e A/C Clus e B p- alue
Skin
G ow h a pH 5.5
G ow h a e (h−1) 0.626 0.594 0.273
Lag phase (min) 234 212 –
Final OD (nm) 1.369 1.231 –
G ow h a 2M NaCl
G ow h a e (h−1) 0.339 0.298 0.011
Lag phase (min) 361 404 –
Final OD (nm) 1.231 1.08 –
Bio ilm a pH 5.5 (OD595 nm) 1.538 1.536 0.994
Blood
G ow h a pH 7.4
G ow h a e (h−1) 0.788 0.728 0.122
Lag phase (min) 191 212 –
Final OD (nm) 1.456 1.389 –
Bio ilm a pH 7 (OD595 nm) 1.475 0.377 0.0003
Adhesion o collagen (OD595 nm) 0.185 0.175 0.671
Skin and Blood
G ow h a pH 4.5
G ow h a e (h−1) 0.335 0.274 0.043
Lag phase (min) 234 276 –
Final OD (nm) 0.591 0.528 –
G ow h a 0.15 M NaCl
G ow h a e (h−1) 0.701 0.670 0.411
Lag phase (min) 212 212 –
Final OD (nm) 1.476 1.470 –
An ioxidan capaci y (nmol/µL) 10.20 10.79 0.428
Cell wall cha ge (OD410 nm) 20.10 27.09 0.084
P o eolysis
High (no isola es) 29 4
Medium (no isola es) 21 14 0.032
Low (no isola es) 10 5
Penicillin esis ance
no. esis an isola es (%) 52 (87%) 12 (48%)
no. suscep ible isola es (%) 8 (13%) 11 (9%) 0.002
Oxacillin esis ance
no. esis an isola es (%) 37 (62%) 10 (43%)
n . suscep ible isola es (%) 23 (38%) 13 (57%) 0.147
Gen amicin esis ance
no. esis an isola es (%) 21 (35%) 2 (9%)
no. suscep ible isola es (%) 39 (65%) 21 (91%) 0.026
sou ces. The use o glucona e as a ca bon sou ce and i s cen al
ole in bac e ial cell di ision and coloniza ion was p e iously
desc ibed o o he bac e ia like S ep ococcus suis (Shi e al.,
2014) and Esche ichia. coli (Sweeney e al., 1996).
T ehalose is no commonly used by S. epide midis as a
ca bon sou ce. Ac ually, he absence o ehalose e men a ion
has been conside ed a signa u e o S. epide midis used o
dis inguish i om o he bac e ial species (Kloos and Schlei e ,
1975). A possible o igin o ehalose ound in he skin, besides
ood and cosme ics (Oh ake and Wang, 2011), a e bac e ia o
he genus P opionibac e ium (also pa o skin na u al lo a),
which a e desc ibed o be capable o syn hesizing his suga
(Piwowa ek e al., 2018). The esul s sugges once mo e ha
P opionibac e ium and S. epide midis o B clus e migh sha e he
same niche, possibly hai ollicles and sebaceous egions whe ein
P opionibac e ium a e en iched (Scha schmid and Fischbach,
2013) and he ehalose p oduced by P opionibac e ium can be
used by S. epide midis as a ca bon and ene gy sou ce.
Ha ing he capaci y o me abolize glucona e and ehalose,
ei he om an h opogenic o mic obial o igin, can be highly
ad an ageous o S. epide midis in an en i onmen o nu ien
limi a ion like he skin.
Resis ance and Modula ion o Coppe
S aphylococcus epide midis s ains belonging o A/C clus e
and B clus e we e associa ed o genes in ol ed in coppe
egula ion, al hough using di e en mechanisms. While s ains
om he A/C clus e we e associa ed o mul icoppe oxidase
(mco), an enzyme in ol ed in he oxida ion o Cu+ o Cu2+
(Si hisak e al., 2005), B clus e s ains we e associa ed o cueR,
a Me R- amily me allo egula o y ansc ip ional ac i a o ha
senses in acellula Cu+and up egula es copA and cueO, wo
genes in ol ed in coppe e lux and oxida ion in esponse o
inc easing coppe concen a ions (Cha u edi and Hende son,
2014). Coppe is u ilized by bac e ia o se e al essen ial
me abolic p ocesses, bu is also c i ical o he main enance
o a heal hy skin, namely o he syn hesis and s abiliza ion
o ex acellula ma ix skin p o eins and angiogenesis (Raju
e al., 1982;Philips e al., 2012). Al hough an impo an
enzyme co ac o and signaling molecule, he in acellula le els
o ee coppe can be damaging o bac e ia, leading o ROS-
ela ed oxida i e s ess de i ed om i s educ ion and oxida ion
cycles, eason by which i is equen ly added o cosme ics as
a biocide. Coppe oxida ion pe o med by sys ems like Mco
and Cue p obably help S. epide midis o igh ly egula e and
main ain coppe homeos asis in he skin (Fes a and Thiele, 2012;
Cha u edi and Hende son, 2014).
De oxi ica ion o Fo maldehyde
S aphylococcus epide midis belonging o B clus e we e
addi ionally associa ed wi h a gene (hxlR) in ol ed in
de oxi ica ion o o maldehyde, a me aboli e ha can be highly
dele e ious o human cells. The o maldehyde- esponsi e
ansc ip ional ac o hxlR is pa o he o maldehyde
de oxi ica ion/assimila ion ia a ibulose monophospha e
(RuMP)-dependen pa hway, h ough which o maldehyde
is con e ed in o uc ose-6 phospha e and subsequen ly
inco po a ed in o he usual ca bon me abolism pa hway (Chen
e al., 2016). Fo maldehyde, is ubiqui ously ound in na u e
and is an impo an me aboli e o bo h bac e ia and human
cells (Bu gos-Ba agan e al., 2017), bu is also one o he mos
syn hesized compounds as he esul o an h opogenic ac i i ies.
Toxici y o o maldehyde o animals, humans and bac e ia (Tang
e al., 2009;Chen e al., 2016) is due o he as eac ion o
o maldehyde wi h ee hiol (−SH) and amine g oups (−NH2)
on p o eins and DNA (Feldman, 1973;Page and Bu ne , 2003),
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Espadinha e al. S. epide midis Clonal Lineages Pa hogenici y
making o maldehyde one o he mos po en p o ein and DNA
c oss-linking agen s.
The p esence o genes o he de oxi ica ion in S. epide midis
s ains belonging o B clus e p obably allowed hem o adap
o o maldehyde esul ing ei he om human and bac e ial
cells me abolism o om con inuous exposu e o o maldehyde
con aining p oduc s (dyes, syn he ic ex iles, disin ec an s, and
cosme ics). In his ega d, S. epide midis migh be unc ioning
no only o i s own bene i bu also in he bene i o
he hos by a oiding ha hese compounds each oxic
concen a ions o human cells.
S ains o A/C Clus e Ha e a Highe
Capaci y o Su i al in Hospi al and
In ec ion En i onmen al Condi ions
Du ing in ec ion S. epide midis has o adap o a new
en i onmen , he bloods eam, whe ein he pH is s abilized a 7.4,
he concen a ion o sal is s eady (0.15 M), speci ic hos ma ix
p o eins a e p oduced, he immune esponse is exace ba ed, and
inhibi o y concen a ions o an ibio ics may be p esen . One o
he s a egies o deal wi h such s esses is he a achmen o he
su ace o a de ice, ollowed by he de elopmen o he bio ilm,
whe e bac e ial cells a e p o ec ed.
To e alua e i S. epide midis belonging o A/C and B clus e s
ha e de eloped di e en capaci ies o adap o an in ec ion
en i onmen , we compa ed hei abili y o bind collagen I,
o g ow and p oduce bio ilm in blood-simila pH and sal
condi ions (g ow h: pH 7.4; 0.15 M NaCl; bio ilm: pH 7), o
esis oxida i e s ess and o e ade he immune sys em (by
measu ing he su ace cha ge and p o eoly ic ac i i y). Mo eo e ,
we sea ched o speci ic genes wi hin hese lineages ha could be
associa ed o a highe in ec ious capaci y.
Binding o Hos Ma ix P o eins and Bio ilm
Fo ma ion a Blood pH
When a medical de ice is in oduced in o he human body, i s
su ace becomes coa ed wi h a laye o hos p o eins (Vaudaux
e al., 1995; on Ei e al., 2002;A ecubie a e al., 2007;Singh
e al., 2012). Fo eign-body associa ed in ec ions a e a ibu ed
o he a achmen o bac e ia o hese hos p o eins, such as
collagen I om issues, and ib onec in and ib inogen om
blood, h ough binding o su ace p o eins (Pa i e al., 1994;
Fos e and Hook, 1998) ollowed by he p oduc ion o bio ilm. To
unde s and i S. epide midis belonging o he wo gene ic lineages
di e ed in hei abili y o cause de ice-associa ed in ec ion, we
es ed hei abili y o bind collagen I (see Table 3), he collagen
ype mo e abundan in human issues (Singh e al., 2012),
a he han he skin. Howe e , ou esul s showed ha binding
o collagen was no a dis inc i e ac o con ibu ing o hei
di e en in ec ious capaci y (ODA/C= 0.185 s. ODB= 0.175,
p= 0.067) (see Supplemen a y Figu e S2A). Mo eo e , we
iden i ied wo adhesins o mic obial su ace componen s
ecognizing adhesi e ma ix molecules (MSCRAMMs), namely
Sd F and Sd I, ha we e associa ed o A/C s ains and ha
ha e been desc ibed o be in ol ed in binding o collagen I and
ib onec in (Ha o d e al., 2001;Sakinc e al., 2005;A ecubie a
e al., 2007), espec i ely. In spi e o he iden i ied associa ion
be ween Sd F and A/C clus e , his did no impac di ec ly he
pheno ype o collagen binding, p obably due o he exis ence
o known edundancy o p o eins o he han Sd F ha bind
collagen I. On he o he hand, he compa ison o he wo lineages
ega ding he abili y o o m bio ilm a pH 7 (simila o blood’s
pH) showed ha A/C s ains p oduced signi ican ly mo e bio ilm
(ODA/C= 1.475; ODB= 0.377, p= 0.0003) (see Table 3 and
Figu e 2D) and we e simul aneously associa ed o he p esence
o he ica ope on, in ol ed in he p oduc ion o polysaccha ide
in e cellula adhesion (PIA) (Benjamini–Hochbe g p= 0.029).
These esul s sugges ha upon skin dis up ion he s ains ha
a e able o p oduce bio ilm and ha su i e be e in blood
en i onmen a e hose belonging o A/C clus e ha in addi ion
o he abili y o binding collagen I ha e he po en ial o bind
ib onec in (mainly ound in he blood a e inju y) and o
p oduce PIA-dependen bio ilms a blood’s pH.
Resis ance o Hos Immune Sys em Du ing In ec ion
Once in he bloods eam, bac e ia a e immedia ely ecognized by
monocy es and neu ophils h ough se e al Pa e n ecognizing
ecep o s (such as Toll-Like ecep o s, Nod-Like ecep o s and
C- ype lec in ecep o s), leading o he exp ession o AMPs,
phagocy osis, deg anula ion, espi a o y bu s and killing and
he o ma ion o neu ophil ex acellula aps ha cap u e
bac e ia inducing a apid in lamma o y esponse (cy okines
and chemokines) (Aki a e al., 2006). Bac e ial phagocy osis by
mac ophages occu s ia he o ma ion o a memb ane-enclosed
phagosome con aining he mic obe in an acidic en i onmen
(can be as low as pH 4.5), ex emely ich in bac e icidal enzymes
and oxic compounds ( eac i e oxygen and ni ogen species and
coppe ) (Weiss and Schaible, 2015).
Acco ding o ou da a, S. epide midis s ains ha e de eloped
se e al mechanisms ha allow hem o su i e wi hin
mac ophages. In pa icula , we obse ed ha al hough A/C
s ains had a signi ican ly highe medium g ow h a e a pH
4.5 (pH o mac ophages milieu) (µA/C= 0.335; µB= 0.274,
p= 0.043) han B s ains, hey did no a y signi ican ly in hei
o al an ioxidan capaci y (see Supplemen a y Figu e S2B). The
lack o di e ence in an ioxidan capaci y migh be due o he
ac ha bo h A/C and B clus e s we e associa ed o genes ha
p o ide esis ance o oxida i e s ess (A/C clus e : mco; B clus e :
c OPQMN ope on) and ole ance o coppe (A/C clus e : mco;
B clus e : cueR) (see Tables 1,2). Especially, s aphyloxan hin
p oduced by c OPQMN was desc ibed in S. au eus o pa icipa e
in he sca enging o ee adicals and o ha e impac in i ulence
(Claudi z e al., 2006;Mish a e al., 2011).
We ha e also compa ed he su ace cha ge and p o eoly ic
ac i i y o he wo clus e s, as a measu e o he capaci y
o e ade he hos immune sys em. Acco ding o ou da a,
s ains o he A/C and B clus e s showed a simila a e age
alue o su ace cha ge measu ed by he ela i e pe cen age o
unbound cy och ome C, bu he alues ob ained a ied om
0 and 78% among s ains (see Supplemen a y Figu e S2C
and Supplemen a y Table S5). In pa icula , closely ela ed
s ains in he phylogene ic ee (DEN116 and ICE21, 101 SNPs)
showed comple ely dis inc ela i e su ace cha ges (72 and
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