title: Changes in the agr locus affect enteritis caused by methicillin-resistant Staphylococcus aureus.
abstract: We studied the characteristics of methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) strains that caused enteritis. In a previous report, we demonstrated that both phenotypic and genotypic changes were associated with MRSA enteritis; and we hypothesized that the accessory gene regulator (agr), which is a global regulator of staphylococcal virulence and upregulates several exoproteins, is the key factor associated with the development of MRSA enteritis. In this study, we examined 12 MRSA isolates associated with enteritis from stool samples and 17 MRSA isolates not associated with enteritis that had the following characteristics: the strains associated with enteritis had the same genotype (genotype A), as detected by pulsed-field gel electrophoresis, or the strains were isolated from stools. The differences between strains that caused enteritis and those that did not cause enteritis strains were examined by quantitative reverse transcription-PCR to assess RNAII, agrA, RNAIII, and tst expression and by sequencing of the agr locus. The levels of expression of agrA, RNAIII, and tst were higher by the MRSA isolates associated with enteritis than by the MRSA isolates not associated with enteritis, whether or not they were of the same genotype. The levels of expression of RNAII by almost all the clinical isolates were similar. Sequencing of the agr locus showed that all MRSA isolates that caused enteritis have agr mutations, whereas the MRSA isolates that did not cause enteritis, with three exceptions, did not. Many of the isolates associated with enteritis had the same mutation, especially at the C-terminal end of agrA. These results suggest a trend in which mutations in the agr locus modify the expression of agrA and RNAIII and the production of toxin, all of which may increase the virulence and influence the occurrence of MRSA enteritis.
authors.affiliation: Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima,Japan. yoichi-sugiyama@hiroshima-u.ac.jp
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: Kazuya
authors.initials: K
authors.lastname: Okii
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohge
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
authors.forename: Eiso
authors.initials: E
authors.lastname: Hiyama
mesh_terms: D000595:Amino Acid Sequence; D000818:Animals; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000235:genetics*; D001427:Bacterial Toxins / Q000096:biosynthesis; D015373:Bacterial Typing Techniques; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D004751:Enteritis / Q000382:microbiology*; D004768:Enterotoxins / Q000096:biosynthesis; D005243:Feces / Q000382:microbiology; D020869:Gene Expression Profiling; D005838:Genotype; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D008969:Molecular Sequence Data; D012313:RNA / Q000096:biosynthesis; D012329:RNA, Bacterial / Q000096:biosynthesis; D016415:Sequence Alignment; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000382:microbiology*; D018089:Superantigens / Q000096:biosynthesis; D015534:Trans-Activators / Q000096:biosynthesis / Q000235:genetics*
chemical_list: C095698:Agr protein, Staphylococcus aureus; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004269:DNA, Bacterial; D004768:Enterotoxins; C034477:RNA primers; D012329:RNA, Bacterial; C096035:RNAIII, Staphylococcus aureus; D018089:Superantigens; D015534:Trans-Activators; C030107:enterotoxin F, Staphylococcal; D012313:RNA