Abstract

Aerococcus urinae (Au) and Globicatella sanguinis (Gs) are gram-positive bacteria belonging to the family Aerococcaceae and colonize the human immunocompromised and catheterized urinary tract. We identified both pathogens in polymicrobial urethral catheter biofilms (CBs) with a combination of 16S rDNA sequencing, proteomic analyses, and microbial cultures. Longitudinal sampling of biofilms from serially replaced catheters revealed that each species persisted in the urinary tract of a patient in cohabitation with 1 or more gram-negative uropathogens. The Gs and Au proteomes revealed active glycolytic, heterolactic fermentation, and peptide catabolic energy metabolism pathways in an anaerobic milieu. A few phosphotransferase system (PTS)–based sugar uptake and oligopeptide ABC transport systems were highly expressed, indicating adaptations to the supply of nutrients in urine and from exfoliating squamous epithelial and urothelial cells. Differences in the Au vs Gs metabolisms pertained to citrate lyase and utilization and storage of glycogen (evident only in Gs proteomes) and to the enzyme Xfp that degrades d-xylulose-5′-phosphate and the biosynthetic pathways for 2 protein cofactors, pyridoxal 6′-phosphate and 4′-phosphopantothenate (expressed only in Au proteomes). A predicted ZnuA-like transition metal ion uptake system was identified for Gs while Au expressed 2 LPXTG-anchored surface proteins, one of which had a predicted pilin D adhesion motif. While these proteins may contribute to fitness and virulence in the human host, it cannot be ruled out that Au and Gs fill a niche in polymicrobial biofilms without being the direct cause of injury in urothelial tissues.

Highlights

  • The genus Aerococcus that was first described in 19531 morphologically and biochemically resembles Enterococci and Staphylococci

  • Longitudinal surveys of microbial communities formed on bladder catheter surfaces from repeatedly catheterized patients with neurogenic bladders revealed that Aerococcaceae family members were part of persistent catheter biofilm (CB), Aerococcus urinae (Au) in 1 patient (P5) and Globicatella sanguinis (Gs) in another (P6)

  • Their quantitative profiles derived from metaproteomic data are presented in Figure 1. 16S rRNA phylogenetic analyses confirmed the presence of Aerococcus and Globicatella at the genus level in the respective samples

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Summary

Introduction

The genus Aerococcus that was first described in 19531 morphologically and biochemically resembles Enterococci and Staphylococci. Difficulties to grow Aerococci in vitro and identify the genus using conventional microbial culture techniques (fastidiousness) explain why their presence in human clinical samples has been historically overlooked.[2] Species most frequently associated with human pathogenicity are Aerococcus urinae (Au) and Aerococcus sanguinicola.[2] High-resolution microbial identification techniques, such as MALDI-TOF and 16S rDNA gene sequencing, support the notion that Au is a more common cause of urinary tract infection (UTI), endocarditis, bacteremia, and urosepsis than previously thought.[2,3,4,5,6] A third Aerococcus species that causes nosocomial infections is Aerococcus viridans.[7,8] Clinical Aerococcus strains are resistant to sulfonamides. Phylogenetic clustering suggests that an Au clade causing UTI, bacteremia, and endocarditis was distinct from other clades

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