Formation and Properties of Persister Cells of Staphylococcus capitis and Staphylococcus epidermidis, Bacteria Inhabiting Human Skin

Abstract

Persisters (P) are the cells surviving, but not reproducing in the presence of lethal doses of antibiotics (AB). These are the cells of a scarce (0.001–1.0%) subpopulation, emerging due to a phenotypic transition, which may be stochastic or induced by stress impacts. Growing in fresh medium, P reproduce the structure of the parent population, which is considered the cause of: (a) recurrent infections; (b) inefficiency of antibiotic treatment; and (c) development of antibiotic resistance, as was discussed in numerous articles and reviews. The goal of the present work was to investigate P formation by bacteria contaminating human skin and their properties, which have not been studied previously. Two approaches were used to measure the frequency of occurrence was determined for P in the populations of stationary-phase cultures of Staphylococcus capitis Р205-1 (UNIQEM, Russia), which is sensitive to polymyxin, Na sulfacyl, and co-trimoxazole, and Staphylococcus epidermidis 14990 АТСС, which is resistant to these antibiotics: (1) traditional, by application of lethal AB doses and (2) by using a lysis solution (LS), which killed the ordinary vegetative cells and selected the persister cells resistant to AB and LS (PAB and PLS, respectively). This is the first report on applicability of the method involving the lysis solution for determination of P abundance in strains with multidrug AB resistance (for the S. epidermidis strain). Unlike most bacterial strains retrieved from collections , the share of P in stationary-phase cultures of staphylococci inhabiting human skin was quite high: ~10% for both S. epidermidis PLS and S. capitis. Heterogeneity in resistance to the lysis solution was revealed in the PAB obtained by the standard procedure: PLS share in S. capitis was ~1% of PAB abundance. These PLS were resistant to AB cross-action. The differences in PLS abundance in the studied strains (10% for S. epidermidis and below 1.0% for S. capitis) correlated with their AB resistance. Long-term incubation (4 months) under standard conditions resulted in the cycle of staphylococci development ending by emergence of dormant forms (DF); their share for both strains was ~0.1% of the number of viable cells in the stationary-phase cultures. The DF of staphylococci had all characteristics of dormant cells: emerged in the cycle of culture development; preserved viability under nongrowth conditions; had no experimentally detectable metabolism (absence of respiration); had specific ultrastructural organization; and were heat-resistant (200‒600 times higher than the vegetative cells at 90°C for 15 min). The correlation between PLS abundance in the cultures of staphylococci and the share of heat-resistant DF confirms our earlier suggestion on persisters as DF percursors.