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Applied and Environmental Microbiology, April 2006, p. 2627-2636, Vol. 72, No. 4
0099-2240/06/$08.00+0 doi:10.1128/AEM.72.4.2627-2636.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Institute of Medical Microbiology and Hygiene, Institutes of Infectious Disease Medicine,1 Institute of Experimental and Clinical Pharmacology and Toxicology, University of Saarland, Homburg/Saar,5 Institute of Medical Microbiology, University of Münster, Münster,3 Institute for Medical Microbiology and Immunology, University of Bonn, Bonn, Germany,4 Department of Veterinary and Biomedical Sciences, University of Nebraska, Lincoln, Nebraska2
Received 11 November 2005/ Accepted 19 January 2006
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0.1%, vol/vol). In contrast to the well-established effects of elevated ethanol concentrations on bacteria, little is known about the consequences of exposure to VLEC. We supplemented growth media for Staphylococcus aureus strain DSM20231 with VLEC (VLEC+ conditions) and determined ultramorphology, growth, and viability compared to those with unsupplemented media (VLEC conditions) for prolonged culture times (up to 8 days). VLEC+-grown late-stationary-phase S. aureus displayed extensive alterations of cell integrity as shown by scanning electron microscopy. Surprisingly, while ethanol in the medium was completely metabolized during exponential phase, a profound delay of S. aureus post-stationary-phase recovery (>48 h) was observed. Concomitantly, under VLEC+ conditions, the concentration of acetate in the culture medium remained elevated while that of ammonia was reduced, contributing to an acidic culture medium and suggesting decreased amino acid catabolism. Interestingly, amino acid depletion was not uniformly affected: under VLEC+ conditions, glutamic acid, ornithine, and proline remained in the culture medium while the uptake of other amino acids was not affected. Supplementation with arginine, but not with other amino acids, was able to restore post-stationary-phase growth and viability. Taken together, these data demonstrate that VLEC have profound effects on the recovery of S. aureus even after ethanol depletion and delay the transition from primary to secondary metabolite catabolism. These data also suggest that the concentration of ethanol needed for bacteriostatic control of S. aureus is lower than that previously reported. |
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In medicine, alcoholic compounds have numerous applications as stabilizers, solvents, and disinfectants. A large variety of therapeutics (typically liquids for oral application, e.g., cough suppressants, expectorants, oral tranquilizer suspensions) contain ethanol at various concentrations. Furthermore, a number of pharmaceuticals for intravenous treatment also contain ethanol at concentrations ranging from 1% (vol/vol) to 96% (vol/vol). Most alcohol-based disinfectants contain ethanol, typically at a concentration of
70 to 85% (vol/vol). As an example, antibiotic lock therapy of implanted intravenous catheters uses alcohol as an antimicrobial disinfectant (9) and is widely applied, particularly in pediatrics (34). Finally, ethanol may also be used for food preservation (35). Given the large range of ethanol concentrations in the different preparations, and considering washout, dilution, and evaporation, the actual concentrations in situ are anticipated to be more diverse and would include very low ethanol concentrations (VLEC); hence, a fundamental understanding of the effects of VLEC on bacterial physiology is important.
In addition to the above applications, ethanol or related alcohols are routinely used in medical microbiology for in vitro testing as a solvent: According to CLSI (formerly NCCLS) guidelines (30), 95% ethanol or methanol is recommended to dissolve various macrolides, chloramphenicol, and rifampin. The final concentration of ethanol in the medium depends on the concentration of the antimicrobial selected; for instance, a solution containing 10 µg/ml of the respective antimicrobial also contains 0.1% (vol/vol) ethanol. Furthermore, bacterial genetic research employing erythromycin resistance as a marker for selection typically employs final concentrations of 10 µg/ml erythromycin, i.e., a solution containing 0.1% (vol/vol) ethanol.
The bactericidal activity of ethanol is due to several factors: disruption of membrane structure or function (1, 12, 15, 36); interference with cell division, affecting steady-state growth (12); variations in fatty acid composition and protein synthesis (8); inhibition of nutrient transport via membrane-bound ATPases (4); alteration of membrane
pH (4, 40) and membrane potential (
) (40); and a decrease in intracellular pH (4, 18, 40). In a recent study with the gram-positive organism Bacillus subtilis, it was demonstrated that treatment with subinhibitory concentrations of ethanol (not affecting vegetative growth) inhibited the initiation of spore development through a selective blockage of key developmental genes under the control of the master transcription factor Spo0A
P (14). These toxic effects have been described for a wide variety of microbial species, and for use of different concentrations of ethanol, ranging from 2.5% to 70% (1, 2, 8, 10, 19, 25, 36). Surprisingly, very little is known about the physiological effects of VLEC. Therefore, the purpose of this study was to determine the effects of VLEC on medically important staphylococci at a concentration frequently encountered in the hospital and laboratory. In this study, we report major effects of VLEC on S. aureus cell integrity, survival, and growth recovery, and we describe the effects of VLEC on metabolism and transcription of select staphylococcal genes.
(This work is presented in partial fulfillment of the requirements for the Ph.D. degree at the University of Saarland, Homburg/Saar, Germany, for I. Chatterjee.)
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Measurement of membrane potential.
Cells were grown in BHI medium at 37°C to an OD600 of 1, centrifuged, and resuspended 1:3 in fresh medium. To monitor the membrane potential (31), 1 µCi/ml of [3H]tetraphenylphosphonium bromide (TPP+; 26 Ci/mmol) was added. TPP+ is a lipophilic cation which diffuses across the bacterial membrane in response to a trans-negative 
. The culture was treated with 0.1% (vol/vol) ethanol after 16 min to estimate the effect of VLEC+ conditions on membrane potential, and samples were filtered and washed as described above. Counts were corrected for nonspecific binding of [3H]TPP+ by subtracting the radioactivity of 10% butanol-treated cell aliquots. For calculation of 
, TPP+ concentrations were applied to the Nernst equation, 
= (2.3 x R x T/F) x log ([TPP+in]/[TPP+out]), where R is the universal gas constant, T is the absolute temperature in Kelvin, F is Faraday's constant, [TPP+in] is the molar concentration of TPP+ inside the bacterial cells, and [TPP+out] is the molar concentration of TPP+ in the medium. The internal volume of 3.4 µl mg of protein1 of staphylococcal cells was used for calculation of [TPP+in].
Gene expression.
RNA was isolated from S. aureus grown in BHI medium (VLEC+ or VLEC) for 3.5, 8, 17, or 22 h. Bacteria were harvested by centrifugation and mechanically disrupted with a Fast Prep FP120 instrument (Qbiogene, Heidelberg, Germany), and RNA was isolated using the RNeasy minikit (QIAGEN, Hilden, Germany) according to the manufacturer's instructions. After treatment with RNase-free DNase I (QIAGEN), total-RNA samples were amplified in an ABI PRISM 7000 sequence detection system using SYBR green PCR Master Mix (Applied Biosystems, Weiterstadt, Germany) and gyrB primers (forward, gyrB f1 [5'-GACTGATGCCGATGTGGA-3']; reverse, gyrB r1 [5'-AACGGTGGCTGTGCAATA-3']) to check for the absence of genomic DNA. Previously transcribed cDNA served as a positive control. RNA was then reverse transcribed (High Capacity cDNA Archive Kit; Applied Biosystems). cDNA was used for real-time amplification with arcA primers (forward, arcA f1 [5'-CTTGGCTATAGGCGTTTCAGAAC-3']; reverse, arcA r1 [5'-GTCGCCTGCGGATTTTCA-3']) or adhE primers (forward, adhE f1 [5'-CACAAAGGTATTGCATTAGTTCTAGCA-3']; reverse, adhE r1 [5'-CGTTACCTGGTCCCACACCTA-3']) and 100 ng of cDNA per reaction. The level of mRNA expression of different genes was normalized against gyrB, which is constitutively expressed (41). The transcript level for each gene of interest was expressed as the n-fold difference relative to the control gene (
, where
CT represents the difference in threshold cycle between the target and control genes).
Metabolite analysis.
Aliquots of bacteria (2 ml) were centrifuged for 5 min at 21,000 x g and 4°C at the indicated time points. The culture supernatants were removed and adjusted to pH 8 with KOH, and the concentrations of glucose, acetate, ammonia, ethanol, and lactate were determined with kits purchased from R-Biopharm AG (Darmstadt, Germany). The concentrations of free amino acids were determined with a Beckman amino acid analyzer by aminoNova AG (Berlin, Germany).
Gas chromatography.
From the incubation culture (brain heart infusion medium with 0.1% ethanol) with bacteria or without bacteria (n = 2 each), 0.1 ml of sample was taken at time zero and at 2, 4, 7, and 24 h. The samples were analyzed by headspace gas chromatography (80°C; column, 0.1% SP-1000/Carbopak C) with flame ionization detection for ethanol quantification or mass selective detection for identification of ethanol and acetaldehyde (29).
Determination of stationary-phase survival.
Single colonies of S. aureus strains were inoculated into 100-ml flasks containing 50 ml of BHI (unsupplemented or supplemented with ethanol), grown at 37°C, and aerated by shaking at 150 rpm for up to 9 days. Aliquots (200 µl) were harvested at 24-h intervals, and the CFU was determined.
Scanning electron microscopy.
Bacterial cells were harvested at different time points (24 h, 48 h, 72 h, 120 h, and 192 h). The pellet was resuspended in a mixture of 1% formaldehyde-1% glutaraldehyde-0.1% picric acid in 0.1 M phosphate buffer (pH 7.2) at room temperature and then stored at 4°C. All formaldehyde solutions were prepared from freshly depolymerized paraformaldehyde. Cell pellets were washed with phosphate buffer and then prepared for scanning electron microscopy. A dense suspension of washed cells was transferred on grids. Cells were dehydrated by use of an ethanol gradient and then subjected to critical-point drying. Subsequently, samples were mounted on aluminum sample holders and sputter coated with platinum, then inspected with an ESEM XL 30 (FEI, The Netherlands) scanning electron microscope at 20 to 30 kV.
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FIG. 1. Effects of VLEC and arginine on micromorphology of S. aureus DSM20231. Shown are representative scanning electron micrographs of S. aureus DSM20231 grown for various times (24 h, 48 h, 72 h, 120 h, and 192 h) in unsupplemented medium (A to E, top to bottom), under VLEC+ conditions (F to J, top to bottom), or under VLEC+ conditions and supplemented with 5 mM arginine (K to O, top to bottom).
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FIG. 2. Analysis of long-term growth, stationary-phase survival, and membrane potential of S. aureus. (A) Growth analysis (OD600) of S. aureus DSM20231 under VLEC ( ) and VLEC+ () conditions, determined in BHI medium. Single colonies were inoculated into BHI in the absence ( ) or presence () of 0.1% (vol/vol) ethanol and incubated at 37°C under microaerophilic conditions for up to 8 days. Data are means ± standard errors of the means of values obtained in three independent experiments. *, P < 0.05; **, P < 0.001 (t test). (B) Viability of S. aureus DSM20231. After growth for the indicated time under VLEC ( ) or VLEC+ () conditions, aliquots were removed and CFU/ml was determined in triplicate. Data are means ± standard deviations of values obtained in two independent experiments. *, P < 0.05; **, P < 0.005 (t test). (C) Ethanol concentration-dependent delayed recovery. (D) Membrane potential measurement of S. aureus DSM20231. Addition of ethanol (0.1%) is indicated by an arrow. Data are representative of two independent experiments.
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Ethanol is rapidly removed from the culture medium.
Ethanol is a volatile organic alcohol (flash point, 13°C); thus, it was surprising that the effects of VLEC on post-stationary-phase recovery persisted until 120 h (5 days) into the growth cycle. We speculated that ethanol would be lost due to evaporation and/or catabolism well before 120 h; hence, we determined the concentration of ethanol in the culture medium throughout the growth cycle. As expected, the concentration of ethanol in the culture medium began to decrease immediately after inoculation, and by 24 h no ethanol remained (Fig. 3A). To assess if ethanol evaporated or was enzymatically catabolized, VLEC+ supernatants were examined by gas chromatography at various time points after supplementation with ethanol both in the presence and in the absence of S. aureus (Fig. 3B). In the absence of microorganisms, the concentration of ethanol in the medium remained stable over 24 h, while in the presence of S. aureus ethanol was depleted from the culture medium by 24 h, suggesting that the bacteria were catabolizing the ethanol. Concomitantly, under VLEC+ conditions, transcription of adhE (the alcohol-acetaldehyde dehydrogenase gene) was elevated earlier (at 3.5 h) than under VLEC conditions, indicating a contribution of alcohol dehydrogenase to ethanol catabolization (Fig. 3C). Most importantly, these data demonstrate that the effects of VLEC on late-stationary-phase growth and survival persist long after ethanol has been depleted from the culture medium, and they suggest that recovery from ethanol-induced alteration is a delayed process.
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FIG. 3. Analysis of ethanol in the culture supernatant and effect of alcohol-aldehyde dehydrogenase (adhE) in VLEC exposure. (A) Determination of ethanol levels in the culture supernatant of S. aureus DSM20231 under VLEC ( ) and VLEC+ conditions () at the indicated time points. (B) Estimation of the nonenzymatic loss of ethanol from the culture supernatant with ( ) or without () bacteria under VLEC+ conditions using gas chromatography. (C) Real-time RT-PCR quantification of alcohol-aldehyde dehydrogenase (adhE) gene expression in S. aureus with or without VLEC at different time points. Expression of the adhE gene in S. aureus DSM20231 was determined in populations grown under VLEC or VLEC+ conditions by real-time RT-PCR at different times as described in Materials and Methods. Shown are transcript quantities relative to the internal control (gyrB) transcript, expressed as n-fold increase. The x axis denotes time (hours). Data are representative of two independent experiments.
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FIG. 4. Analysis of external pH and levels of metabolites of the culture supernatant. External pH (A) and levels of glucose (B), acetate (C), and ammonia (D) in the culture supernatant of S. aureus DSM20231 were determined under VLEC ( ) and VLEC+ () conditions at the indicated time points. Data are representative of two independent experiments.
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FIG. 5. Depletion of free amino acids from the BHI medium. Shown are concentrations of free amino acids L-serine (A), L-glycine (B), L-arginine (C), L-glutamic acid (D), L-ornithine (E), and L-proline (F) in BHI culture medium of S. aureus DSM20231 grown under VLEC ( ) and VLEC+ ( ) conditions. Data are mean molar concentrations (nmol/ml) ± standard deviations of two independent experiments.
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Arginine restores post-stationary-phase recovery under VLEC+ conditions.
Amino acid catabolism is an important source of carbon and energy. The selective depletion of amino acids from the culture medium (Fig. 6) led us to speculate that supplementation of the culture medium with a depleted amino acid would restore post-stationary-phase growth. We tested this hypothesis by supplementation of VLEC cultures with single amino acids at a concentration of 2 mM and assessed their growth and viability. Interestingly, only arginine restored the post-stationary-phase recovery and viability (Fig. 6A; also data not shown). The catabolism of arginine usually involves the arginine deiminase (ADI) pathway. To ascertain if VLEC+ conditions resulted in increased transcription of genes of the ADI pathway, we determined the relative concentration of mRNA for the arcA gene (encoding arginine deiminase) by real-time reverse transcription-PCR (RT-PCR) (Fig. 6B). Consistent with our hypothesis, arcA transcript levels were significantly greater at 3.5 h, 8 h, 17 h, and 22 h in staphylococci grown under VLEC+ relative to VLEC conditions.
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FIG. 6. (A) Effect of L-arginine supplementation. S. aureus DSM20231 was grown under VLEC ( ) or VLEC+ () conditions, or in VLEC supplemented with 2 mM L-arginine ( ), or in VLEC with 5 mM L-arginine ( ) in BHI medium, and cell densities were determined as described in Fig. 2. Data are representative of two independent experiments. (B) Real-time RT-PCR quantification of microaerobic arcA (arginine deiminase) gene expression. Expression of the arcA gene in S. aureus DSM20231 populations grown with or without VLEC was determined by real-time RT-PCR at different time intervals as described in Materials and Methods. Shown are transcript quantities relative to the internal control (gyrB) transcript, expressed as n-fold increase.
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Additionally, VLEC+ conditions selectively inhibited the utilization of amino acids such as glutamate, proline, and ornithine. D-Glutamate is found in the second position of the peptidoglycan stem peptides in virtually all species analyzed thus far (33) and is essential for growth in Escherichia coli (28) and S. aureus (6, 11, 13). The other "glutamate family" amino acids ornithine and proline can be converted into glutamate: ornithine by the ornithine aminotransferase (SA0818) and the
1-pyrroline-5-carboxylate dehydrogenase (SA2341) and proline by the proline dehydrogenase (SA1585). Thus, the inability to acquire, or synthesize, glutamate under VLEC+ conditions may contribute to cell lysis in the presence of ethanol.
Ethanol enhances the ability of staphylococci to form a biofilm (23). Recent transcriptional profiling data on staphylococci growing in biofilms has suggested that the bacteria are growing anaerobically (3, 32, 42). Consistent with that suggestion, these studies noted increased expression of the anaerobic alternative energy-generating ADI pathway (3, 32, 42). The ADI pathway is composed of three enzymes, arginine deiminase (arcA), ornithine transcarbomoylase (arcB), and carbamate kinase (arcC). Together, these enzymes convert arginine to ornithine, ammonia, and carbon dioxide, yielding 1 mol of ATP per mol of arginine consumed. Our data demonstrate that ethanol up-regulates expression of the ADI pathway, leading us to speculate that ethanol enhances biofilm formation, in part, through an alteration of the metabolic flux toward the ADI pathway.
In conclusion, to our knowledge this is the first report demonstrating the effects of VLEC on S. aureus growth, viability, metabolism, and cell wall morphology. These effects of VLEC were evident only after the complete depletion of ethanol from the culture medium, suggesting that bacterial recovery from, and adaptation to, ethanol stress is a prolonged process. These observations are incongruent with a prevailing dogma, i.e., that bacteria rapidly adapt or die when exposed to disinfectants, and they open new perspectives in our understanding of bacterial senescence in the presence of subinhibitory concentrations of antiseptic agents.
We are indebted to M. Laue, N. Pütz, C. Schröder, M. Josten, and K. Hilgert for technical help in part of the experiments, to S. Foster (Sheffield, United Kingdom) for S. aureus strain SH1000, and to H. Labischinski, J. Gehrke, and M. Haber for helpful suggestions and discussions.
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B by repression of the negative regulator gene icaR. Infect. Immun. 72:3838-3848.This article has been cited by other articles:
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