High level methicillin resistance correlates with reduced Staphylococcus aureus endothelial cell damage
Abstract There has been controversy about the intrinsic virulence of methicillin-resistant Staphylococcus aureus (MRSA) as compared to methicillin-susceptible S. aureus (MSSA). To address this discrepancy, the intrinsic virulence of 42 MRSA and 40 MSSA clinical isolates was assessed by testing endothelial cell (EC) damage, a surrogate marker for virulence in blood stream infections. Since these clinical isolates represent a heterogeneous group, well characterized S. aureus laboratory strains with SCC mec loss- and gain-of-function mutations were used in addition. The clinical MRSA isolates carrying typical hospital acquired SCC mec types (I, II or III) induced significantly less damage (47.8%) as compared to isolates with other SCC mec types (62.3%, p = 0.03) and MSSA isolates (64.2%, p 2 = 0.4464, p 32μ/ml) grew significantly slower as compared to isolates with low-level resistance ( p = 0.047). The level of EC damage positively correlated with α- and δ-toxin production ( p p n = 21, 56.3%) were significantly less cytotoxic as compared to invasive MSSA isolates ( n = 20, 68.0%, p
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