Effects of toluidine blue O (TBO)-photodynamic inactivation on community-associated methicillin-resistant Staphylococcus aureus isolates

J Microbiol Immunol Infect. 2017 Feb;50(1):46-54. doi: 10.1016/j.jmii.2014.12.007. Epub 2015 Jan 10.

Abstract

Background/objectives: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was recognized as a leading pathogen and has been shown to be genetically different from the health care-associated MRSA (HA-MRSA). Photodynamic therapy (PDT) is considered a potential alternative method for the treatment of resistant bacterial infections, but the effect of PDT on CA-MRSA is unknown. The purpose of this study was to compare the bactericidal effects of toluidine blue O (TBO) on CA-MRSA and HA-MRSA and investigate the photodynamic inactivation effects of TBO (TBO-PDI) against bacterial virulence factors.

Materials and methods: TBO-PDI effects were determined by measuring the survival fractions for four strains and bactericidal activities for 26 CA-MRSA isolates and 26 HA-MRSA isolates. The influences of TBO-PDI on DNA fragmentation and the activities of protease, lipase, staphylococcal α-hemolysin, and enterotoxin were studied.

Results: TBO-PDI has effective bactericidal activity against both CA- and HA-MRSA. However, the bactericidal activity of TBO-PDI was significantly higher against HA-MRSA than CA-MRSA isolates. In addition, TBO-PDI treatment using a sublethal TBO concentration led to reduced production of several virulence factors, including protease, lipase, staphylococcal α-hemolysin, and enterotoxin.

Conclusion: Although TBO-PDI is slightly less effective against CA-MRSA than HA-MRSA isolates, TBO-PDI could reduce the production of virulence factors at a sublethal TBO concentration, which would be beneficial for treating CA-MRSA infections.

Keywords: CA-MRSA; photodynamic inactivation; virulence factors.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Community-Acquired Infections / microbiology*
  • Cross Infection / microbiology
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Methicillin-Resistant Staphylococcus aureus / physiology
  • Microbial Viability / drug effects
  • Photosensitizing Agents / pharmacology*
  • Staphylococcal Infections / microbiology*
  • Tolonium Chloride / pharmacology*
  • Virulence Factors / analysis

Substances

  • Anti-Bacterial Agents
  • Photosensitizing Agents
  • Virulence Factors
  • Tolonium Chloride