Caparon, M. G. | bioRxiv Science

bioRxiv2025

Metabolic cross-talk promotes persistence of Enterococcus in a model of polymicrobial catheter-associated urinary tract infection

Catheter-associated urinary tract infections (CAUTI) account for 70%[~]80% of urinary tract infections (UTI) and can lead to adverse outcomes. Most CAUTIs are polymicrobial with resilient communities maintaining a consistent composition of species over time, despite antibiotic treatment and catheter replacement. However, the mechanisms promoting persistence are poorly understood. Here we examine how a chemical interaction between Gram-positive Enterococcus faecalis and Gram-negative Klebsiella pneumoniae can explain their high rate of co-occurrence on long-term indwelling urinary catheters. Sequence analyses of longitudinal isolates from several human patients co-infected with E. faecalis and K. pneumoniae revealed that despite frequent replacement, catheters became re-colonized with the same or a nearly identical consortium of strains throughout the study collection period. Using artificial urine medium (AUM), monoculture revealed that the K. pneumoniae isolates grew robustly and formed biofilm, while the E. faecalis isolates grew poorly and did not form biofilm. However, co-culture of paired isolates resulted in enhanced E. faecalis growth and biofilm, which could be reproduced by supplementing E. faecalis with cell-free K. pneumoniae conditioned AUM supernatant (KpAUMSup). Analyses using comparative transcriptomics, mutant strains and chemical inhibitors with cell culture and murine CAUTI models revealed that: i) KpAUMSup, but not AUM, stimulated expression of the E. faecalis Fsr quorum-sensing system; ii) Fsr was required for E. faecalis to respond to KpAUMSup; iii) E. faecalis cultured in KpAUMSup was more efficient in initiating CAUTI; and iv) Disruption of Fsr inhibited initiation of CAUTI. This interspecies signaling may help explain the high rate of co-colonization of these CAUTI pathogens and highlights new therapeutic strategies to treat polymicrobial CAUTI.

microbiology↗

bioRxiv2023

Volatile profiling distinguishes Streptococcus pyogenes from other respiratory streptococcal species

Sore throat is one of the most common complaints encountered in the ambulatory clinical setting. Rapid, culture-independent diagnostic techniques that do not rely on pharyngeal swabs would be highly valuable as a point-of-care strategy to guide outpatient antibiotic treatment. Despite the promise of this approach, efforts to detect volatiles during oropharyngeal infection have yet been limited. In our research study, we sought to evaluate for specific bacterial volatile organic compounds (VOC) biomarkers in isolated cultures in vitro, in order to establish proof-of-concept prior to initial clinical studies of breath biomarkers. A particular challenge for diagnosis of pharyngitis due to Streptococcus pyogenes is the likelihood that many metabolites may be shared by S. pyogenes and other related oropharyngeal colonizing bacterial species. Therefore, we evaluated whether sufficient metabolic differences are present that distinguish the volatile metabolome of Group A streptococci from other streptococcal species that also colonize the respiratory mucosa, such as S. pneumoniae and S. intermedius. In this work, we identify candidate biomarkers that distinguish S. pyogenes from other species, and establish highly produced VOCs that indicate presence of S. pyogenes in vitro, supporting future breath-based diagnostic testing for streptococcal pharyngitis. IMPORTANCEAcute pharyngitis accounts for approximately 15 million ambulatory care visits in the USA. The most common and important bacterial cause of pharyngitis is Streptococcus pyogenesis, accounting for 15% to 30% of pediatric pharyngitis. Distinguishing between bacterial and viral pharyngitis is key to management in US practice. Culture of a specimen obtained by throat swab is the standard laboratory procedure for the microbiologic confirmation of pharyngitis, however this method is time consuming which delays appropriate treatment. If left untreated, S. pyogenes pharyngitis may lead to local and distant complications. In this study, we characterized the volatile metabolomes of S. pyogenes and other related oropharyngeal colonizing bacterial species. We identify candidate biomarkers that distinguish S. pyogenes from other species and provides evidence to support future breath-based diagnostic testing for streptococcal pharyngitis.

microbiology↗