Trends in Microbiology
ReviewStaphylococcus aureus determinants for nasal colonization
Section snippets
The nasal cavity is the primary habitat of Staphylococcus aureus
Staphylococcus aureus is seen as a commensal as well as a major human pathogen responsible for a wide range of serious acute and chronic diseases. Analysis of isolates from infected patients showed that at least nosocomial infections are mostly endogenous 1, 2 and nasal carriage has been identified as a major risk factor for several types of infections 3, 4, 5. Only approximately 20% of the healthy human population is persistently colonized in the nose with S. aureus. In this group of
S. aureus adherence to nasal surfaces
A crucial step in the establishment of nasal colonization is most likely the adhesion of bacteria to the nasal epithelial cells. S. aureus seems to predominantly colonize the anterior part of the nasal cavity (vestibulum nasi), which is lined by a stratified, keratinized, non-ciliated squamous epithelium. During differentiation, nasal epithelial cells in the anterior change their appearance from columnar to anucleated, squamous cells termed corneocytes, which are highly keratinized and are
Growth conditions and regulatory changes in response to the nasal environment
S. aureus is constantly removed from the nose through shedding of squamous epithelial cells and mucus. Thus, the bacterial proliferation rate has to be high enough to compensate for this mechanical clearance and presumably also other antibacterial defense mechanisms. However, the physiological state of S. aureus in the nasal cavity is not well investigated. Expression analysis of genes that are indicative for certain metabolic states of S. aureus was chosen to address this question 36, 44, 45.
S. aureus immune evasion during colonization
In addition to overcoming the mechanical clearance in the nasal cavity, S. aureus must circumvent innate antibacterial defenses to achieve persistent colonization 49, 50. S. aureus is able to counteract the most important mechanisms, namely antimicrobial molecules such as lysozyme, bactericidal fatty acids, defensins, immunoglobulins and the complement system (Table 2).
S. aureus is lysozyme-resistant due to the combined activity of the cell wall modifying enzyme OatA and the presence of WTA [51]
Concluding remarks
Since the last review on staphylococcal nasal carriage in this journal, a decade ago [5], major progress has been made in understanding the usually well balanced interaction between S. aureus and its host. A large plethora of well conducted genetic studies now convincingly show that almost all S. aureus isolates of human origin can be assigned to a limited number of clonal complexes, all of which are equally efficient in colonizing the human nose. By contrast, human genetic factors seem to be
Acknowledgments
This work was supported by DFG SFB 766 (Weidenmaier, Wolz), DFG SFB TR34 (Weidenmaier, Wolz), and Fortuene Grant 1846-0-0 from the Medical Faculty of the University of Tuebingen (Weidenmaier).
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