1. Introduction
The discovery of antibiotics is among the 20
th centuryʼs most important achievements in human and veterinary medicine [
1]. Their promise has, however, been tarnished by the appearance of resistance and the subsequent transfer of the associated genetic determinants to pathogenic bacteria, hindering the treatment of infections [
2]. Although the presence of antibiotic resistance in beneficial and commensal bacteria poses no direct risk to human or animal health, populations of such microorganisms are potential reservoirs of resistance genes that pathogens may acquire [
3,
4]. The food chain is pivotal in the transmission of such genes, a consequence of the high cell densities and stress conditions the associated microbiota may experience [
5,
6]. Transfer can occur either during food processing or intestinal transit [
7,
8].
Milk and fermented dairy products are key players in the transmission of antibiotic resistance in food [
9]. Large gene loads for antimicrobial resistance have been repeatedly reported in milk and dairy products [
10,
11,
12,
13]. Interest in antibiotic resistance in the dairy setting has largely focused on lactic acid bacteria (LAB) [
3,
14,
15], but this clashes with more recent postulates of the One Health concept, which understands all environments -and thus their microbiota- to be connected [
16]. Given the huge microbial diversity seen in some cheeses [
17], plus the fact that the population sizes of several taxa may exceed those of LAB [
18,
19,
20], focusing antibiotic resistance only on the latter type of microorganisms is insufficient. However, distinguishing intrinsic from acquired resistance in food-associated bacteria can be challenging, as it is distinguishing acquired resistance due to mutations from resistance due to acquired genes [
14]; as regards transference, only the latter resistance is of great concern [
21]. Indeed, resistance/susceptibility (R/S) cut-offs for many species have yet to be established [
22].
Staphylococcus equorum is a member of the coagulase-negative staphylococci (CNS), a bacterial group whose members are frequently detected in food-processing environments and fermented foods [
23,
24,
25,
26,
27]; certainly,
S. equorum is a majority commensal population in some cheeses [
28,
29,
30]. CNS species help maintain the colour of fermented meats [
31], and contribute to the flavour of all fermented foods via the production of low molecular weight aromatic compounds [
30]. They also inhibit the growth of undesirable microorganisms [
32]. Therefore, although they do not enjoy Generally Regarded as Safe (GRAS) status, and carry no European Qualified Presumption of Safety (QPS) label, selected strains of
S. equorum have been proposed as starters or adjunct cultures for some fermented foods [
33,
34,
35]. No incidents of food poisoning or infections with
S. equorum (or any other CNS species) have ever been reported [
36]. However, in order of not to spread antibiotic resistance genes through the food chain, starters, and adjunct cultures should contain no transferable ARGs. Work on the antibiotic R/S profiles of
S. equorum strains has been particularly scant [
24,
37,
38,
39]. Further, these works have mostly involved disk diffusion assays, which do not allow MICs to be established, which are needed for the establishment of reliable R/S cut-offs.
The present work reports a broth microdilution survey of the MICs for 16 antibiotics in S. equorum strains (n=30) isolated from traditional blue-veined cheeses made from raw milk. To examine the links between strain phenotype and genetics, 13 strains were then subjected to genome sequencing. This prompted further phenotypic testing with respect to additional antibiotics, and allowed acquired resistance caused by mutations to be distinguished from resistance afforded by acquired genes.
3. Discussion
Commensal and beneficial food-borne bacteria may play a role in disseminating antibiotic resistance to pathogens by acting as reservoirs of genetic determinants [
45]. A comprehensive understanding of the whole pool of genes available and the transfer process is essential if we are to combat this resistance [
35].
S. equorum populations can become large in a number of fermented foods [
21,
23,
24,
25,
26,
28], yet the antibiotic resistance properties of this speciesʼ strains have been little studied [
38,
46,
47]. In this work, strains of
S. equorum isolated from a Spanish traditional blue-veined cheese were subjected to phenotypic, genetic, and genomic analyses in order to determine their antibiotic R/S profiles, to identify the genetic basis of the phenotypic resistances noted, and to search their genomes for antibiotic resistance-associated genes. As in other bacterial populations from cheese [
48,
49,
50], the combined fingerprinting profiles revealed wide genetic diversity, which was confirmed by phylogenomic analysis of the sequenced strains. The examination of unrelated, non-clonal strains is important if the results of R/S assays results are to be reliable and extendible to new
S. equorum strains.
In agreement with previous studies [
37,
39,
51], low MICs were returned for most antibiotics in the present work; indeed, all were considered susceptible. Some MICs, however, fell above the cut-offs for Staphylococcus spp. established by the EUCAST [
40], although they were below those established by the CLSI [
41]; these strains were, therefore, also considered susceptible to the antibiotics concerned. Further genetic analyses of the strains showing the highest MICs might be advisable to exclude the presence of low-resistance conferring systems [
52,
53]. The MICs above the CLSI cut-off to penicillin G correlated well with an enhanced MIC for ampicillin, although a cut-off for this latter antibiotic has yet to be established. EUCAST has not developed cut-offs for ampicillin and penicillin G due to widespread resistance to these antibiotics among staphylococcal isolates, which makes their clinical use impractical [
40]. The MIC values for ampicillin and penicillin G obtained with the microdilution assays were not reproduced by the MTS system. Despite of this, the largest MICs were always exhibited by the same strains, suggesting a differential resistance as compared to more susceptible ones. This resistance level, however, was much lower than that recorded in clinically-resistant
S. aureus strains (16-256 µg mL
-1) [
54,
55]. Low resistance might be provided by dissimilar cell structures (cell-wall permeability, membrane charges, penicillin binding protein variants, etc.) or the differential activity of unspecific transporters (multidrug systems, efflux pumps) [
56]. Anyway, the bimodal topology of the distribution curves for these antibiotics (
Figure S2), strongly suggests that a part of the population has got acquired resistance. The presence of colonies within the inhibition halos points towards undefined mutations accounting for such resistance. In contrast to β-lactams, some strains showed different (and quite high) MIC values for erythromycin and chloramphenicol. These values were considered compatible with the presence of dedicated resistance systems and the involvement of acquired (and possibly transferable) genes.
In the absence of species-specific R/S cut-offs, authorized agencies recommend the use of those of closely related species [
40,
57]. However, knowing whether a given strain is susceptible or resistant to an antibiotic is still challenging, particularly if the cut-offs cited by different sources (such as those of EUCAST and CLSI) are dissimilar [
40,
41]. In addition to clinical R/S cut-offs, microbiological (MCOFFs) or ecological cut-offs (ECOFFs) may also serve to distinguish susceptible from resistant strains [
36,
58]. MCOFFs and ECOFFs describe the MIC above which bacterial isolates have phenotypically detectable acquired resistance mechanisms [
59]. This should better allow the identification of strains carrying transferable resistances, and thus help prevent their use in food (and feed) systems [
60]. Examining the data in the literature has the potential to help establish
S. equorum such microbiological or ecological cut-offs, but differences between surveys in terms of the antibiotics tested, the concentration ranges contemplated, the methodologies used (disk diffusion, plate, and broth microdilution, Etest, etc.), and the media and culture conditions imposed, etc., hamper any direct comparisons of results [
24,
37,
38,
39,
51]. Analysis of the distribution of MICs from large sets of antibiotic resistance assays using software programs such as ECOFFinder [
61] or NRI [
62] were utilized in this study to propose
S. equorum-specific cut-offs. The incorporation of new MIC data by surveying more strains from different sources can help establish robust and reliable cut-offs for this species.
Genome sequencing and comparative analysis are currently the gold standards for characterizing the genetic potential of microorganisms, including the detection of ARGs in bacteria [
63], the prediction of phenotypic resistance [
64,
65], and the assessment of its transferability [
66]. Comparing the genomes of antibiotic-resistant and susceptible bacteria would further allow distinctions to be made between genes known to be spread through bacterial species and housekeeping genes involved in antibiotic resistance [
67]. The distribution of the resistome in chromosomal and plasmid contigs has recently been reported following genome analysis of different
Staphylococcus species [
68,
69,
70], including
S. equorum strains [
71]. Chromosomal genes are found on large contigs harbouring well-recognized housekeeping genes, while genes on plasmids are usually found in small contigs and in the vicinity of genes coding for replication proteins or proteins involved in plasmid maintenance and mobilization. The genome analysis undertaken in the present work led to further phenotypic testing for antibiotics that were not included in the Sensititre panel. It also allowed for acquired but silent genes to be detected. In the absence of antibiotic pressure, the acquisition of tightly regulated genes (silent genes) that do not lead to the phenotypic expression of resistance have been abundantly described [
47], of these some might easily activate under certain conditions [
72]. The transfer of silent genes to clinically important pathogens could lead to therapy failure [
73].
Genes of the
bla and
mec families have been repeatedly reported to mediate resistance in
Staphylococcus spp. to β-lactam antibiotics [
74]. In the
S. equorum strains of this work, only genes of the
bla family were identified: an identical blaR1-blaZI operon on plasmid contigs in five strains, and a
bla gene in all other strains on the bacterial chromosome. Whether the contigs harbour the complete plasmid molecules is not currently known. Neither
blaZ nor
bla, however, afforded moderate or strong resistance to ampicillin or penicillin G. Indeed, the strains carrying the genes for both betalactamases were among the most susceptible to both antibiotics. These results lead us to foresee that the phenotypic resistance to penicillin G is not due to acquired genes. Even though large plasmids have been recently introduced in Gram-positive bacteria by electroporation [
75], no colonies were obtained by transforming plasmid DNA from the five strains into
S. aureus, suggesting the
S. equorum plasmidic BlaZ system is not functional. As reported for
S. aureus, sequence variation in the
blaR1-blaZI region [
47,
76], or mutations in the promoter region [
77], may also account for the discrepancies observed between genotype and phenotype. As pointed out above, despite being silent, acquired genes such as
blaZ and
lnu(A) may still represent a hazard.
The
msr(A) and
fosB/fosD genes proved to be polymorphic. The protein variants encoded by the different ORFs were thought to be responsible for the different MICs recorded for erythromycin and fosfomycin. As regards erythromycin resistance, the simultaneous presence of
msr(A) and
mph(C) in a single strain, as might be the case in some of the present strains, has previously been associated with enhanced MICs [
43].
norA encodes an efflux pump of the major facilitator superfamily that has been associated with resistance to fluoroquinolones in
Staphylococcus [
44]. However, this gene in the
S. equorum strains was not associated with ciprofloxacin resistance. Lüthje and Schwarz [
78] propose
norA to be a core gene in staphylococci and suggest fusaric acid and siderophores be its natural substrates.
Plasmids are the major route of dissemination of resistance determinants; therefore, resistance genes harboured on plasmids are the most likely to be transferred [
79]. Small plasmids conferring chloramphenicol resistance via cat genes coding for chloramphenicol o-acetyl transferases have been abundantly characterized in
Staphylococcus species of different origins [
80,
81]. Plasmids such as pC221 and pC223 belong to the rolling-circle replicating (RCR) plasmids of the pT181 family and have been shown to replicate in several Gram-positive species, including staphylococci and
Bacillus subtilis [
82]. In addition to
cat,
blaR1-blaZI, and
lnu(A) determinants were also found to be plasmid-encoded in this work. The in vitro conjugal transfer of
lnuA-containing plasmids, and their lincomycin-associated resistance, from
S. equorum to
Staphylococcus spp.,
E. faecalis and
Tetragenococcus halophilus, has already been reported [
46].
lnuA-containing plasmids from
S. equorum cheese strains are larger (contigs of 32-34 kbp) than those in
S. equorum strains from fermented seafood (2.6-2.8 kbp; these last plasmids also replicate by an RCR mechanism) [
46]. Differences in the size and mode of replication can influence the transfer and host range of plasmids, which may limit their spread capability. In the present work, pCAT was successfully transferred to
S. aureus by electroporation. The presence of an
oriT sequence followed by ORFs encoding Mob proteins further suggests pCAT has a capacity for mobilization by other means (e.g., conjugation). Certainly, the 1BCExtra-1
fosB/fosD gene, which is thought to lie on the chromosome, was flanked by ORFs encoding Tn
552-associated proteins, strongly suggesting horizontal acquisition by transposon-mediated integration. Indeed, Tn
552 has long been recognized for its capacity to integrate plasmids on the chromosome [
83]. Although posing a lesser risk, this fosfomycin resistance gene is thought to be easily transmitted via horizontal transfer events. Together, the above results suggest that
S. equorum is already a reservoir of easily transferable ARGs. Therefore, full phenotypic and genetic characterizations of any
S. equorum strains being contemplated for use as starters or adjunct cultures in food fermentations are advisable.