Bacteriophage infection drives loss of β-lactam resistance in methicillin-resistant Staphylococcus aureus

  1. My Tran
  2. Angel J Hernandez Viera
  3. Patricia Q Tran
  4. Erick D Nilsen
  5. Lily Tran
  6. Charlie Y Mo  Is a corresponding author
  1. Department of Bacteriology, University of Wisconsin-Madison, United States
6 figures, 5 tables and 4 additional files

Figures

Figure 1 with 2 supplements
Infection by bacteriophage ΦStaph1N drives the loss of β-lactam resistance in MRSA.

(A) Schematic of the experimental setup. Drug-resistant (AbxR), phage-sensitive (PhageS) bacterial cultures are infected with phage. The population of infected cells is passaged and allowed to recover. The surviving cell population is resistant to phage infection (PhageR) but has evolved sensitivity to antibiotics (AbxS). (B) ΦStaph1N infects MRSA strains MRSA252, MW2, and LAC (left panel). Following infection with ΦStaph1N, evolved cultures of the three MRSA strains are resistant to ΦStaph1N (right panel). (C) ΦStaph1N-treated, evolved MRSA strains show significant loss of resistance against oxacillin, compared to the parental strains. Loss of resistance is indicated by the area of bacterial clearance surrounding the antibiotic resistance strip. (D) ΦStaph1N treatment causes loss of resistance against different β-lactams. Plotted are the fold reductions of minimal inhibitory concentration (MIC) between treated and mock-treated cells. OXI = oxacillin; CEF = cefazolin; AMX = amoxicillin; AMX + CA = amoxicillin and clavulanic acid; VANC = vancomycin. Error bars represent the Standard Error of the Mean (SEM) of three independent replicates.

Figure 1—figure supplement 1
Phage sensitivity of MRSA strains.

Efficiencies of plaquing of phages on MRSA252, MW2, and LAC. Phages were 10-fold serially diluted and spotted onto top agar overlays of each strain.

Figure 1—figure supplement 2
Growth curves of MRSA strains under varying levels of ΦStaph1N infection.

MRSA252, MW2, and LAC cultures were infected with ΦStaph1N at the indicated multiplicity of infection (MOI). The optical density (OD600) of the cultures was monitored on an automated plate reader. Each condition was tested in three independent replicates and error bars represent the Standard Deviation (SD).

Figure 2 with 4 supplements
Evo2 is a variant of ΦStaph1N with higher activity against MRSA.

(A) Evo2 shows comparable infectivity towards MRSA252 but improved infectivity towards MW2 and LAC, relative to ΦStaph1N. The same plaquing data is also shown in Figure 2—figure supplement 1. (B) Similar to ΦStaph1N, Evo2 infection reduces β-lactam resistance in MRSA. (C) Evo2 infection reduces the MIC against oxacillin in clinical isolates of USA300 (ADLs). All error bars represent the Standard Error of the Mean (SEM) of three independent replicates.

Figure 2—figure supplement 1
Isolation and sequencing analysis of Evo2.

(A) Individual Evo2 plaques appeared in larger ΦStaph1N plaques on LAC. Individual plaques were isolated and propagated in liquid culture. Evo2 shows improved plaquing on MW2 and LAC. Plaquing data in the right panels are the same as in Figure 2A. (B) Evo2 is a mutant form of ΦStaph1N with a nonsense mutation in ORF141. The A to C mutation (marked by the arrow) in Evo2 converts Serine 77 of ORF141 into a stop codon.

Figure 2—figure supplement 2
Growth curves of MRSA strains under varying levels of Evo2 infection.

MRSA252, MW2, and LAC cultures were infected with Evo2 at the indicated multiplicity of infection (MOI). The optical density (OD600) of the cultures was monitored on an automated plate reader. Each condition was tested in three independent replicates and error bars represent the Standard Deviation (SD).

Figure 2—figure supplement 3
Phage ΦΝΜ1γ6 infection LAC does not drive the loss of β-lactam resistance.

(A) LAC treated with ΦΝΜ1γ6 evolves resistance against ΦΝΜ1γ6, evidenced by the reduction of plaquing from the parental to the evolved populations. (B) Evolved and parental LAC populations show comparable MICs against different β-lactams and vancomycin.

Figure 2—figure supplement 4
Phage SATA8505 infection drives loss of oxacillin resistance.

(A) MRSA strains MRSA252, MW2, and LAC treated with SATA8585 evolve resistance against SATA8585, evidenced by the reduction of plaquing from the parental to the evolved populations. (B) Evolved and parental MRSA show reduced MICs against oxacillin.

Figure 3 with 2 supplements
Phage infection of MRSA strains produces distinct mutational profiles.

(A) Coding sequences (CDS) with mutations from the three MRSA strains following phage treatment or mock treatment. For each strain, three isolates were sequenced and their mutations identified. Mutations are color-coded based on the number of occurrences among the three replicates. Information on all detected genetic variants is listed in Supplementary file 1. (B) Categories of genes with mutations that arose in each MRSA strain and treatment condition.

Figure 3—figure supplement 1
Types of polymorphisms in MRSA strains following infection by phage or a mock treatment.

Plotted are the polymorphisms that were found in a gene with an assigned COG category.

Figure 3—figure supplement 2
Plaquing efficiency of Evo2 and ΦStaph1N on MW2 and LAC strains with knockouts in mgrA, arl, and sarA.
Phage infection changes the transcriptomic profile of MRSA.

Differential expression analysis was performed on the transcriptomes of MW2 (top panel) and LAC (bottom panel). For both strains, Evo2-infected samples were compared to uninfected controls. Three biological replicates were analyzed for each condition. Horizontal dotted lines represent an adjusted p-value cut-off of 0.002, while vertical dotted lines represent a log2 fold change of –2 or 2 in expression. Transcripts with a log2 fold change between –2 or 2 and a pvalue >0.002 are labeled as grey dots (Not significant, NS); transcripts that pass either the fold change or p-value cutoff (but not the other) are represented as blue and green dots, respectively; transcripts that pass both cutoffs are shown as red dots. Genes discussed in the main text are labeled. Data for all the transcripts with significant fold changes is shown in Supplementary file 2.

Figure 5 with 1 supplement
Phage treatment of MRSA results in attenuated virulence phenotypes.

(A) MW2 and LAC strains display hemolytic activity on rabbit blood agar plates, while MRSA252 does not. (B) Phage-treated MW2 and LAC strains display reduced hemolysis compared to uninfected cells. (C) Surviving cultures of MW2 and LAC treated with either ΦStaph1N (blue) or Evo2 (red) show reduced clumping rates compared to mock untreated cells (teal). Each condition was tested in three independent replicates and error bars represent the Standard Deviation (SD).

Figure 5—figure supplement 1
Effect of phage infection on biofilm formation in MRSA strains.

Cultures were infected or mock-infected with either ΦStaph1N or Evo2. RP62a is a strain of S. epidermidis with known biofilm-forming capability, while LM1680 is a derivative of RP62a that has lost biofilm-forming ability (Christensen et al., 1982; Jiang et al., 2013). Biofilm biomass was assessed by staining with Crystal Violet. Solubilized crystal violet was quantified by measuring absorbance at 600 nm. Values represent averages and Standard Deviations (SD) of three replicates. Statistical significance was determined with a two-tailed t-test.

Co-treatment of MRSA with bacteriophage and β-lactam.

(A) Checkerboard assays of MRSA strains with gradients of oxacillin and Evo2 (top panels) or ΦStaph1N (bottom panels). The oxacillin gradient is a twofold serial dilution of drug concentration (µg/mL), while the phage MOI gradient is a 10-fold serial dilution of MOI. The rows and columns of each plate are labeled with letters and numbers, respectively. The black-white gradient in each well reflects the optical density of the culture and is the mean value from three biological replicates. MRSA strains co-treated with oxacillin and (B) Evo2 or (C) ΦStaph1N were tested for their phage resistance and oxacillin resistance. The letter/number combination reflects the well from which the cells were picked for analysis. Wells that could not produce a viable culture are labeled as NG (no growth). For wells that regrew, we calculated the efficiency of plaquing (EOP) of phage and measured the fold reduction in oxacillin MIC. Cultures that showed no detectable viral plaques are labeled as resistant (R).

Tables

Table 1
Minimum inhibitory concentrations (µg/mL) against oxacillin of MRSA strains treated with different MOIs of phage.
MRSA252
ΦStaph1NEvo2
MOIRep 1Rep 2Rep 3Rep 1Rep 2Rep 3
10–20.250.1250.38NG20.5
10–3NG0.940.1910.751
10–40.50.250.190.7510.5
10–50.250.38NG0.38NGNG
Mock>256>256>256>256>256>256
MW2
ΦStaph1NEvo2
MOIRep 1Rep 2Rep 3Rep 1Rep 2Rep 3
10–2324244NGNG
10–33224484NGNG
10–44896323NGNG
10–59664242NGNG
Mock964832964832
LAC
ΦStaph1NEvo2
MOIRep 1Rep 2Rep 3Rep 1Rep 2Rep 3
10–2NGNG20.064NGNG
10–3NG31.50.032NGNG
10–4321.51NGNGNG
10–532160.38NGNGNG
Mock324848324848
  1. NG: no growth detected.

Table 2
Minimal inhibitory concentrations (µg/mL) of mock- or Evo2-treated MRSA strains against different antibiotics.
MockEvo2
StrainAntibioticRep 1Rep 2Rep 3Rep 1Rep 2Rep 3
MRSA252Oxacillin>256>256>2560.380.750.5
Rifampicin0.0470.0320.0120.0230.0470.023
Mupirocin0.750.510.50.50.38
Erythromycin>256>256>256>256>256>256
Teicoplanin664440.75
Fosfomycin1288886
Daptomycin232222
MW2Oxacillin4832320.7510.75
Rifampicin0.0320.0470.0640.0230.0230.032
Mupirocin0.50.250.50.380.380.25
Erythromycin10.750.750.250.50.25
Teicoplanin21.51.51.511
Fosfomycin11.51.50.511
Daptomycin1.521.50.750.53
LACOxacillin4824640.190.0640.047
Rifampicin0.0470.0470.0470.0320.0320.047
Mupirocin0.50.750.750.50.50.5
Erythromycin3331.512
Teicoplanin10.510.50.50.75
Fosfomycin66121.5121
Daptomycin0.5310.06420.75
  1. Rep = biological replicate.

Table 3
Efficiencies of plaquing (EOPs)* of ΦStaph1N, Evo2, and ΦNM1γ6 on clinical isolates of USA300 (ADL1-30).
StrainΦStaph1NEvo2ΦNM1γ6
RN42201.0E+001.0E+001.0E+00
ADL11.7E-022.7E+006.7E-01
ADL22.0E-013.3E+001.0E+00
ADL36.0E-022.0E+001.7E-02
ADL41.3E-031.0E+001.7E-01
ADL51.2E-022.7E+001.0E+00
ADL61.5E-021.7E+001.0E+00
ADL76.0E-011.7E+006.7E-01
ADL89.0E-022.0E+003.3E-01
ADL96.0E-031.3E+002.0E-04
ADL105.0E-011.3E+001.0E-03
ADL111.0E+001.0E+003.3E-01
ADL129.0E-042.0E+006.7E-07
ADL137.0E-022.7E+002.3E-01
ADL142.7E-013.3E+001.0E-05
ADL159.0E-023.0E+002.0E-02
ADL162.4E-015.6E+007.8E-02
ADL173.3E+001.0E+012.4E+00
ADL186.7E+001.4E+011.6E-02
ADL197.1E-011.6E+002.3E+00
ADL206.2E+007.8E+012.4E+00
ADL215.2E+005.6E+003.3E-06
ADL229.5E-012.0E+005.2E-01
ADL231.5E+003.3E+011.2E-01
ADL247.1E-015.6E+003.3E-06
ADL257.1E-011.8E+002.3E-01
ADL262.4E-023.9E+002.2E-03
ADL271.3E+007.8E+001.7E+00
ADL281.9E+008.9E+008.9E-02
ADL291.9E+001.0E+011.3E-04
ADL306.7E-011.4E+001.7E-05
  1. *

    Phage EOPs on the clinical isolates are standardized to their respective EOP on the laboratory strain S. aureus RN4220.

Table 4
Mutated genes in MRSA following infection with phages ΦStaph1N or Evo2.
GeneDescriptionStrainPhage infection/treatmentReference
sarATranscriptional regulator of antibiotic resistance and virulenceMW2Evo2Li et al., 2016; Zielinska et al., 2012
mgrATranscriptional regulator of antibiotic resistance and virulenceMW2ΦStaph1N, Evo2Crosby et al., 2016; Kwiecinski et al., 2021
rpoBBeta subunit of RNA polymerase
Transcriptional regulator of antibiotic resistance
LACΦStaph1N, Evo2Panchal et al., 2020
arlRTranscriptional regulator of antibiotic resistance and virulenceLACΦStaph1N, Evo2Kwiecinski et al., 2021; Bai et al., 2019; Walker et al., 2013
spoVGTranscriptional regulator of antibiotic resistance and virulenceLACΦStaph1N, Evo2Schulthess et al., 2011; Liu et al., 2016
cysECysteine and methionine synthesis, serine O-acetyltransferaseMW2Evo2Chen et al., 2019
metKCysteine and methionine synthesis,
S-adenosylmethionine (SAM) synthetase
MW2ΦStaph1N, Evo2Markham et al., 1984
trpFPhenylalanine, tyrosine and tryptophan synthesis, phosphoribosylanthranilate isomeraseLACΦStaph1N, Evo2Proctor and Kloos, 1973
femAPeptidoglycan synthesis, pentaglycine synthesisMRSA252ΦStaph1N, Evo2Maidhof et al., 1991; Srisuknimit et al., 2017
murEPeptidoglycan synthesis, UDP-MurNAc tripeptide synthesisMW2ΦStaph1N, Evo2Gardete et al., 2004
trpSAminoacyl-tRNA synthesis, tryptophanyl-tRNA synthesisMW2ΦStaph1N, Evo2Xu et al., 1989
ytqAtRNA modifications, mnm5s2U synthesisMW2ΦStaph1N, Evo2Jaroch et al., 2024
yvcDUnknownMW2Evo2
natAABC transporterMW2ΦStaph1N, Evo2Kobayashi et al., 2001
tcaBPredicted multidrug efflux pumpMW2ΦStaph1N, Evo2Maki et al., 2004
fmhCFem-like factorsLACΦΝΜ1γ6Willing et al., 2020
rsaC ncRNAmodulates oxidative stress response and metal immunityMW2ΦStaph1N+oxacillinLalaouna et al., 2019
nrdFclass 1b ribonucleoside-diphosphate reductase subunit beta; beta subunit contains a metal-based cofactor; involved in DNA synthesisMW2ΦStaph1N+oxacillinMasalha et al., 2001
fstAT ncRNAUnknownMW2ΦStaph1N+oxacillin
rpoCDNA-directed RNA polymerase subunit beta'MW2ΦStaph1N+oxacillin
tRNATransfer RNAMW2ΦStaph1N+oxacillin
Key resources table
Reagent type (species) or resourceDesignationSource or referenceIdentifiersAdditional information
Strain, strain background (Staphylococcus aureus)MRSA MW2 (USA400)Baba et al., 2002MW2
Strain, strain background (Staphylococcus aureus)MRSA LAC (USA300)Voyich et al., 2005LAC
Strain, strain background (Staphylococcus aureus)MRSA252 (USA200)Holden et al., 2004MRSA252
Strain, strain background (Staphylococcus epidermidis)S. epidermidis RP62aChristensen et al., 1982RP62amethicillin-resistant biofilm-producing S. epidermidis
Strain, strain background (Staphylococcus epidermidis)S. epidermidis LM1680Jiang et al., 2013LM1680Derived from S. epidermidis RP62a; carries genomic deletion that inactivates biofilm production
OtherΦStaph1NŁobocka et al., 2012ΦStaph1NBacteriophage of the Kayvirus genus
OtherEvo2This studyEvo2Derived from ΦStaph1N
OtherΦNM1γ6Marraffini laboratoryΦNM1γ6Bacteriophage of the Dubowvirus genus, lytic version of temperate phage ΦNM1
OtherΦNM4γ4Marraffini laboratoryΦNM4γ4Bacteriophage of the Dubowvirus genus, lytic version of temperate phage ΦNM4
OtherΦ12Marraffini laboratoryΦ12Bacteriophage of the Triavirus genus
OtherAndhraHatoum-Aslan laboratoryAndhraBacteriophage of the Andravirus genus, infects S. epidermidis
OtherSATA8505Environmental isolate; Pincus et al., 2015SATA8505Bacteriophage of the Kayvirus genus, isolated from the environment in this study
Strain, strain background (Staphylococcus aureus)ADL1Levin laboratory; Land et al., 2015ADL1USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL2Levin laboratory; Land et al., 2015ADL2USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL3Levin laboratory; Land et al., 2015ADL3USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL4Levin laboratory; Land et al., 2015ADL4USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL5Levin laboratory; Land et al., 2015ADL5USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL6Levin laboratory; Land et al., 2015ADL6USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL7Levin laboratory; Land et al., 2015ADL7USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL8Levin laboratory; Land et al., 2015ADL8USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL9Levin laboratory; Land et al., 2015ADL9USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL10Levin laboratory; Land et al., 2015ADL10USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL11Levin laboratory; Land et al., 2015ADL11USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL12Levin laboratory; Land et al., 2015ADL12USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL13Levin laboratory; Land et al., 2015ADL13USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL14Levin laboratory; Land et al., 2015ADL14USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL15Levin laboratory; Land et al., 2015ADL15USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL16Land et al., 2015ADL16USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL17Levin laboratory; Land et al., 2015ADL17USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL18Levin laboratory; Land et al., 2015ADL18USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL19Levin laboratory; Land et al., 2015ADL19USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL20Levin laboratory; Land et al., 2015ADL20USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL21Levin laboratory; Land et al., 2015ADL21USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL22Levin laboratory; Land et al., 2015ADL22USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL23Levin laboratory; Land et al., 2015ADL23USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL24Levin laboratory; Land et al., 2015ADL24USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL25Levin laboratory; Land et al., 2015ADL25USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL26Levin laboratory; Land et al., 2015ADL26USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL27Levin laboratory; Land et al., 2015ADL27USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL28Levin laboratory; Land et al., 2015ADL28USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL29Levin laboratory; Land et al., 2015ADL29USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)ADL30Levin laboratory; Land et al., 2015ADL30USA300, Patient isolate
Strain, strain background (Staphylococcus aureus)AH1263Horswill laboratoryAH1263LAC, ErmS
Strain, strain background (Staphylococcus aureus)AH3455Horswill laboratoryAH3455LAC mgrA::tetM
Strain, strain background (Staphylococcus aureus)AH1975Horswill laboratoryAH1975LAC Δarl
Strain, strain background (Staphylococcus aureus)AH1525Horswill laboratoryAH1525LAC sarA::kan
Strain, strain background (Staphylococcus aureus)AH843Horswill laboratoryAH843MW2
Strain, strain background (Staphylococcus aureus)AH3456Horswill laboratoryAH3456MW2 mgrA::tetM
Strain, strain background (Staphylococcus aureus)AH3060Horswill laboratoryAH3060MW2 arl::tet
Strain, strain background (Staphylococcus aureus)AH5679Horswill laboratoryAH5679MW2 sarA::Tn(Erm)
Software, algorithmFiltlongWick, 2021v.0.2.1; RRID:SCR_024020
Software, algorithmMinimap2Li, 2018v.2.22; RRID:SCR_018550
Software, algorithmSAMtoolsLi et al., 2009v.13; RRID:SCR_002105
Software, algorithmBaktaSchwengers et al., 2021v.1.10.3; RRID:SCR_026400
Software, algorithmeggNOG-mapperCantalapiedra et al., 2021v.2.1.12; RRID:SCR_021165
Software, algorithmBowtie 2Langmead and Salzberg, 2012v2.5.4; RRID:SCR_016368
Software, algorithmfeatureCountsLiao et al., 2014v.2.0.8; RRID:SCR_012919
Software, algorithmR Project for Statistical Computinghttps://www.r-project.org/v.4.4.0; RRID:SCR_001905
Software, algorithmDESeq2Love et al., 2014v.1.44.0; RRID:SCR_015687
Software, algorithmtidyverseWickham et al., 2019v.2.0.0; RRID:SCR_019186
Software, algorithmEnhancedVolcanohttps://github.com/kevinblighe/EnhancedVolcanov.1.22.0; RRID:SCR_018931
Software, algorithmTrimmomaticBolger et al., 2014v.0.39; RRID:SCR_011848
Software, algorithmSPAdesBankevich et al., 2012v.4.0.0; RRID:SCR_000131
Software, algorithmblastnAltschul et al., 1997v2.16.0; RRID:SCR_001598
Software, algorithmcheckvNayfach et al., 2021v.1.0.3
Software, algorithmtaxmyphageMillard et al., 2025v.0.3.4
Software, algorithmFlyeKolmogorov et al., 2019v.2.9.3; RRID:SCR_017016
Software, algorithmProdigalHyatt et al., 2010v.2.6.3; RRID:SCR_011936

Additional files

Download links

A two-part list of links to download the article, or parts of the article, in various formats.

Downloads (link to download the article as PDF)

Open citations (links to open the citations from this article in various online reference manager services)

Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)

  1. My Tran
  2. Angel J Hernandez Viera
  3. Patricia Q Tran
  4. Erick D Nilsen
  5. Lily Tran
  6. Charlie Y Mo
(2025)
Bacteriophage infection drives loss of β-lactam resistance in methicillin-resistant Staphylococcus aureus
eLife 13:RP102743.
https://doi.org/10.7554/eLife.102743.3