Research Article Prophages in Enterococcal Isolates from Renal Transplant Recipients: Renal Failure Etiologies Promote Selection of Strains Agnieszka Daca, 1 Tomasz Jarzembowski, 2 Jacek M. Witkowski, 3 Ewa Bryl, 1 BolesBaw Rutkowski, 4 and Alicja Dwbska-UlizieN 4 1 Department of Pathology and Experimental Rheumatology, Medical University of Gda´ nsk, Dębinki 7 Street, 80-211 Gda´ nsk, Poland 2 Department of Microbiology, Medical University of Gda´ nsk, Do Studzienki 38 Street, 80-227 Gda´ nsk, Poland 3 Department of Pathophysiology, Medical University of Gda´ nsk, Dębinki 7 Street, 80-211 Gda´ nsk, Poland 4 Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gda´ nsk, Dębinki 7 Street, 80-952 Gda´ nsk, Poland Correspondence should be addressed to Tomasz Jarzembowski; tjarzembowski@gumed.edu.pl Received 24 February 2014; Revised 11 June 2014; Accepted 16 June 2014; Published 3 July 2014 Academic Editor: Carla R. Arciola Copyright © 2014 Agnieszka Daca et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Infections caused by commensal bacteria may be fatal for the patients under immunosuppressive therapy. his results also from diiculty in identiication of high risk strains. Enterococcal infections are increasingly frequent but despite many studies on virulence traits, the diference between commensal and pathogenic strains remains unclear. Prophages are newly described as important elements in competition between strains during colonization, as well as pathogenicity of the strains. Here we evaluate a diference in presence of pp4, pp1, and pp7 prophages and ASA (aggregation substance) gene expression in enterococcal isolates from renal transplant recipients (RTx) with diferent etiology of the end-stage renal failure. Prophages sequence was screened by PCR in strains of Enterococcus faecalis isolated from urine and feces of 19 RTx hospitalized at Medical University of Gdansk and 18 healthy volunteers. FLOW-FISH method with use of linear locked nucleic acid (LNA) probe was used to assess the ASA gene expression. Additionally, ability of bioilm formation was screened by crystal violet staining method. Presence of prophages was more frequent in fecal isolates from immunocompromised patients than in isolates from healthy volunteers. Additionally, both composition of prophages and ASA gene expression were related to the etiology of renal disease. 1. Introduction For many years Enterococcus species were believed to be harmless to humans and considered medically unimportant. Recently, enterococci have become one of the most common nosocomial pathogens, causing mortality rate up to 61% [1]. In the last decade enterococci have been reported as the second most common cause of wound and urinary tract infection and the third most common cause of bacteremia. Enterococcus faecalis, oten regarded as a normal commensal of intestinal tract [2], is increasingly considered as a cause of nosocomial infections in patients undergoing immunosup- pressive therapy due to, for example, organ transplantation [3, 4]. his is attributed, for example, both to the acquisition of multidrug resistance and to virulence factors [5]. Renal transplant recipients (RTx) oten sufer from various uro- logical malformations, which additionally increase the risk of even life-threatening infections caused by, for example, enterococcal strains. Colonization of urinary tract by enterococci is epidemi- ologically associated with ASA (aggregation substance). he ASA encoded protein increases enterococcal adherence [6–8] and protects from killing by polymorphonuclear leukocytes [9, 10]. Although its urovirulent action has not been con- irmed, ASA protein participates by adherence in irst step of bioilm formation. Apart from the previously described virulence determinants, it has been recently discovered that enterococci may possess bacteriophages integrated as lyso- genic prophages. Prophages, thanks to the active mechanism of integration to bacterial chromosome and excision, are able Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 514689, 6 pages http://dx.doi.org/10.1155/2014/514689