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Staphylococcus epidermidis biofilms: importance and implications
James P O'Gara1, Hilary Humphreys1
1Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Education and Research Centre, Smurfit Building, Beaumont Hospital, Dublin 9, Ireland.
Abstract:
The coagulase-negative staphylococci and, in particular, Staphylococcus epidermidis, have emerged as major nosocomial pathogens associated with infections of implanted medical devices. These organisms, which are among the most prevalent bacteria of the human skin and mucous membrane microflora, present unique problems in the diagnosis and treatment of infections involving biofilm formation on implanted biomaterials. Epidemiological data that address whether invasive S. epidermidis strains can be traced to commensal organisms or an endemic occurrence of distinct strains with enhanced virulence have important implications for the implementation of appropriate infection control measures. An extracellular polysaccharide adhesin represents a key virulence determinant in S. epidermidis and is required for biofilm formation. Production of this adhesin, which is encoded by the ica operon, is subject to phase variable regulation (ON <---> OFF switching). Recent advances in understanding the molecular events controlling polysaccharide adhesin synthesis and the potential clinical implications of its phase variable regulation are outlined. Further research in this area may contribute to the development of novel strategies for therapeutic intervention. Finally, in addition to antibiotic prophylaxis, preventive strategies to control S. epidermidis medical device-related infections are focusing on the development of improved biomaterials and physical electrical barriers to impede bacterial colonisation.
Insights
Staphylococcus epidermidis causes device infections via biofilm formation. Understanding its virulence factors, like polysaccharide adhesin, and phase variable regulation is key to developing new treatments and preventing hospital-acquired infections.
Area of Science:
- Microbiology
- Infectious Diseases
- Biomaterials Science
Background:
- Coagulase-negative staphylococci, particularly Staphylococcus epidermidis, are significant nosocomial pathogens.
- These bacteria commonly colonize human skin and mucous membranes, complicating diagnosis and treatment of device-associated infections.
- Biofilm formation on implanted biomaterials is a critical challenge in managing these infections.
Purpose of the Study:
- To review advances in understanding Staphylococcus epidermidis biofilm formation.
- To explore the role of extracellular polysaccharide adhesin and its phase variable regulation in virulence.
- To discuss implications for infection control and therapeutic strategies.
Main Methods:
- Review of current literature on Staphylococcus epidermidis pathogenesis.
- Analysis of molecular mechanisms controlling polysaccharide adhesin synthesis via the ica operon.
- Examination of epidemiological data regarding strain virulence and origin.
Main Results:
- Extracellular polysaccharide adhesin is a key virulence factor required for biofilm formation in S. epidermidis.
- Production of this adhesin is regulated by a phase-variable ON/OFF switching mechanism.
- Understanding this regulation offers insights into bacterial adaptation and infection persistence.
Conclusions:
- Phase variable regulation of polysaccharide adhesin synthesis impacts S. epidermidis virulence and infection dynamics.
- Further research into these molecular events can inform novel therapeutic interventions.
- Preventive strategies include improved biomaterials and physical barriers alongside antibiotic prophylaxis.
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