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Molecular aspects on pathogenesis of wound and foreign body infections due to staphylococci
1Department of Medical Microbiology, Lund University Hospital, Sweden.
Abstract:
Rapid progress has been made in our understanding how various mucosal bacteria and virus pathogens bind to specific epithelial cell receptors and cause infections in respiratory gastrointestinal and the urogenital tracts, during the last decade. In the present review, I summarize our understanding how pathogens can colonize subepithelial tissues in open wounds and burns by binding to specific subepithelial matrix components such as collagen, laminin, fibronectin and to fibrin in blood clots and cause pyogenic infections. Serum and tissue fibronectin show a high affinity for various surfaces compared to other body fluid proteins. Based on the recent discovery of specific fibronectin binding surface proteins (FNBP) of S. aureus recently cloned and expressed in E. coli a new concept is presented how S. aureus, coagulase-negative staphylococci (CNS) and other wound pathogens bind to wound sutures, intravascular catheters and various prosthesis materials and initiate foreign body infections. Finally, new principles for treating wound infections with hydrophobized and fibronectin substituted wound dressings to decrease the critical bacterial numbers (approx. 10(5) per mg tissue (7] to spead up healing of infected wounds is presented.
Insights
Pathogens bind to wound components like collagen and fibrin, causing infections. New dressings using fibronectin may reduce bacterial load and speed healing of wound infections.
Area of Science:
- Microbiology
- Biomedical Engineering
Background:
- Pathogen adhesion to epithelial cells causes infections in various tracts.
- Pathogens also colonize subepithelial tissues in wounds by binding to matrix components like collagen and fibronectin.
Purpose of the Study:
- To review pathogen colonization of subepithelial tissues.
- To present a new concept for foreign body infections initiated by Staphylococcus aureus and other wound pathogens.
- To introduce novel wound dressing principles for treating infections.
Main Methods:
- Review of current understanding of pathogen-host interactions.
- Discussion of fibronectin binding surface proteins (FNBP) of S. aureus.
- Presentation of fibronectin-substituted wound dressings.
Main Results:
- Pathogens bind to subepithelial matrix components (collagen, laminin, fibronectin) and fibrin in blood clots, leading to pyogenic infections.
- Serum and tissue fibronectin exhibit high surface affinity.
- Specific fibronectin binding proteins (FNBP) on S. aureus facilitate binding to foreign materials, initiating infections.
Conclusions:
- Understanding pathogen binding to matrix components is crucial for treating wound infections.
- Fibronectin-based strategies, including novel wound dressings, offer a promising approach to reduce bacterial burden and promote healing.
- Targeting pathogen adhesion mechanisms can lead to improved therapeutic interventions for foreign body and wound infections.