Commentary: Significance of Staphylococcus epidermidis in Health Care-Associated Infections, from Contaminant to Clinically Relevant Pathogen: This Is a Wake-Up Call!

Widerström, Micael

doi:10.1128/jcm.00743-16

Cited by 62 publications

(46 citation statements)

References 31 publications

(33 reference statements)

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“…Although commensal S. epidermidis isolates display high rates of resistance to antibiotics of clinical relevance (Morgenstern et al, 2016a ), their default status as commensal bacteria renders this phenomenon largely irrelevant for the healthy human host. However, with the advent of implanted medical devices such as prosthetic joints and fracture fixation devices, S. epidermidis has emerged as an important opportunistic pathogen (Otto, 2009 ; Widerstrom, 2016 ). In fact, the implanted medical device may actually facilitate infection since any S. epidermidis inadvertently introduced into the surgical site are capable of rapidly adhering to, and accumulating upon, the surface of the device.…”

Section: Introductionmentioning

confidence: 99%

Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection

et al. 2017

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Staphylococcus epidermidis is a permanent member of the normal human microbiota, commonly found on skin and mucous membranes. By adhering to tissue surface moieties of the host via specific adhesins, S. epidermidis is capable of establishing a lifelong commensal relationship with humans that begins early in life. In its role as a commensal organism, S. epidermidis is thought to provide benefits to human host, including out-competing more virulent pathogens. However, largely due to its capacity to form biofilm on implanted foreign bodies, S. epidermidis has emerged as an important opportunistic pathogen in patients receiving medical devices. S. epidermidis causes approximately 20% of all orthopedic device-related infections (ODRIs), increasing up to 50% in late-developing infections. Despite this prevalence, it remains underrepresented in the scientific literature, in particular lagging behind the study of the S. aureus. This review aims to provide an overview of the interactions of S. epidermidis with the human host, both as a commensal and as a pathogen. The mechanisms retained by S. epidermidis that enable colonization of human skin as well as invasive infection, will be described, with a particular focus upon biofilm formation. The host immune responses to these infections are also described, including how S. epidermidis seems to trigger low levels of pro-inflammatory cytokines and high levels of interleukin-10, which may contribute to the sub-acute and persistent nature often associated with these infections. The adaptive immune response to S. epidermidis remains poorly described, and represents an area which may provide significant new discoveries in the coming years.

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Section: Introductionmentioning

confidence: 99%

Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection

et al. 2017

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“…Coagulase-negative staphylococcus (CoNS) is a part of the commensal bacterial microflora of healthy people. However, with the development of interventional therapy and the increasing number of immunocompromised patients, these bacteria are becoming the most important causes of nosocomial infections [ 1 , 2 ]. CoNS bloodstream infections have been estimated in as many as 250,000 cases annually in the US.…”

Section: Introductionmentioning

confidence: 99%

Extreme diversity and multiple SCCmec elements in coagulase-negative Staphylococcus found in the Clinic and Community in Beijing, China

Chen

Zheng

et al. 2017

Ann Clin Microbiol Antimicrob

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BackgroundCoagulase-negative staphylococci (CoNS) are recognized as a large reservoir of staphylococcal cassette chromosome mec (SCCmec) harboured by Staphylococcus aureus. However, data of SCCmec in CoNS are relatively absent particularly in China.MethodsSeventy-eight CoNS clinical and 47 community isolates were collected in Beijing. PCR was performed to classify SCCmec types. Under oxacillin treatment, quantitative real-time reverse transcription PCR (qRT-PCR) was performed to compare mecA mRNA levels and mRNA half-life between isolates with single SCCmec element and those with multiple one. Their growth curves were analysed. Their bacterial cell wall integrity was also compared by performing a Gram stain. All ccr complex segments were sequenced and obtained ccr segments were analysed by phylogenetic analyses.ResultsAll 78 clinical isolates had mecA segments compared with 38% in community isolates (total 47). Only 29% clinical isolates and 33% community isolates (among mecA positive isolates) harboured a single previously identified SCCmec type; notably, 17% clinical isolates and 28% community isolates had multiple SCCmec types. Further studies indicated that isolates with multiple SCCmec elements had more stable mecA mRNA expression compared with isolates with single SCCmec elements. CoNS with multiple SCCmec elements demonstrated superior cell wall integrity. Interestingly, phylogenetic analyses of obtained 70 ccr segments indicated that horizontal gene transfer of the ccr complex might exist among various species of clinical CoNS, community CoNS and S. aureus.ConclusionsCoNS recovered from patients carried extremely diverse but distinctive SCCmec elements compared with isolates from the community. More attention should be given to CoNS with multiple SCCmec not only because they had superior cell wall integrity, but also because CoNS and S. aureus might acquire multiple SCCmec through the ccr complex.Electronic supplementary materialThe online version of this article (doi:10.1186/s12941-017-0231-z) contains supplementary material, which is available to authorized users.

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“…Hereby, we found that biofilm formation was frequent among our strains isolated from catheters and blood cultures. This observation is well associated with advantages provided by biofilm as a life mode to conquer hospital environment (25). Furthermore, important observation to note is that a considerable number of catheter isolates were unable to form biofilm.…”

Section: Discussionmentioning

confidence: 93%

Overview of Genetic Background Beyond Polysaccharide Intercellular Adhesion Production in Staphylococcus epidermidis

Mekni¹,

Achour²,

Hassen³

2016

Jundishapur J Microbiol

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Background: An important observation during quantification experiments of Staphylococcus epidermidis biofilm is that there is a great difference in the biofilm biomass of different strains despite the same experimental conditions. Objectives: This study aimed to study the genotypic background beyond differential rates of Polysaccharide Intercellular Adhesion (PIA) production in S. epidermidis biofilm forming strains. Methods: A number of 126 strains were isolated from blood cultures (n = 40), catheter cultures (n = 50), and other specimens (n = 36). The strains were obtained from patients hospitalized at the bone marrow transplant center of Tunis. Biofilm micro-plate assay, hemagglutination, and susceptibility to proteinase K methods were used to assess biofilm characteristics in the studied strains. Conventional and real time PCR were used to assess genotypic background of biofilm formation. Results: Using PCR method, we demonstrated that there is a significant difference in ica genes (P < 0.01) and not in adhesion rsb and sar genes distribution between biofilm forming and non-biofilm forming strains. Almost all strains harbored agr type I. None of studied strains harbored IS256 inside ica operon. Ica-independent biofilm formation was detected in 11 strains that were confirmed to have proteinaceous matrix. Using Kernel density estimation, we established that biofilm biomass was higher in ica-dependent than ica-independent biofilm forming population. Using qRT-PCR, we found a significant correlation between biofilm biomass and RNAIII expression level (r 2 = 0.95); but no correlation was found for biofilm biomass neither with icaA nor with ccpA genes.

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Commentary: Significance of Staphylococcus epidermidis in Health Care-Associated Infections, from Contaminant to Clinically Relevant Pathogen: This Is a Wake-Up Call!

Abstract: ) describes a rapid single nucleotide polymorphism-based assay for distinguishing between S. epidermidis isolates from hospital and nonhospital sources, which represents an important contribution to the characterization and understanding of S. epidermidis health careassociated infections.

Cited by 62 publications

References 31 publications

Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection

Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection

Extreme diversity and multiple SCCmec elements in coagulase-negative Staphylococcus found in the Clinic and Community in Beijing, China

Overview of Genetic Background Beyond Polysaccharide Intercellular Adhesion Production in Staphylococcus epidermidis

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