Difficult-to-Treat Pathogens: A Review on the Management of Multidrug-Resistant Staphylococcus epidermidis
Valentina Siciliano,
Rosa Anna Passerotto,
Marta Chiuchiarelli
et al.
Abstract:Multidrug-resistant Staphylococcus epidermidis (MDRSE) is responsible for difficult-to-treat infections in humans and hospital-acquired-infections. This review discusses the epidemiology, microbiology, diagnosis, and treatment of MDRSE infection and identifies knowledge gaps. By using the search term “pan resistant Staphylococcus epidermidis” OR “multi-drug resistant Staphylococcus epidermidis” OR “multidrug-resistant lineages of Staphylococcus epidermidis”, a total of 64 records have been identified from vari… Show more
“…Hospital-acquired infections (HAI) are considered a major issue globally, with various types of bacteria exerting the highest impact on the occurrence of these infections. Different Staphylococcus spp., which form a part of human natural skin microbiota, have been very often isolated from diverse clinical sources and form a clinically significant group of bacteria causing nosocomial infections [ [ [1] , [2] , [3] , [4] ]]. Among all the staphylococci (staph) group, Staphylococcus aureus is the most renowned pathogen, contributing to dangerous human and animal infections, including bloodstream infections and foodborne intoxications (FI).…”
“…Hospital-acquired infections (HAI) are considered a major issue globally, with various types of bacteria exerting the highest impact on the occurrence of these infections. Different Staphylococcus spp., which form a part of human natural skin microbiota, have been very often isolated from diverse clinical sources and form a clinically significant group of bacteria causing nosocomial infections [ [ [1] , [2] , [3] , [4] ]]. Among all the staphylococci (staph) group, Staphylococcus aureus is the most renowned pathogen, contributing to dangerous human and animal infections, including bloodstream infections and foodborne intoxications (FI).…”
“…In addition, Borrelia can alter their surface proteins, facilitating immune evasion [3]. The ability to persist in diverse host tissues, including joints, skin, and the central nervous system, underlines their adaptability and pathogenic potential [4].…”
The genus Borrelia encompasses a diverse group of spirochetes transmitted primarily by ticks, with Borrelia burgdorferi causing Lyme disease, which is prevalent in North America and Europe. Borrelia’s structural adaptations and ability to persist in diverse host tissues underscore its pathogenic potential. Beyond traditional infectious responses, Borrelia engages in complex interactions with the host immune system, contributing to autoimmune mechanisms such as molecular mimicry and persistent infections. This intricate interplay manifests in symptoms resembling various autoimmune diseases, including systemic lupus erythematosus, dermatomyositis, local scleroderma, and systemic sclerosis. However, these associations lack a precise explanation, emphasizing the need for further investigation. The cases of misdiagnosis between Lyme borreliosis and autoimmune diseases highlight the critical importance of accurate diagnostics and adherence to guidelines. Understanding Borrelia’s impact on immune responses is pivotal for advancing diagnostics and targeted therapeutic interventions in Lyme borreliosis and its potential autoimmune implications.
“…S. epidermidis has the ability to form a biofilm that impedes phagocytosis by immune cells and the effect of antimicrobial peptides, hence weakening the efficiency of antibiotic therapy [ 4 ]. In addition, device-associated infections cause enormous medical and economic burdens on healthcare systems worldwide [ 5 ].…”
Staphylococcus epidermidis (S. epidermidis) is part of the human skin flora but can also cause nosocomial infections, such as device-associated infections, especially in vulnerable patient groups. Here, we investigated clinical isolates of linezolid-resistant S. epidermidis (LRSE) collected from blood cultures at the University Hospital Münster (UHM) during the period 2020–2022. All detected isolates were subjected to whole genome sequencing (WGS) and the relatedness of the isolates was determined using core genome multilocus sequence typing (cgMLST). The 15 LRSE isolates detected were classified as multilocus sequence type (ST) 2 carrying the staphylococcal cassette chromosome mec (SCCmec) type III. All isolates showed high-level resistance for linezolid by gradient tests. However, no isolate carried the cfr gene that is often associated with linezolid resistance. Analysis of cgMLST data sets revealed a cluster of six closely related LRSE isolates, suggesting a transmission event on a hematological/oncological ward at our hospital. Among the included patients, the majority of patients affected by LRSE infections had underlying hematological malignancies. This confirms previous observations that this patient group is particularly vulnerable to LRSE infection. Our data emphasize that the surveillance of LRSE in the hospital setting is a necessary step to prevent the spread of multidrug-resistant S. epidermidis among vulnerable patient groups, such as patients with hematological malignancies, immunosuppression or patients in intensive care units.
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