Staphylococcus epidermidis in Biomaterial-Associated Infections

Mack, Dietrich; Davies, Angharad; Harris, Llinos G.; Jeeves, Rose E.; Pascoe, Ben; Knobloch, J; Rohde, Holger; Wilkinson, Thomas S.

doi:10.1007/978-1-4614-1031-7_2

Cited by 41 publications

(51 citation statements)

References 208 publications

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“…epidermidis is the most frequent cause of device-related infections (6). One of the important regulators that control the production of S. epidermidis virulence factors is the agr quorum-sensing system.…”

Section: Discussionmentioning

confidence: 99%

“…Over 150 million intravascular devices are used each year in the United States alone (4), and a major risk factor for CoNS disease is the presence of a medical implant (5). For many of these infections, S. epidermidis makes up more than 80% of the clinical burden of CoNS (3,6).…”

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confidence: 99%

“…The ability of S. epidermidis to colonize implanted devices and form a biofilm is its primary mechanism of pathogenesis (1,6). The polysaccharide intercellular adhesin (PIA) produced by proteins encoded in the icaADBC locus is one of the best-characterized biofilm determinants (7).…”

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confidence: 99%

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Staphylococcus epidermidis agr Quorum-Sensing System: Signal Identification, Cross Talk, and Importance in Colonization

et al. 2014

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e Staphylococcus epidermidis is an opportunistic pathogen that is one of the leading causes of medical device infections. Global regulators like the agr quorum-sensing system in this pathogen have received a limited amount of attention, leaving important questions unanswered. There are three agr types in S. epidermidis strains, but only one of the autoinducing peptide (AIP) signals has been identified (AIP-I), and cross talk between agr systems has not been tested. We structurally characterized all three AIP types using mass spectrometry and discovered that the AIP-II and AIP-III signals are 12 residues in length, making them the largest staphylococcal AIPs identified to date. S. epidermidis agr reporter strains were developed for each system, and we determined that cross-inhibitory interactions occur between the agr type I and II systems and between the agr type I and III systems. In contrast, no cross talk was observed between the type II and III systems. To further understand the outputs of the S. epidermidis agr system, an RNAIII mutant was constructed, and microarray studies revealed that exoenzymes (Ecp protease and Geh lipase) and low-molecular-weight toxins were downregulated in the mutant. Follow-up analysis of Ecp confirmed the RNAIII is required to induce protease activity and that agr cross talk modulates Ecp activity in a manner that mirrors the agr reporter results. Finally, we demonstrated that the agr system enhances skin colonization by S. epidermidis using a porcine model. This work expands our knowledge of S. epidermidis agr system function and will aid future studies on cell-cell communication in this important opportunistic pathogen.

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Staphylococcus epidermidis agr Quorum-Sensing System: Signal Identification, Cross Talk, and Importance in Colonization

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“…Staphylococci, above all Staphylococcus aureus and Staphylococcus epidermidis, are the most frequent causes of biofilm-associated infections on indwelling medical devices, with S. epidermidis representing up to 75% of all clinical isolates in some cases [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Synergy between antibiotics and natural agents results in increased antimicrobial activity against Staphylococcus epidermidis

Abidi

Kettab

Sherwani

et al. 2015

J Infect Dev Ctries

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Introduction: Staphylococcus epidermidis is one of the most frequent causes of biofilm-associated infections on indwelling medical devices. With the emergence of methicillin-resistant S. epidermidis (MRSE), there is an urgent need to discover novel active agents against a range of Gram-positive pathogens. We screened the clinical isolates of S. epidermidis for susceptibility/resistance against commonly prescribed antibiotics. Furthermore, we tested some natural agents alone and in combination with antibiotics to find possible synergistic antimicrobial effects. Methodology: S. epidermidis clinical isolates were screened for susceptibility/resistance against vancomycin, erythromycin, tetracycline, chloramphenicol, ampicillin, ofloxacin, cephalexin, and gentamicin using the Kirby-Bauer disk diffusion method. The antimicrobial potential of Camellia sinensis, Juglans regia, and Hippophae rhamnoides alone and in combination with antibiotics were examined using the disk diffusion method, where the antimicrobial potential activity was measured in terms of formation of zones of inhibition. Results: Most S. epidermidis isolates were found to be resistant to one or more antibiotics. Gentamycin and ofloxacin were found to be the most effective antibiotics against S. epidermidis isolates. Extracts of Hippophae rhamnoides, Juglans regia, and Camellia sinensis were found to be equally effective against S. epidermidis isolates. In combination with antibiotics, these extracts exhibited appreciable synergistic activity; the highest synergistic activity was observed with erythromycin and cephalexin. In the case of cephalexin, a reversion in resistance was observed. Conclusions: The plant extracts used in the study exhibited additive and synergistic antibacterial activity against S. epidermidis, hence providing an effective alternative to deal with the problem of multidrug resistance.

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“…PIA is a predominant S. epidermidis intercellular adhesin that mediates biofilm accumulation, but it is not produced in all S. epidermidis strains (19). Instead, Aap is present in about 90% of clinical S. epidermidis isolates (14) and in 94.8% of commensal isolates from health care personnel (20), indicating that Aap may serve as an ideal vaccine target for pre-venting S. epidermidis biofilm infection.…”

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A Single B-Repeat of Staphylococcus epidermidis Accumulation-Associated Protein Induces Protective Immune Responses in an Experimental Biomaterial-Associated Infection Mouse Model

Lin

Zhang

et al. 2014

Clin. Vaccine Immunol.

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Nosocomial infections are the fourth leading cause of morbidity and mortality in the United States, resulting in 2 million infections and ϳ100,000 deaths each year. More than 60% of these infections are associated with some type of biomedical device. Staphylococcus epidermidis is a commensal bacterium of the human skin and is the most common nosocomial pathogen infecting implanted medical devices, especially those in the cardiovasculature. S. epidermidis antibiotic resistance and biofilm formation on inert surfaces make these infections hard to treat. Accumulation-associated protein (Aap), a cell wall-anchored protein of S. epidermidis, is considered one of the most important proteins involved in the formation of S. epidermidis biofilm. A small recombinant protein vaccine comprising a single B-repeat domain (Brpt1.0) of S. epidermidis RP62A Aap was developed, and the vaccine's efficacy was evaluated in vitro with a biofilm inhibition assay and in vivo in a murine model of biomaterial-associated infection. A high IgG antibody response against S. epidermidis RP62A was detected in the sera of the mice after two subcutaneous immunizations with Brpt1.0 coadministered with Freund's adjuvant. Sera from Brpt1.0-immunized mice inhibited in vitro S. epidermidis RP62A biofilm formation in a dose-dependent pattern. After receiving two immunizations, each mouse was surgically implanted with a porous scaffold disk containing 5 ؋ 10 6 CFU of S. epidermidis RP62A. Weight changes, inflammatory markers, and histological assay results after challenge with S. epidermidis indicated that the mice immunized with Brpt1.0 exhibited significantly higher resistance to S. epidermidis RP62A implant infection than the control mice. Day 8 postchallenge, there was a significantly lower number of bacteria in scaffold sections and surrounding tissues and a lower residual inflammatory response to the infected scaffold disks for the Brpt1.0-immunized mice than for of the ovalbumin (Ova)-immunized mice. N osocomial infections, also known as hospital-acquired infections, are the fourth leading cause of morbidity and mortality in the United States, resulting in 2 million infections and ϳ100,000 deaths each year, with a total medical cost of more than $30 billion (1, 2). More than 60% of these infections are associated with some type of biomedical device. Staphylococcus epidermidis represents one of the most prevalent causes of device-related nosocomial infection (3-5); treatment of S. epidermidis infections is complicated because of an increase in the number of multidrugresistant strains and the ability of S. epidermidis to form biofilms (6, 7). Given that traditional drug release from a medical implant can provide only short-term protection, a lifelong immune response induced by vaccination may be a promising new prevention strategy for controlling S. epidermidis device-related infections (8-10).Accumulation-associated protein (Aap), a cell wall-anchored protein of S. epidermidis, is considered one of the most important proteins involved in the form...

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Staphylococcus epidermidis in Biomaterial-Associated Infections

Cited by 41 publications

References 208 publications

Staphylococcus epidermidis agr Quorum-Sensing System: Signal Identification, Cross Talk, and Importance in Colonization

Staphylococcus epidermidis agr Quorum-Sensing System: Signal Identification, Cross Talk, and Importance in Colonization

Synergy between antibiotics and natural agents results in increased antimicrobial activity against Staphylococcus epidermidis

A Single B-Repeat of Staphylococcus epidermidis Accumulation-Associated Protein Induces Protective Immune Responses in an Experimental Biomaterial-Associated Infection Mouse Model

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