Pathogenesis of infections due to coagulase-negative staphylococci. Lancet Infect Dis 2:675-85

Institute of Medical Microbiology, University of Münster Hospital and Clinics, Münster, Germany.
The Lancet Infectious Diseases (Impact Factor: 22.43). 12/2002; 2(11):677-85. DOI: 10.1016/S1473-3099(02)00438-3
Source: PubMed


As a group, the coagulase-negative staphylococci (CoNS) are among the most frequently isolated bacteria in the clinical microbiology laboratory and are becoming increasingly important, especially as causes of hospital-acquired infections. These bacteria are normal inhabitants of human skin and mucous membranes and, therefore, one of the major challenges of daily diagnostic work is to distinguish clinically significant CoNS from contaminant strains. This overview addresses current knowledge of the pathogenesis of infections due to CoNS and particularly focuses on virulence factors of the species Staphylococcus epidermidis. S epidermidis has been identified as a major cause of nosocomial infections, especially in patients with predisposing factors such as indwelling or implanted foreign polymer bodies. Most important in the pathogenesis of foreign-body-associated infections is the ability of these bacteria to colonise the polymer surface by the formation of a thick, multilayered biofilm. Biofilm formation takes place in two phases. The first phase involves the attachment of the bacteria to polymer surfaces that may be either unmodified or coated with host extracellular matrix proteins. In the second phase, the bacteria proliferate and accumulate into multilayered cell clusters that are embedded in an extracellular material. The bacterial factors involved in both phases of biofilm formation are discussed in this review. In addition, the most important aspects of the pathogenic potential of S saprophyticus, S lugdunensis, and S schleiferi are described, although, compared with S epidermidis, much less is known in these species concerning their virulence factors.

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    • "Joint prostheses and fixation implants usually fail due to staphylococci [21] and gram-negative bacilli infections [20]. Staphylococci, particularly Staphylococcus aureus and coagulase-negative staphylococci (CNS), such as S. epidermidis species, are the most common causative agents, in case of medical device-associated infections [22]. Another example, commonly causing infections due to its ability for fast colonization and slime formation, is the gram-negative bacilli Pseudomonas aeruginosa. "
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    ABSTRACT: Parylene C surface was modified by the use of oxygen plasma treatment and characterized by microscopic and surface-sensitive techniques (E-SEM, AFM, XPS, LDI-TOF-MS, contact angle). The influence of the treatment on surface properties was investigated by calculations of surface free energy (Owens-Wendt method). Moreover, early adhesion (Culture Plate Method, Optical Microscopy Test) and biofilm formation ability (Cristal Violet Assay) on the parylene C surface was investigated. The bacteria strains which are common causative agents of medical device-associated infections (Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa - reference strains and clinical isolates) were used. It was concluded that chemical (oxygen insertion) and physical (nanotopography generation) changes, have a significant impact on the biocompatibility in terms of increased hydrophilicity (θw of unmodified sample=88°±2°, θw of 60min modified sample=17.6°±0.8°) and surface free energy (SFE of unmodified sample=42.4mJ/m(2), and for 60min modified sample=70.1mJ/m(2)). At the same time, no statistical effect on biofilm production and bacteria attachment to the modified surface of any of the tested strains was observed. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Jul 2015 · Materials Science and Engineering C
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    • "Staphylococcus epidermidis which is known as a coagulase-negative and Gram-positive Staphylococcus, is one of the five significant microorganisms that are located on human skin and mucosal surfaces with the ability of causing nosocomial infections due to the wide usage of medical implants and devices, hence until 1980 S. epidermidis was considered as an opportunistic microorganism, while in accordance to various infections increasement such as cardiovascular, CNS shunts, joints, blood stream infections, etc. The mentioned bacteria is regarded as one of the main cause of nosocomial infections [7]. Later researches show that the activity of Staphylococcus epidermidis lipase enzyme can produce various types of esters such as geranyl, unsaturated and medium-chain esters without organic solvents; therefore this ability can be considered as an advantage in the biotechnology field of studies [8]. "
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    ABSTRACT: Staphylococci are known as clustering Gram-positive cocci, nonmotile, non-spore forming facultatively anaerobic that classified in two main groups, coagulase-positive and coagulase-negative. Staphylococcus epidermidis with the highest percentage has the prominent role among coagulase-negative Staphylococci that is the most important reason of clinical infections. Due to various virulence factors and unique features, this microorganism is respected as a common cause of nosocomial infections. Because of potential ability in biofilm formation and colonization in different surfaces, also using of medical implant devices in immunocompromised and hospitalized patients the related infections have been increased. In recent decades the clinical importance and the emergence of methicillin-resistant Staphylococcus epidermidis strains have created many challenges in the treatment process.
    Full-text · Article · Sep 2014
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    • "They have been isolated from different body sites including the mucous membranes such as the nose, throat, vaginal wall and the gastrointestinal tract [1-3]. CoNS colonising several niche in the human body are recognised as established pathogens playing great roles in different human infections [4,5]. However, the pathogenic roles of CoNS colonising the gastrointestinal tract is not very well established. "
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    ABSTRACT: Background Staphylococcus epidermidis is the most frequently isolated species of the coagulase negative staphylococci from human stool. However, it is not clear how its presence in the gut affects the cellular structures and functions of this organ. In this study therefore, the pathogenicity of strains of S. epidermidis which were isolated from the stool samples of apparently healthy children was investigated in mice and rats. Methods The albino mice (22—30 g) and albino rats (100-155 g) of both sexes were infected orally and intraperitoneally with graded doses of the bacteria and subjected to behavioral and histopathological examinations. Results Acute infection in these animals caused temporary behavioural changes as shown by restlessness and abdominal stretchings but did not result in death even at a dosage of 2 × 109 cfu/kg. Daily administration of the same dose for 14 days resulted in the death of 11 out of 21 (52.4%) mice. Histopathological examination of the affected organs showed congestions, aggregations and multinucleated hepatocytes in the liver, infiltration of the kidney tubule interstitial by chronic inflammatory cells, coagulative necrosis of the kidney, spleen, intestine and stomach cells as well as marked stroma fibrosis of the spleen. Coagulative necrosis of cells was the most frequently occurring pathological alteration. Lethality and pathological effects reflected the virulence factors expressed by the organism which are biofilm formation, haemagglutination properties and capsule production. Conclusions The results indicate that strains of S. epidermidis colonising the gut can cause serious pathological changes on certain organs such as kidney, liver, intestine, stomach and spleen which, depending on their severity, could be fatal.
    Full-text · Article · Jul 2014 · BMC Gastroenterology
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