Abstract
BackgroundStaphylococcus epidermidis is a common pathogen in medical device-associated infections and have an ability to form adherent slime. We aimed to study the effects of icaA and icaD genes on the slime formation of Staphylococcus epidermidis associated with catheter-associated infections.MethodsS. epidermidis isolates from the central venous catheter blood of patients with catheter-associated infections, and from the nasal vestibules of healthy volunteers, intensive care unit hospital staff, and patients, were collected. Slime phenotype was determined by Congo red agar test. The icaA/D was detected by polymerase chain reaction. Slime was examined using scanning electron microscopy.ResultsA total of 82 S. epidermidis isolates were collected. We found a statistically significant difference with regards to slime production between the clinical isolates from the catheter blood specimens and those from the nasal vestibules (p<0.05). All S. epidermidis slime positive strains isolated were icaA positive. There was a greater correlation between the presence of both icaA and icaD and the slime production than the single expression of icaA or icaD and the presence of slime in all groups. The co-expression of mecA and icaD was associated with enhanced resistance to antibiotics.ConclusionS. epidermidis bacteria are significant nosocomial pathogens, and icaA/D can clarify the adhesion mechanism in the pathogenesis of infections associated with medical devices. This study result could be useful for the development of rapid diagnosis for slime producing and methicillin resistant S. epidermidis strains.
Highlights
Staphylococcus epidermidis is a common pathogen in medical device-associated infections and have an ability to form adherent slime
Twenty-two S. epidermidis studied were isolated from patients blood taken from intravascular catheters; another 60 strains of S. epidermidis isolated from the nasal vestibules of healthy non-medical volunteers, patients, and intensive care unites (ICU) hospital staff were investigated
Slime by S. epidermidis isolates Slime-forming ability of S. epidermidis can be inferred by phenotypic effects when grown on Congo red agar
Summary
Staphylococcus epidermidis is a common pathogen in medical device-associated infections and have an ability to form adherent slime. Coagulase-negative staphylococci (CNS) are the most frequent cause of nosocomial blood stream infections [1], in particular, Staphylococcus epidermidis, which has emerged as a major pathogen [2]. S. epidermidis is isolated with increasing frequency as the causative pathogen of nosocomial sepsis, and accounts for approximately 30% of all nosocomial blood stream infections [4]. These infections are often indolent and unresponsive to antimicrobials [5], and. Coagulase-negative staphylococci, S epidermidis, are the important cause of infections associated with foreign materials. A study has been conducted to investigate the ica gene as a marker of the S. epidermidis adhesive aptitude [11]
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