Chapter 4 : Colonization of Medical Devices by Coagulase-Negative Staphylococci

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In 1981, intravenous catheters infected with staphylococci by perfusion were investigated by scanning electron microscopy (SEM) to demonstrate the mode of adhesion. Bacterial cells, primarily those of staphylococci, followed by and , were shown to be attached to the inner surface of the catheter. The thickest bacterial layers were found in catheters infected by coagulase-negative staphylococci (CoNS). Right heart flow-directed catheters removed from 18 critically ill patients after an average of 2.6 days after insertion were covered by a bacterial biofilm. In a neonatal intensive care unit, CoNS caused the majority of the nosocomial bacteremias. A study of arterial and central venous catheters removed from patients after 1 to 14 days revealed an extensive biofilm on all 42 arterial and 26 central venous catheters. By using special biofilm culture recovery methods, it was shown that 81% of the catheters were colonized by bacteria growing in slime-enclosed biofilms. It was speculated that the colonization represents a nidus for infection and bacteremia in these patients. Staphylococci also produced biofilm on polyvinyl chloride (PVC) endotracheal tubes used in neonates. Adherence of staphylococci to various intravascular catheter materials was investigated; these materials were composed of silicone elastomer, thermoplastic polyurethane, and polyurethane coated with Hydromer, a coating that absorbs water and provides a hydrophilic sheath around the catheter. Production of slime is necessary for colonization and is also observed with many other pathogens, including .

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4

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Figure 1

Scanning electron micrograph (magnification, × 5,000) of KH11. Massive colonization and slime production on cellulose acetate after 24 h of cultivation are shown.

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4
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Image of Figure 2
Figure 2

Genetic organization of the operon involved in PIA biosynthesis. The genes are cotranscribed. The upstream located gene encodes a regulator protein. M, membrane localized; Sec, secreted; Hairpin, transcription terminator; Pr and Pi, promoters. (Adapted from references 52 and 64.)

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4
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Image of Figure 3
Figure 3

Two-step model of staphylococcal biofilm formation. The first step in biofilm formation is the adherence of the bacterial cells to a surface. The second step is the imbedding of the cells in a thick slime matrix (biofilm). One type of slime has been identified as PIA. Within this biofilm, cells appear to have reduced physiological activity in an anoxic environment, and exhibit a decreased sensitivity to many antibiotics, compared with their planktonic counterparts.

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4
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1. Akiyama, H.,, R. Torigoe,, and J. Arata. 1993. Interaction of Staphylococcus aureus cells and silk threads in vitro and in mouse skin. J. Dermatol. Sci. 6:247257.
2. Ali-Vehmas, T.,, P. Westphalen,, V. Myllys,, and M. Sandholm. 1997. Binding of Staphylococcus aureus to milk fat globules increases resistance to penicillin-G. J. Dairy Res. 64:253260.
3. Anglen, J.,, P. S. Apostoles,, G. Christensen,, B. Gainor,, and J. Lane. 1996. Removal of surface bacteria by irrigation. J. Orthop. Res. 14:251254.
4. Anwar, H.,, J. L. Strap,, and J. W. Costerton. 1992. Eradication of biofilm cells of Staphylococcus aureus with tobramycin and cephalexin. Can. J. Microbiol. 38:618625.
5. Arizono, T.,, M. Oga,, and Y. Sugioka. 1992. Increased resistance of bacteria after adherence to polymethyl methacrylate. An in vitro study. Acta Orthop. Scand. 63:661664.
6. Arnaboldi, L. 1996. Antimicrobial prophylaxis with ceftriaxone in neurosurgical procedures. A prospective study of 100 patients undergoing shunt operations. Chemotherapy 42:384390.
7. Arvaniti, A.,, N. K. Karamanos,, G. Dimitracopoulos,, and E. D. Anastassiou. 1994. Isolation and characterization of a novel 20-kDa sulfated polysaccharide from the extracellular slime layer of Staphylococcus epidermidis. Arch. Biochem. Biophys. 308:432438.
8. Atmaca, S.,, S. EIci,, and K. Gul. 1996. Comparison of slime production under aerobic and anaerobic conditions. Cytobios 88:149152.
9. Baddour, L. M.,, L. P. Barker,, G. D. Christensen,, J. T. Parisi,, and W. A. Simpson. 1990. Phenotypic variation of Staphylococcus epidermidis in infection of transvenous endocardial pacemaker electrodes. J. Clin. Microbiol. 28:676679.
10. Baldassarri, L.,, G. Donnelli,, A. Gelosia,, M. C. Voglino,, A. W. Simpson,, and G. D. Christensen. 1996. Purification and characterization of the staphylococcal slime-associated antigen and its occurrence among Staphylococcus epidermis clinical isolates. Infect. Immun. 64:34103415.
11. Barker, L. P.,, W. A. Simpson,, and G. D. Christensen. 1990. Differential production of slime under aerobic and anaerobic conditions. J. Clin. Microbiol. 28:25782579.
12. Bergamini, T. M.,, J. C. Peyton,, and W. G. Cheadle. 1992. Prophylactic antibiotics prevent bacterial biofilm graft infection. J. Surg. Res. 52:101105.
13. Berthaud, N.,, and J. F. Desnottes. 1997. In-vitro bactericidal activity of quinupristin/dalfopristin against adherent Staphylococcus aureus. J. Antimicrob. Chemother. 39:(Suppl. A):99102.
14. Boussard, P.,, A. Pithsy,, and M. J. Devleeschouwer. 1993. Relationship between slime production, antibiotic sensitivity and the phagetype of coagulase-negative staphylococci. J. Clin. Pharm. Ther. 18:271274.
15. Braga, P. C.,, M. Dal Sasso,, and S. Maci. 1997. Cefodizime: effects of sub-inhibitory concentrations on adhesiveness and bacterial morphology of Staphylococcus aureus and Escherichia coli: comparison with cefotaxime and ceftriaxone. J. Antimicrob. Chemother. 39:7984.
16. Cameron, J. S. 1995. Host defences in continuous ambulatory peritoneal dialysis and the genesis of peritonitis. Pediatr. Nephrol. 9:647662.
17. Campbell, I. M.,, D. N. Crozier,, and A. B. Pawagi. 1986. Effect of hypobaric oxygen and oleic acid on respiration of Staphylococcus aureus. Eur. J. Clin. Microbiol. 5:622628.
18. Campbell, I. M.,, D. N. Crozier,, A. B. Pawagi,, and I. A. Buivids. 1983. In vitro response of Staphylococcus aureus from cystic fibrosis patients to combinations of linoleic and oleic acids added to nutrient medium. J. Clin. Microbiol. 18:408415.
19. Caputy, G. G.,, and J. W. Costerton. 1982. Morphological examination of the glycocalyces of Staphylococcus aureus strains Wiley and Smith. Infect. Immun. 36:759767.
20. Chang, C. C.,, and K. Merritt. 1992. Microbial adherence on poly(methyl methacrylate) (PMMA) surfaces. J. Biomed. Mater. Res. 26:197207.
21. Chervu, A.,, W. S. Moore,, M. Chvapil,, and T. Henderson. 1991. Efficacy and duration of antistaphylococcal activity comparing three antibiotics bonded to Dacron vascular grafts with a collagen release system. J. Vase. Surg. 13:897901.
22. Christensen, G. D.,, L. M. Baddour,, B. M. Madison,, J. T. Parisi,, S. N. Abraham,, D. L. Hasty,, J. H. Lowrance,, J. A. Josephs,, and W. A. Simpson. 1990. Colonial morphology of staphylococci on Memphis agar: phase variation of slime production, resistance to beta-lactam antibiotics, and virulence. J. Infect. Dis. 161:11531169.
23. Christensen, G. D.,, L. M. Baddour,, and W. A. Simpson. 1987. Phenotypic variation of Staphylococcus epidermidis slime production in vitro and in vivo. Infect. Immun. 55:28702877.
24. Christensen, G. D.,, L. P. Barker,, T. P. Mawhinney,, L. M. Baddour,, and W. A. Simpson. 1990. Identification of an antigenic marker of slime production for Staphylococcus epidermidis. Infect. Immun. 58:29062911.
25. Christensen, G. D.,, W. A. Simpson,, A. L. Bisno,, and E. H. Beachey. 1982. Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surfaces. Infect. Immun. 37:318326.
26. Cramton, S. E.,, C. Gerke,, N. F. Schnell,, W. W. Nichols,, and F. Götz. 1999. The intercellular adhesion (ica) locus is present in Staphylococcus aureus and is required for biofilm formation. Infect. Immun. 67: 54275433.
27. Darouiche, R. O.,, G. C. Landon,, J. M. Patti,, L. L. Nguyen,, R. C. Fernau,, D. McDevitt,, C. Greene,, T. Foster,, and M. Klima. 1997. Role of Staphylococcus aureus surface adhesins in orthopaedic device infections: are results model-dependent? J. Med. Microbiol. 46:7579.
28. Dasgupta, M. K.,, H. Shishido,, S. Salama,, R. Singh,, M. Larabie,, and R. G. Micetich. 1997. The effects of macrolide and quinolone antibiotics in methicillin-resistant Staphylococcus aureus biofilm growth. Adv. Peril Dial. 13:214217.
29. Dasgupta, M. K.,, K. Ward,, P. A. Noble,, M. Larabie,, and J. W. Costerton. 1994. Development of bacterial biofilms on silastic catheter materials in peritoneal dialysis fluid. Am. J. Kidney Dis. 23:709716.
30. Deighton, M.,, and R. Borland. 1993. Regulation of slime production in Staphylococcus epidermidis by iron limitation. Infect. Immun. 61:44734479.
31. Deighton, M. A.,, R. Borland,, and J. A. Capstick. 1996. Virulence of Staphylococcus epidermidis in a mouse model: significance of extracellular slime. Epidemiol. Infect. 117:267280.
32. Diaz-Bianco, J.,, R. C. Clawson,, S. M. Roberson,, C. B. Sanders,, A. K. Pramanik,, and J. J. Herbst. 1989. Electron microscopic evaluation of bacterial adherence to polyvinyl chloride endotracheal tubes used in neonates. Crit. Care Med. 17:13351340.
33. Drewry, D. T.,, L. Galbraith,, B. J. Wilkinson,, and S. G. Wilkinson. 1990. Staphylococcal slime: a cautionary tale. J. Clin. Microbiol. 28:12921296.
34. Duguid, I. G.,, E. Evans,, M. R. Brown,, and P. Gilbert. 1992. Effect of biofilm culture upon the susceptibility of Staphylococcus epidermidis to tobramycin. J. Antimicrob. Chemother. 30:803810.
35. Dunne, W. M., Jr. 1990. Effects of subinhibitory concentrations of vancomycin or cefamandole on biofilm production by coagulase-negative staphylococci. Antimicrob. Agents Chemother. 34:390393.
36. Dunne, W. M., Jr.,, and E. M. Burd. 1992. The effects of magnesium, calcium, EDTA, and pH on the in vitro adhesion of Staphylococcus epidermidis to plastic. Microbiol. Immunol. 36:10191027.
37. Dunne, W. M., Jr.,, E. O. Mason, Jr.,, and S. L. Kaplan. 1993. Diffusion of rifampin and vancomycin through a Staphylococcus epidermidis biofilm. Antimicrob. Agents Chemother. 37:25222526.
38. Elci, S.,, S. Atmaca,, and K. Gul. 1995. Effect of iron limitation on the amount of slime produced by strains of Staphylococcus epidermidis. Cytobios 84:141146.
39. Espersen, F.,, B. J. Wilkinson,, B. Gahrn-Hansen,, V. Thamdrup Rosdahl,, and I. Clemmensen. 1990. Attachment of staphylococci to silicone catheters in vitro. APMIS 98:471478.
40. Evans, E.,, M. R. Brown,, and P. Gilbert. 1994. Iron chelator, exopolysaccharide and protease production in Staphylococcus epidermidis: a comparative study of the effects of specific growth rate in biofilm and planktonic culture. Microbiology 140:153153.
41. Farber, B. F.,, M. H. Kaplan,, and A. G. Clogston. 1990. Staphylococcus epidermidis extracted slime inhibits the antimicrobial action of glycopeptide antibiotics. J. Infect. Dis. 161:3740.
42. Fey, P. D.,, J. S. Ulphani,, F. Götz,, C. Heilmann,, D. Mack,, and M. E. Rupp. 1999. Characterization of the relationship between polysaccharide intercellular adhesin and hemagglutination in Staphylococcus epidermidis. J. Infect. Dis. 179:15611564.
43. Fleiszig, S. M.,, D. J. Evans,, M. F. Mowrey-McKee,, R. Payor,, T. S. Zaidi,, V. Vallas,, E. Muller,, and G. B. Pier. 1996. Factors affecting Staphylococcus epidermidis adhesion to contact lenses. Optom. Vis. Sci. 73:590594.
44. Flock, J. I.,, S. A. Hienz,, A. Heimdahl,, and T. Schennings. 1996. Reconsideration of the role of fibronectin binding in endocarditis caused by Staphylococcus aureus. Infect. Immun. 64:18761878.
45. Francois, P.,, P. Vaudaux,, and P. D. Lew. 1998. Role of plasma and extracellular matrix proteins in the physiopathology of foreign body infections. Ann. Vase. Surg. 12:3440.
46. Frank, U.,, and F. D. Daschner. 1989. In vitro activity of sulbactam plus ampicillin against hospital isolates of coagulase-negative staphylococci and Acinetobacter species. Infection 17:272274.
47. Gabriel, M. M.,, C. L. Schultz,, L. A. Wilson,, and D. G. Ahearn. 1996. Effect of Staphylococcus epidermidis on hydrogel contact lens retention on the rabbit eye. Curr. Microbiol. 32:176178.
48. Gagnon, R. F.,, A. D. Harris,, J. Prentis,, and G. K. Richards. 1989. The effects of heparin on rifampin activity against Staphylococcus epidermidis biofilms. Adv. Perit. Dial. 5:138142.
49. Gagnon, R. F.,, G. K. Richards,, and G. Obst 1993. The modulation of rifampin action against Staphylococcus epidermidis biofilms by drug additives to peritoneal dialysis solutions. Perit. Dial. Int. 13(Suppl. 2):S345S347.
50. Gagnon, R. F.,, G. K. Richards,, and L. Wiesenfeld. 1991. Staphylococcus epidermidis biofilms: unexpected outcome of double and triple antibiotic combinations with rifampin. ASAIO Trans. 37:M158M160.
51. Galliani, S.,, M. Viot,, A. Cremieux,, and P. Van der Auwera. 1994. Early adhesion of bacteremic strains of Staphylococcus epidermidis to polystyrene: influence of hydrophobicity, slime production, plasma, albumin, fibrinogen, and fibronectin. J. Lab. Clin. Med. 123:685692.
52. Gerke, C.,, A. Kraft,, R. Sussmuth,, O. Schweitzer,, and F. Götz. 1998. Characterization of the N-acetylglucosaminyl transferase activity involved in the biosynthesis of the Staphylococcus epidermidis polysaccharide intercellular adhesin. J. Biol. Chem. 273:1858618593.
53. Goldmann, D. A. 1990. Coagulase-negative staphylococci: interplay of epidemiology and bench research. Am. J. Infect. Control 18:211221.
54. Goldmann, D. A.,, and G. B. Pier. 1993. Pathogenesis of infections related to intravascular catheterization. Clin. Microbiol. Rev. 6:176192.
55. Gorman, S. P.,, C. G. Adair,, and W. M. Mawhinney. 1994. Incidence and nature of peritoneal catheter biofilm determined by electron and confocal laser scanning microscopy. Epidemiol. Infect. 112:551559.
56. Gracia, E.,, A. Fernandez,, P. Conchello,, A. Lacleriga,, L. Paniagua,, F. Serai,, and B. Amorena. 1997. Adherence of Staphylococcus aureus slime-producing strain variants to biomaterials used in orthopaedic surgery. Int. Orthop. 21:4651.
57. Gristina, A. G.,, R. A. Jennings,, P. T. Naylor,, Q. N. Myrvik,, and L. X. Webb. 1989. Comparative in vitro antibiotic resistance of surface-colonizing coagulase-negative staphylococci. Antimicrob. Agents Chemother. 33:813816.
58. Hall, S. L.,, R. T. Hall,, W. G. Barnes,, S. W. Riddell,, L. Meng,, J. T. Parisi,, H. W. Kilbride,, and D. Maulik. 1990. Relationship of maternal to neonatal colonization with coagulase-negative staphylococci. Am. J. Perinatol. 7:384388.
59. Hamilton-Miller, J. M.,, and S. Shah. 1997. Activity of quinupristin/dalfopristin against Staphylococcus epidermidis in biofilms: a comparison with ciprofloxacin. J. Antimicrob. Chemother. 39(Suppl. A): 103108.
60. Hamilton-Miller, J. M.,, S. Shah,, and C. Smith. 1993. Anomalous growth of Staphylococcus epidermidis in the presence of Silastic and glycopeptide antibiotics. FEMS Microbiol. Lett. 113:145147.
61. Heilmann, C.,, C. Gerke,, F. Perdreau-Remington,, and F. Götz. 1996. Characterization of Tn917 insertion mutants of Staphylococcus epidermidis affected in biofilm formation. Infect. Immun. 64:277282.
62. Heilmann, C.,, and F. Götz. 1998. Further characterization of Staphylococcus epidermidis transposon mutants deficient in primary attachment or intercellular adhesion. Zentralbl. Bakteriol. 287:6983.
63. Heilmann, C.,, M. Hussain,, G. Peters,, and F. Götz. 1997. Evidence for autolysin-mediated primary attachment of Staphylococcus epidermidis to a polystyrene surface. Mol. Microbiol. 24:10131024.
64. Heilmann, C.,, O. Schweitzer,, C. Gerke,, N. Vanittanakom,, D. Mack,, and F. Götz. 1996. Molecular basis of intercellular adhesion in the biofilm-forming Staphylococcus epidermidis. Mol. Microbiol. 20: 10831091.
65. Heinzelmann, M.,, D. O. Herzig,, B. Swain,, M. A. Mercer-Jones,, T. M. Bergamini,, and H. C. Polk, Jr. 1997. Phagocytosis and oxidative-burst response of planktonic Staphylococcus epidermidis RP62A and its non-slime-producing variant in human neutrophils. Clin. Diagn. Lab. Immunol. 4:705710.
66. Hjelm, E.,, and I. Lundell-Etherden. 1991. Slime production by Staphylococcus saprophyticus. Infect. Immun. 59:445448.
67. Hussain, M.,, J. G. Hastings,, and P. J. White. 1992. Comparison of cell-wall teichoic acid with highmolecular-weight extracellular slime material from Staphylococcus epidermidis. J. Med. Microbiol. 37: 368375.
68. Hussain, M.,, M. Herrmann,, C. von Eiff,, F. Perdreau-Remington,, and G. Peters. 1997. A 140-kilodalton extracellular protein is essential for the accumulation of Staphylococcus epidermidis strains on surfaces. Infect. Immun. 65:519524.
69. Hussain, M.,, M. H. Wilcox,, and P. J. White. 1993. The slime of coagulase-negative staphylococci: biochemistry and relation to adherence. FEMS Microbiol. Rev. 10:191207.
70. Hussain, M.,, M. H. Wilcox,, P. J. White,, M. K. Faulkner,, and R. C. Spencer. 1992. Importance of medium and atmosphere type to both slime production and adherence by coagulase-negative staphylococci. J. Hosp. Infect. 20:173184.
71. Ishak, M. A.,, D. H. Groschel,, G. L. Mandell,, and R. P. Wenzel. 1985. Association of slime with pathogenicity of coagulase-negative staphylococci causing nosocomial septicemia. J. Clin. Microbiol. 22: 10251029.
72. Isiklar, Z. U.,, R. O. Darouiche,, G. C. Landon,, and T. Beck. 1996. Efficacy of antibiotics alone for orthopaedic device related infections. Clin. Orthop. 332:184189.
73. Jennings, D. A.,, M. J. Morykwas,, W. W. Burns,, M. E. Crook,, W. P. Hudson,, and L. C. Argenta. 1991. In vitro adhesion of endogenous skin microorganisms to breast prostheses. Ann. Plast. Surg. 27: 216220.
74. Jones, J. W.,, R. J. Scott,, J. Morgan,, and J. V. Pether. 1992. A study of coagulase-negative staphylococci with reference to slime production, adherence, antibiotic resistance patterns and clinical significance. J. Hosp. Infect. 22:217227.
75. Kaebnick, H. W.,, D. F. Bandyk,, T. W. Bergamini,, and J. B. Towne. 1987. The microbiology of explanted vascular prostheses. Surgery 102:756762.
76. Khardori, N.,, E. Wong,, H. Nguyen,, C. Jeffery-Wiseman,, E. Wallin,, R. P. Tewari,, and G. P. Bodey. 1991. Effect of subinhibitory concentrations of clindamycin and trospectomycin on the adherence of Staphylococcus epidermidis in an in vitro model of vascular catheter colonization. J. Infect. Dis. 164:108113.
77. Kojima, Y.,, M. Tojo,, D. A. Goldmann,, T. D. Tosteson,, and G. B. Pier. 1990. Antibody to the capsular polysaccharide/adhesin protects rabbits against catheter-related bacteremia due to coagulase-negative staphylococci. J. Infect. Dis. 162:435441.
78. Kristinsson, K. G. 1989. Adherence of staphylococci to intravascular catheters. J. Med. Microbiol. 28: 249257.
79. Kunin, C. M.,, and C. Steele. 1985. Culture of the surfaces of urinary catheters to sample urethral flora and study the effect of antimicrobial therapy. J. Clin. Microbiol. 21:902908.
80. Locci, R.,, G. Peters,, and G. Pulverer. 1981. Microbial colonization of prosthetic devices. III. Adhesion of staphylococci to lumina of intravenous catheters perfused with bacterial suspensions. Zentralbl. Bakteriol. Mikrobiol. Hyg. B 173:300307.
81. Locci, R.,, G. Peters,, and G. Pulverer. 1981. Microbial colonization of prosthetic devices. IV. Scanning electron microscopy of intravenous catheters invaded by yeasts. Zentralbl. Bakteriol. Mikrobiol. Hyg. B. 173:419424.
82. Ludwicka, A.,, R. Locci,, B. Jansen,, G. Peters,, and G. Pulverer. 1983. Microbial colonization of prosthetic devices. V. Attachment of coagulase-negative staphylococci and "slime"-production on chemically pure synthetic polymers. Zentralbl. Bakteriol. Mikrobiol. Hyg. B 177:527532.
83. Lundberg, F.,, S. Schliamser,, and A. Ljungh. 1997. Vitronectin may mediate staphylococcal adhesion to polymer surfaces in perfusing human cerebrospinal fluid. J. Med. Microbiol. 46:285296.
84. Mack, D.,, W. Fischer,, A. Krokotsch,, K. Leopold,, R. Hartmann,, H. Egge,, and R. Laufs. 1996. The intercellular adhesin involved in biofilm accumulation of Staphylococcus epidermidis is a linear beta-1,6-linked glucosaminoglycan: purification and structural analysis. J. Bacteriol. 178:175183.
85. Mack, D.,, M. Haeder,, N. Siemssen,, and R. Laufs. 1996. Association of biofilm production of coagulase-negative staphylococci with expression of a specific polysaccharide intercellular adhesin. J. Infect. Dis. 174:881884.
86. Mack, D.,, M. Nedelmann,, A. Krokotsch,, A. Schwarzkopf,, J. Heesemann,, and R. Laufs. 1994. Characterization of transposon mutants of biofilm-producing Staphylococcus epidermidis impaired in the accumulative phase of biofilm production: genetic identification of a hexosamine-containing polysaccharide intercellular adhesin. Infect. Immun. 62:32443253.
87. Mack, D.,, J. Riedewald,, H. Rohde,, T. Magnus,, H. H. Feucht,, H. A. Eisner,, R. Laufs,, and M. E. Rupp. 1999. Essential functional role of the polysaccharide intercellular adhesin of Staphylococcus epidermidis in hemagglutination. Infect. Immun. 67:10041008.
88. Mack, D.,, N. Siemssen,, and R. Laufs. 1992. Parallel induction by glucose of adherence and a polysaccharide antigen specific for plastic-adherent Staphylococcus epidermidis: evidence for functional relation to intercellular adhesion. Infect. Immun. 60:20482057.
89. Magnotta, S.,, A. Bogucki,, R. F. Vieth,, and R. W. Coughlin. 1997. Comparative behavior of E. coli and S. aureus regarding attachment to and removal from a polymeric surface. J. Biomater. Sci. Polym. Educ. 8:683689.
90. Marone, P.,, L. Perversi,, V. Monzillo,, R. Maserati,, and E. Antoniazzi. 1995. Ocular infections: antibiotics and bacterial adhesion on biomaterials used in ocular surgery. Ophthalmologica 209:315318.
91. Marone, P.,, L. Perversi,, A. Navarra,, V. Monzillo,, and E. Sartirana. 1993. Activity of daptomycin against enterococci and coagulase-negative staphylococci (CNS): relationship between CNS susceptibility and slime production. J. Chemother. 5:151154.
92. Marrie, T. J.,, and J. W. Costerton. 1984. Scanning and transmission electron microscopy of in situ bacterial colonization of intravenous and intraarterial catheters. J. Clin. Microbiol. 19:687693.
93. Marrie, T. J.,, J. Nelligan,, and J. W. Costerton. 1982. A scanning and transmission electron microscopic study of an infected endocardial pacemaker lead. Circulation 66:13391341.
94. Martinez-Martinez, L.,, A. Pascual,, M. I. Giglio,, E. J. Perea,, and G. Giglio. 1991. Effect of subinhibitory concentrations of beta-lactams on the production of slime, surface hydrophobicity and adhesion of Staphylococcus epidermidis. Enferm. Infecc. Microbiol. Clin. 9:543546. (Erratum, 10:10.)
95. Matassova, N. B.,, M. V. Rodnina,, R. Endermann,, H. P. Kroll,, U. Pleiss,, H. Wild,, and W. Wintermeyer. 1999. Ribosomal RNA is the target for oxazolidinones, a novel class of translational inhibitors. RNA 5: 939946.
96. Matthews, K. R.,, S. P. Oliver,, and S. H. King. 1991. Expression of glycocalyx by coagulase-negative Staphylococcus species isolated from bovine milk. J. Appl. Bacterial. 70:227232.
97. McKenney, D.,, J. Hubner,, E. Muller,, Y. Wang,, D. A. Goldmann,, and G. B. Pier. 1998. The ica locus of Staphylococcus epidermidis encodes production of the capsular polysaccharide/adhesin. Infect. Immun. 66:47114720.
98. McKenney, D.,, K. L. Pouliot,, Y. Wang,, V. Murthy,, M. Ulrich,, G. Doring,, J. C. Lee,, D. A. Goldmann,, and G. B. Pier. 1999. Broadly protective vaccine for Staphylococcus aureus based on an in vivo-expressed antigen. Science 284:15231527.
99. Mempel, M.,, H. Feucht,, W. Ziebuhr,, M. Endres,, R. Laufs,, and L. Griiter. 1994. Lack of mecA transcription in slime-negative phase variants of methicillin-resistant Staphylococcus epidermidis. Antimicrob. Agents Chemother. 38:12511255.
100. Mempel, M.,, E. Muller,, R. Hoffmann,, H. Feucht,, R. Laufs,, and L. Gruter. 1995. Variable degree of slime production is linked to different levels of beta-lactam susceptibility in Staphylococcus epidermidis phase variants. Med. Microbiol. Immunol. (Berlin) 184:109111.
101. Miyake, Y.,, S. Fujiwara,, T. Usui,, and H. Suginaka. 1992. Simple method for measuring the antibiotic concentration required to kill adherent bacteria. Chemotherapy 38:286290.
102. Moreillon, P.,, J. M. Entenza,, P. Francioli,, D. McDevitt,, T. J. Foster,, P. Francois,, and P. Vaudaux. 1995. Role of Staphylococcus aureus coagulase and clumping factor in pathogenesis of experimental endocarditis. Infect. Immun. 63:47384743.
103. Muller, E.,, J. Hubner,, N. Gutierrez,, S. Takeda,, D. A. Goldmann,, and G. B. Pier. 1993. Isolation and characterization of transposon mutants of Staphylococcus epidermidis deficient in capsular polysaccharide/ adhesin and slime. Infect. Immun. 61:551558.
104. Muller, E.,, S. Takeda,, H. Shiro,, D. Goldmann,, and G. B. Pier. 1993. Occurrence of capsular polysaccharide/adhesin among clinical isolates of coagulase-negative staphylococci. J. Infect. Dis. 168: 12111218.
105. Nakashio, S.,, H. Iwasawa,, F. Y. Dun,, K. Kanemitsu,, and J. Shimada. 1995. Everninomicin, a new oligosaccharide antibiotic: its antimicrobial activity, post-antibiotic effect and synergistic bactericidal activity. Drugs Exp. Clin. Res. 21:716.
106. Nickel, J. C.,, G. Reid,, A. W. Bruce,, and J. W. Costerton. 1986. Ultrastructural microbiology of infected urinary stone. Urology 28:512515.
107. Nilsson, M.,, L. Frykberg,, J. I. Flock,, L. Pei,, M. Lindberg,, and B. Guss. 1998. A fibrinogen-binding protein of Staphylococcus epidermidis. Infect. Immun. 66:26662673.
108. Nomura, S.,, F. Lundberg,, M. Stollenwerk,, K. Nakamura,, and A. Ljungh. 1997. Adhesion of staphylococci to polymers with and without immobilized heparin in cerebrospinal fluid. J. Biomed. Mater. Res. 38:3542.
109. Oga, M.,, Y. Sugioka,, C. D. Hobgood,, A. G. Gristina,, and Q. N. Myrvik. 1988. Surgical biomaterials and differential colonization by Staphylococcus epidermidis. Biomaterials 9:285289.
110. Ohtomo, T.,, T. Yamada,, and K. Yoshida. 1988. Outermost-cell-surface changes in an encapsulated strain of Staphylococcus aureus after preservation by freeze-drying. Appl. Environ. Microbiol. 54:24862491.
111. Ohtomo, T.,, K. Yoshida,, and C. L. San Clemente. 1981. Effect of bile acid derivatives on taurine biosynthesis and extracellular slime production in encapsulated Staphylococcus aureus S-7. Infect. Immun. 31:798807.
112. Olson, M. E.,, I. Ruseska,, and J. W. Costerton. 1988. Colonization of n-butyl-2-cyanoacrylate tissue adhesive by Staphylococcus epidermidis. J. Biomed. Mater. Res. 22:485495.
113. Oshida, T.,, M. Sugai,, H. Komatsuzawa,, Y. M. Hong,, H. Suginaka,, and A. Tomasz. 1995. A Staphylococcus aureus autolysin that has an N-acetylmuramoyl-L-alanine amidase domain and an endo-beta-N-acetylglucosaminidase domain: cloning, sequence analysis, and characterization. Proc. Natl. Acad. Sci. USA 92:285289.
114. Pascual, A.,, I. Garcia,, E. Ramirez de Arellano,, and E. J. Perea. 1995. Activity of sparfloxacin on Staphylococcus epidermidis attached to plastic catheters. J. Antimicrob. Chemother. 36:425430.
115. Pascual, A.,, E. Ramirez de Arellano,, L. Martinez Martinez,, and E. J. Perea. 1993. Effect of polyurethane catheters and bacterial biofilms on the in vitro activity of antimicrobials against Staphylococcus epidermidis. J. Hosp. Infect. 24:211218.
116. Passerini, L.,, K. Lam,, J. W. Costerton,, and E. G. King. 1992. Biofilms on indwelling vascular catheters. Crit. Care Med. 20:665673.
117. Passerini, L.,, P. T. Phang,, F. L. Jackson,, K. Lam,, J. W. Costerton,, and E. G. King. 1987. Biofilms on right heart flow-directed catheters. Chest 92:440460.
118. Patel, R.,, M. S. Rouse,, K. E. Piper,, and J. M. Steckelberg. 1999. In vitro activity of linezolid against vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus and penicillin- resistant Streptococcus pneumoniae. Diagn. Microbiol. Infect. Dis. 34:119122.
119. Perdreau-Remington, F.,, M. A. Sande,, G. Peters,, and H. F. Chambers. 1998. The abilities of a Staphylococcus epidermidis wild-type strain and its slime-negative mutant to induce endocarditis in rabbits are comparable. Infect. Immun. 66:27782781.
120. Peters, G. 1984. Pathogenesis of staphylococcal infections of implanted plastics and intravascular catheters. Infection 12:235239.
121. Peters, G.,, R. Locci,, and G. Pulverer. 1981. Microbial colonization of prosthetic devices. II. Scanning electron microscopy of naturally infected intravenous catheters. Zentralbl. Baketeriol. Mikrobiol. Hyg. B. 173:293299.
122. Raad, I.,, A. Alrahwan,, and K. Rolston. 1998. Staphylococcus epidermidis: emerging resistance and need for alternative agents. Clin. Infect. Dis. 26:11821187.
123. Raad, I.,, R. Darouiche,, R. Hachem,, M. Sacilowski,, and G. P. Bodey. 1995. Antibiotics and prevention of microbial colonization of catheters. Antimicrob. Agents Chemother. 39:23972400.
124. Ramirez de Arellano, E.,, A. Pascual,, L. Martinez-Martinez,, and E. J. Perea. 1994. Activity of eight antibacterial agents on Staphylococcus epidermidis attached to Teflon catheters. J. Med. Microbiol. 40: 4347.
125. Rather, P. N.,, A. P. Davis,, and B. J. Wilkinson. 1986. Slime production by bovine milk Staphylococcus aureus and identification of coagulase-negative staphylococcal isolates. J. Clin. Microbiol. 23:858862.
126. Read, R. R.,, P. Eberwein,, M. K. Dasgupta,, S. K. Grant,, K. Lam,, J. C. Nickel,, and J. W. Costerton. 1989. Peritonitis in peritoneal dialysis: bacterial colonization by biofilm spread along the catheter surface. Kidney Int. 35:614621.
127. Reed, W. P.,, M. R. Moody,, K. A. Newman,, P. D. Light,, and J. W. Costerton. 1986. Bacterial colonization of Hemasite access devices. Surgery 99:308317.
128. Reid, G.,, J. D. Denstedt,, Y. S. Kang,, D. Lam,, and C. Nause. 1992. Microbial adhesion and biofilm formation on ureteral stents in vitro and in vivo. J. Urol. 148:15921594.
129. Richards, G. K.,, R. F. Gagnon,, G. Obst,, and G. B. Kostiner. 1993. The effect of peritoneal dialysis solutions on rifampin action against Staphylococcus epidermidis in the fluid and biofilm phases of growth. Peril. Dial. Int. 13(Suppl 2):S341S344.
130. Richards, G. K.,, R. J. Morcos,, and R. F. Gagnon. 1994. The differential activity of aminoglycoside antibiotics with rifampin explored in a kinetic in vitro model of implant-associated infection (Staphylococcus epidermidis). Adv. Perit. Dial. 10:183188.
131. Richards, G. K.,, J. Prentis,, and R. F. Gagnon. 1990. The effect of protamine on antibiotic action against Staphylococcus epidermidis biofilms. ASAIO Trans. 36:M296M299.
132. Rimland, D.,, and W. Alexander. 1989. Absence of factors associated with significant urinary tract infections caused by coagulase-negative staphylococci. Diagn. Microbiol. Infect. Dis. 12:123127.
133. Rossi, T.,, R. Peltonen,, J. Laine,, E. Eerola,, J. Vuopio-Varkila,, and P. Kotilainen. 1996. Eradication of the long-term carriage of methicillin-resistant Staphylococcus aureus in patients wearing dentures: a follow-up of 10 patients. J. Hosp. Infect. 34:311320.
134. Rozgonyi, F.,, and G. Seltmann. 1985. Pathogenicity and virulence of methicillin resistant Staphylococcus aureus: slime layer production. Acta Microbiol. Hung. 32:155165.
135. Rupp, M. E.,, and K. E. Hamer. 1998. Effect of subinhibitory concentrations of vancomycin, cefazolin, ofloxacin, L-ofloxacin and D-ofloxacin on adherence to intravascular catheters and biofilm formation by Staphylococcus epidermidis. J. Antimicrob. Chemother. 41:155161.
136. Sanger, J. R.,, N. K. Sheth,, and T. R. Franson. 1989. Adherence of microorganisms to breast prostheses: an in vitro study. Ann. Plast. Surg. 22:337342.
137. Santini, C.,, P. Baiocchi,, M. Venditti,, C. Brandimarte,, A. Tarasi,, L. Rizzo,, F. Speziale,, P. Fiorani,, and P. Serra. 1993. Aorto-femoral graft infections: a clinical and microbiological analysis. J. Infect. 27: 1726.
138. Sardelic, F.,, P. Y. Ao,, D. A. Taylor,, and J. P. Fletcher. 1996. Prophylaxis against Staphylococcus epidermidis vascular graft infection with rifampicin-soaked, gelatin-sealed Dacron. Cardiovasc. Surg. 4: 389392.
139. Schumacher-Perdreau, F.,, C. Heilmann,, G. Peters,, F. Götz,, and G. Pulverer. 1994. Comparative analysis of a biofilm-forming Staphylococcus epidermidis strain and its adhesion-positive, accumulation-negative mutant M7. FEMS Microbiol. Lett. 117:7178.
140. Schwank, S.,, Z. Rajacic,, W. Zimmerli,, and J. Blaser. 1998. Impact of bacterial biofilm formation on in vitro and in vivo activities of antibiotics. Antimicrob. Agents Chemother. 42:895898.
141. Sheth, N. K.,, T. R. Franson,, and P. G. Sohnle. 1985. Influence of bacterial adherence to intravascular catheters on in vitro antibiotic susceptibility. Lancet ii: 12661268.
142. Shibl, A. M.,, M. A. Ramadan,, and A. F. Tawfik. 1994. Differential inhibition by clindamycin on slime formation, adherence to teflon catheters and hemolysin production by Staphylococcus epidermidis. J. Chemother. 6:107110.
143. Shiro, H.,, E. Muller,, N. Gutierrez,, S. Boisot,, M. Grout,, T. D. Tosteson,, D. Goldmann,, and G. B. Pier. 1994. Transposon mutants of Staphylococcus epidermidis deficient in elaboration of capsular polysaccharide/adhesin and slime are avirulent in a rabbit model of endocarditis. J. Infect. Dis. 169: 10421049.
144. Svensson, E.,, H. Hanberger,, M. Nilsson,, and L. E. Nilsson. 1997. Factors affecting development of rifampicin resistance in biofilm- producing Staphylococcus epidermidis. J. Antimicrob. Chemother. 39: 817820.
145. Takahashi, A.,, S. Yomoda,, T. Kanda,, Y. Fukumura,, T. Ohkubo,, M. Inoue,, and I. Kobayashi. 1997. Slime formation as a marker of serious infection with methicillin-resistant Staphylococcus aureus. J. Med. 28:8798.
146. Tchekmedyian, N. S.,, K. Newman,, M. R. Moody,, J. W. Costerton,, J. Aisner,, S. C. Schimpff,, and W. P. Reed. 1986. Special studies of the Hickman catheter of a patient with recurrent bacteremia and candidemia. Am. J. Med. Sci. 291:419424.
147. Thomas, V. L.,, B. A. Sanford,, R. Moreno,, and M. A. Ramsay. 1997. Enzyme-linked lectinsorbent assay measures N-acetyl-D-glucosamine in matrix of biofilm produced by Staphylococcus epidermidis. Curr. Microbiol. 35:249254.
148. Tojo, M.,, N. Yamashita,, D. A. Goldmann,, and G. B. Pier. 1988. Isolation and characterization of a capsular polysaccharide adhesin from Staphylococcus epidermidis. J. Infect. Dis. 157:713722. (Erratum, 158:268.)
149. Tollefson, D. F.,, D. F. Bandyk,, H. W. Kaebnick,, G. R. Seabrook,, and J. B. Towne. 1987. Surface biofilm disruption. Enhanced recovery of microorganisms from vascular prostheses. Arch. Surg. 122:3843.
150. Udo, E. E.,, L. E. Jacob,, and T. D. Chugh. 1995. Antimicrobial resistance of coagulase-negative staphylococci from a Kuwait hospital. Microb. Drug Resist. 1:315320.
151. Vaudaux, P. 1998. Phenotypic antibiotic tolerance of Staphylococcus aureus in implant-related infections: relationship with in vitro colonization of artificial surfaces. Drug Resist. Update 1:352357.
152. Virden, C. P.,, M. K. Dobke,, P. Stein,, C. L. Parsons,, and D. H. Frank. 1992. Subclinical infection of the silicone breast implant surface as a possible cause of capsular contracture. Aesthetic Plast. Surg. 16: 173179.
153. von Eiff, C.,, and G. Peters. 1999. Comparative in-vitro activities of moxifloxacin, trovafloxacin, quinupristin/dalfopristin and linezolid against staphylococci. J. Antimicrob. Chemother. 43:569573.
154. Wadstrom, T. 1989. Molecular aspects of bacterial adhesion, colonization, and development of infections associated with biomaterials. J. Invest. Surg. 2:353360.
155. Watts, J. L.,, A. S. Naidu,, and T. Wadstrom. 1990. Collagen binding, elastase production, and slime production associated with coagulase-negative staphylococci isolated from bovine intramammary infections. J. Clin. Microbiol. 28:580583.
156. Williams, I.,, W. A. Venables,, D. Lloyd,, F. Paul,, and I. Critchley. 1997. The effects of adherence to silicone surfaces on antibiotic susceptibility in Staphylococcus aureus. Microbiology 143(Pt 7):24072413.
157. Yasuda, H.,, Y. Ajiki,, T. Koga,, and T. Yokota. 1994. Interaction between clarithromycin and biofilms formed by Staphylococcus epidermidis. Antimicrob. Agents Chemother. 38:138141.
158. Ziebuhr, W.,, C. Heilmann,, F. Götz,, P. Meyer,, K. Wilms,, E. Straube,, and J. Hacker. 1997. Detection of the intercellular adhesion gene cluster (ica) and phase variation in Staphylococcus epidermidis blood culture strains and mucosal isolates. Infect. Immun. 65:890896.
159. Ziebuhr, W.,, V. Krimmer,, S. Rachid,, I. LdBner,, F. Götz,, and J. Hacker. 1999. A novel mechanism of phase variation of virulence in Staphylococcus epidermidis: evidence for control of the polysaccharide intercellular adhesin synthesis by alternating insertion and excision of the insertion sequence element IS256. Mol. Microbiol. 3 2:345356.


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Table 1

Biofilm formation by CoNS on catheters and other prosthetic devices

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4
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Table 2

CoNS colonize nearly any synthetic polymer

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4
Generic image for table
Table 3

Adherence of CoNS to polymers precoated with various blood compounds

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4
Generic image for table
Table 4

Antibiotics tested to prevent biofilm formation or to cure staphylococcal foreign-body infection

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4
Generic image for table
Table 5

Synergistic and antagonistic activities of various antibiotic combinations in treatment of staphylococcal biofilm infections

Citation: Götz F, Peters G. 2000. Colonization of Medical Devices by Coagulase-Negative Staphylococci, p 55-88. In Waldvogel F, Bisno A (ed), Infections Associated with Indwelling Medical Devices, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818067.ch4

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