The genetics of staphylococcal biofilm formation--will a greater understanding of pathogenesis lead to better management of device-related infection?
Staphylococcus epidermidis and Staphylococcus aureus are common causes of biofilm-mediated prosthetic device-related infection. The polysaccharide adhesion mechanism encoded by the ica operon is currently the best understood mediator of biofilm development, and represents an important virulence determinant. More recently, the contributions of other virulence regulators, including the global regulators agr, sarA and sigmaB, to the biofilm phenotype have also been investigated. Nevertheless, little has changed at the bedside; the clinical and laboratory diagnosis of device-related infection can be difficult, and biofilm resistance frequently results in failure of therapy. This review assesses the way in which advances in the understanding of biofilm genetics may impact on the clinical management of device-related infection.
Fitzpatrick
F
F
Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Education and Research Centre, Dublin, Ireland.
Humphreys
H
H
O'Gara
J P
JP
D018829:Adhesins, Bacterial / Q000502:physiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018441:Biofilms / Q000254:growth & development*; D015964:Gene Expression Regulation, Bacterial; D009238:N-Acetylmuramoyl-L-alanine Amidase / Q000378:metabolism; D009876:Operon / Q000235:genetics; D011135:Polysaccharides, Bacterial / Q000096:biosynthesis; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013210:Staphylococcus / Q000201:enzymology / Q000235:genetics* / Q000472:pathogenicity*; D013682:Teichoic Acids / Q000378:metabolism
D018829:Adhesins, Bacterial; D000900:Anti-Bacterial Agents; D011135:Polysaccharides, Bacterial; D013682:Teichoic Acids; C048165:adhesin, Staphylococcus aureus; D009238:N-Acetylmuramoyl-L-alanine Amidase