title: Polysaccharide intercellular adhesin or protein factors in biofilm accumulation of Staphylococcus epidermidis and Staphylococcus aureus isolated from prosthetic hip and knee joint infections.
abstract: Nosocomial staphylococcal foreign-body infections related to biofilm formation are a serious threat, demanding new therapeutic and preventive strategies. As the use of biofilm-associated factors as vaccines is critically restricted by their prevalence in natural staphylococcal populations we studied the distribution of genes involved in biofilm formation, the biofilm phenotype and production of polysaccharide intercellular adhesin (PIA) in clonally independent Staphylococcus aureus and Staphylococcus epidermidis strains isolated from prosthetic joint infections after total hip or total knee arthroplasty. Biofilm formation was detected in all S. aureus and 69.2% of S. epidermidis strains. Importantly, 27% of biofilm-positive S. epidermidis produced PIA-independent biofilms, in part mediated by the accumulation associated protein (Aap). Protein-dependent biofilms were exclusively found in S. epidermidis strains from total hip arthroplasty (THA). In S. aureus PIA and proteins act cooperatively in biofilm formation regardless of the infection site. PIA and protein factors like Aap are of differential importance for the pathogenesis of S. epidermidis in prosthetic joint infections (PJI) after THA and total knee arthroplasty (TKA), implicating that icaADBC cannot serve as a general virulence marker in this species. In S. aureus biofilm formation proteins are of overall importance and future work should focus on the identification of functionally active molecules.
authors.affiliation: Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. rohde@uke.uni-hamburg.de
authors.forename: Holger
authors.initials: H
authors.lastname: Rohde
authors.forename: Eike C
authors.initials: EC
authors.lastname: Burandt
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Siemssen
authors.forename: Lars
authors.initials: L
authors.lastname: Frommelt
authors.forename: Christoph
authors.initials: C
authors.lastname: Burdelski
authors.forename: Sabine
authors.initials: S
authors.lastname: Wurster
authors.forename: Stefanie
authors.initials: S
authors.lastname: Scherpe
authors.forename: Angharad P
authors.initials: AP
authors.lastname: Davies
authors.forename: Llinos G
authors.initials: LG
authors.lastname: Harris
authors.forename: Matthias A
authors.initials: MA
authors.lastname: Horstkotte
authors.forename: Johannes K-M
authors.initials: JK
authors.lastname: Knobloch
authors.forename: Chandran
authors.initials: C
authors.lastname: Ragunath
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Kaplan
authors.forename: Dietrich
authors.initials: D
authors.lastname: Mack
mesh_terms: D018829:Adhesins, Bacterial / Q000378:metabolism*; D001426:Bacterial Proteins / Q000378:metabolism*; D018441:Biofilms / Q000254:growth & development*; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D011135:Polysaccharides, Bacterial / Q000378:metabolism; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000378:metabolism*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*
chemical_list: D018829:Adhesins, Bacterial; D001426:Bacterial Proteins; D011135:Polysaccharides, Bacterial