title: Staphylococcus epidermidis as a cause of bacteremia.
abstract: Staphylococcus epidermidis is a biofilm-producing commensal organism found ubiquitously on human skin and mucous membranes, as well as on animals and in the environment. Biofilm formation enables this organism to evade the host immune system. Colonization of percutaneous devices or implanted medical devices allows bacteria access to the bloodstream. Isolation of this organism from blood cultures may represent either contamination during the blood collection procedure or true bacteremia. S. epidermidis bloodstream infections may be indolent compared with other bacteria. Isolation of S. epidermidis from a blood culture may present a management quandary for clinicians. Over-treatment may lead to patient harm and increases in healthcare costs. There are numerous reports indicating the difficulty of predicting clinical infection in patients with positive blood cultures with this organism. No reliable phenotypic or genotypic algorithms currently exist to predict the pathogenicity of a S. epidermidis bloodstream infection. This review will discuss the latest advances in identification methods, global population structure, pathogenicity, biofilm formation, antimicrobial resistance and clinical significance of the detection of S. epidermidis in blood cultures. Previous studies that have attempted to discriminate between invasive and contaminating strains of S. epidermidis in blood cultures will be analyzed.
authors.affiliation: School of Biomedical Sciences, Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.|Microbiology Department, Pathology Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kleinschmidt
authors.affiliation: School of Biomedical Sciences, Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Flavia
authors.initials: F
authors.lastname: Huygens
authors.affiliation: School of Biomedical Sciences, Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Joan
authors.initials: J
authors.lastname: Faoagali
authors.affiliation: School of Biomedical Sciences, Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Irani U
authors.initials: IU
authors.lastname: Rathnayake
authors.affiliation: School of Biomedical Sciences, Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Hafner
mesh_terms: D000818:Animals; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology*; D018441:Biofilms / Q000254:growth & development; D001769:Blood / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D005838:Genotype; D014943:Global Health; D006801:Humans; D017720:Molecular Epidemiology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology*; D013212:Staphylococcus epidermidis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D014774:Virulence
keywords: Staphylococcus epidermidis; bacteremia; biofilm; virulence