Ortho-Preferred

Staph epidermidis

  - Discussion:
    - is a coagulase negative, gram positive organism;
    - has emerged as one of the most common organisms in total joint infections (and in other implanted devices);
    - it is often minimally toxic (as compared to other bacterial infections), and many patients will have minimal symptoms of infection;
    - it is particularly prone to recurrence following joint replantation; 
    - ref: Infection in total joint replacements. Why we screen MRSA when MRSE is the problem?
    - biofilm and colonization of implants:
           - its high recurrence rate may be related to its propensity to form a biofilm layer (extra-cellular glycocalyx) which coats the
                    bacteria, which protects by engulfment by neutrophils;
           - slime layer may make antibiotic penetration and bacteria eradication more difficult; 
           - references:
                    - Adherence of Staphylococcus epidermidis to biomaterials is augmented by PIA.
                    - Occurrence of ica genes for slime in a collection of Staph epidermidis strains from orthopedic prosthesis infections.
                    - Surgical biomaterials and differential colonization by Staphylococcus epidermidis. 
                    - Bacterial adherence to bioinert and bioactive materials studied in vitro. 
                    - SdrF, a Staphylococcus epidermidis surface protein, binds type I collagen.
                    - Identification and preliminary characterization of cell-wall-anchored proteins of Staphylococcus epidermidis.
                    - Screening for S. epi markers discriminating between flora strains and those responsible for infections of joint prostheses.
                    - S epi
in orthopedic device infections: the role of bacterial internalization in human osteoblasts and biofilm formation.

    - vancomycin 
            - reference:
                  -  Medical Intelligence: Emergence of Vancomycin Resistance In Coagulase-Negative Staphylococci

    - zyvox 
            - reference:
                  - [Linezolid in the treatment of antibiotic-resistant gram-positive infections of the musculoskeletal system.
    - rifampin:
         - treatment of staph implant related infection:
            - in the report by Konig, et al, authors report on success of a single case of staph epi infection over an orthopaedic implant
                     w/ combo of rifampin and cipro;
            - references: 
                      - Treatment of staphylococcal implant infection with rifampicin-ciprofloxacin in stable implants
                      - Antibiotic susceptibility among S epidermidis isolated from prosthetic joint infections, with focus on doxycycline.
                     - Vancomycin resistant Staphylococcus epidermidis caused prosthesis infection. Linezolid and rifampicin healed the
                                 complicated infection
                     - Foreign body infections due to Staphylococcus epidermidis.
                     - Time-dependent effects of rifampicin on staphylococcal biofilms      
                     - Rifampicin enhances activity of daptomycin and vancomycin against both a polysaccharide intercellular adhesin (PIA)-dependent and -independent Staphylococcus epidermidis biofilm.

                     - Antimicrobials as potential adjunctive agents in the treatment of biofilm infection with Staphylococcus epidermidis.

    - doxycycline:
                     - Antibiotic susceptibility among Staphylococcus epidermidis isolated from prosthetic joint infections, with focus on doxycycline.

    - controversies:
         - chlorohexidene prep:
               - Decreased susceptibility to chlorhexidine and prevalence of disinfectant resistance genes among clinical isolates of Staphylococcus epidermidis.


         - NAC:
               - Effect of different agents with potential antibiofilm activity on antimicrobial susceptibility of biofilms formed by Staphylococcus spp. isolated from implant-related infections.



                      - Open debridement of acute gram-positive infections after total knee arthroplasty
                      - Successful treatment of Staphylococcus epidermidis hip prosthesis infection with oral linezolid.




Antibiotic-loaded synthetic calcium sulfate beads for prevention of bacterial colonization and biofilm formation in periprosthetic infections.

Sequence types of Staphylococcus epidermidis associated with prosthetic joint infections are not present in the laminar airflow during prosthetic joint surgery.

Does surgical prophylaxis with teicoplanin constitute a therapeutic advance?

Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin.

Antimicrobial susceptibility of coagulase-negative staphylococci on tissue allografts and isolates from orthopedic patients.

Antibiotic resistance in exopolysaccharide-forming Staphylococcus epidermidis clinical isolates from orthopaedic implant infections.

Berberine inhibits Staphylococcus epidermidis adhesion and biofilm formation on the surface of titanium alloy.


- Treatment



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, May 1, 2017 6:23 am