- 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;
- biofilm and colonization of implanta:
- 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 synthesis in a collection of Staphylococcus epidermidis strains from orthopedic prosthesis infections.
- Surgical biomaterials and differential colonization by Staphylococcus epidermidis.
- Bacterial adherence to bioinert and bioactive materials studied in vitro.
- Treatment:
- vancomycin
- references:
- Medical Intelligence: Emergence of Vancomycin Resistance In Coagulase-Negative Staphylococci.
- zyvox
- references:
- Linezolid in the treatment of antibiotic-resistant gram-positive infections of the musculoskeletal system.
- controversies:
- 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.
DP König et al. Archives of Ortho and Trauma Surgery. Abs 121 Issue 5 (2001) pp 297-299
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.
