Coagulase Negative Staphylococci CNS

CNS are an element in the normal flora of human skin and mucosa. They are classic opportunists that only cause infections given a certain host disposition.

■ S. epidermidis. This is the pathogen most frequently encountered in CNS infections (70-80% of cases). CNS cause mainly foreign body infections. Examples of the foreign bodies involved are intravasal catheters, continuous ambulant peritoneal dialysis (CAPD) catheters, endoprostheses, metal plates and screws in osteosynthesis, cardiac pacemakers, artificial heart valves, and shunt valves. These infections frequently develop when foreign bodies in the macroorganism are covered by matrix proteins (e.g., fibrinogen, fibronectin) to which the staphylococci can bind using specific cell wall proteins. They then proliferate on the surface and produce a polymeric substance—the basis of the developing biofilm. The staphylococci within the biofilm are protected from antibiotics and the immune system to a great extent. Such biofilms can become infection foci from which the CNS enter the bloodstream and cause sepsislike illnesses. Removal of the foreign body is often necessary.

■ S. saprophyticus is responsible for 10-20% of acute urinary tract infections, in particular dysuria in young women, and for a small proportion of cases of nonspecific urethritis in sexually active men.

Antibiotic treatment of CNS infections is often problematic due to the multiple resistance often encountered in these staphylococci, especially S. hemo-lyticus.

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Essentials of Human Physiology

Essentials of Human Physiology

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