How is a Staphylococcus epidermidis infection typically treated?

From the Guidelines

Staphylococcus epidermidis is typically found in clusters, and its infections are usually treated with antibiotics, with the choice of antibiotic depending on the severity and location of the infection. When considering treatment options, it's essential to prioritize the most recent and highest quality evidence to minimize morbidity, mortality, and improve quality of life. However, the provided evidence from 1 does not directly address the typical treatment of Staphylococcus epidermidis infections, but rather discusses the judicious use of glycopeptides in Belgium, highlighting the emergence of resistant pathogens like vancomycin-resistant enterococci (VRE) and vancomycin- or teicoplanin-resistant S. epidermidis.

Some key points to consider in the treatment of Staphylococcus epidermidis infections include:

• The bacterium's ability to form protective biofilms on surfaces, which can make it difficult to eradicate
• The frequent development of antibiotic resistance, particularly methicillin resistance
• The importance of antibiotic susceptibility testing to guide therapy
• The potential need for removal of infected medical devices, such as catheters or prosthetic joints, in cases involving biofilm formation.

Given the lack of direct evidence from 1 on the treatment of Staphylococcus epidermidis infections, a general approach to treatment might involve:

• Oral antibiotics for uncomplicated infections
• Intravenous antibiotics for more severe infections or those involving implanted medical devices
• Consideration of the potential need for longer treatment courses due to the bacterium's ability to form biofilms.

From the FDA Drug Label

Vancomycin Hydrochloride for Injection, USP has been used successfully in combination with either rifampin, an aminoglycoside, or both in early-onset prosthetic valve endocarditis caused by S. epidermidis or diphtheroids.

The typical treatment for a Staphylococcus epidermidis infection is with vancomycin 2, often in combination with other antibiotics such as rifampin or an aminoglycoside.

• Vancomycin is effective against S. epidermidis and is used to treat various infections, including endocarditis and prosthetic valve endocarditis.
• The treatment approach may involve combining vancomycin with other antibiotics to ensure effective treatment of the infection.

From the Research

Treatment of Staphylococcus epidermidis Infections

• Staphylococcus epidermidis is typically treated with vancomycin, which provides reliable bactericidal activity against this microorganism, including methicillin-resistant strains 3.
• Vancomycin is the treatment of choice for infections caused by methicillin-resistant staphylococci and for serious gram-positive infections in penicillin-allergic patients 3.
• However, with the emergence of multidrug-resistant S. epidermidis, alternative therapies such as ceftaroline may be considered 4.
• Ceftaroline has been shown to be effective against methicillin and linezolid-resistant S. epidermidis isolates 4.

Characteristics of Staphylococcus epidermidis Infections

• S. epidermidis is the most common cause of primary bacteremia and infections of indwelling medical devices 5.
• The ability of S. epidermidis to cause disease is linked to its natural niche on human skin and its ability to attach and form biofilm on foreign bodies 5.
• S. epidermidis produces a series of molecules that provide protection from host defenses, including exopolymers and phenol-soluble modulins (PSMs) 6.

Resistance to Antibiotics

• Multidrug-resistant S. epidermidis strains have been identified, with decreased susceptibility to vancomycin and other antibiotics 7.
• The mecA gene is commonly found in multidrug-resistant S. epidermidis strains, and other genes such as ant(4')-Ia, aac(6')/aph(2''), ermC, and tetK are also frequently detected 7.
• Heteroresistance to vancomycin is a significant therapeutic problem, and markers to identify these strains are needed to guide treatment decisions 7.