From the Guidelines
Staphylococcus epidermidis infections should be treated with vancomycin as the standard therapy, according to the most recent and highest quality evidence available 1.
Key Considerations
- Staphylococcus epidermidis is a common cause of opportunistic infections, particularly in patients with implanted medical devices or compromised immune systems.
- The bacterium has become increasingly resistant to antibiotics, with a high percentage of hospital strains showing methicillin resistance.
- Treatment duration and approach may vary depending on the complexity of the infection, ranging from 7-14 days for simple infections to 4-6 weeks for more complex cases.
Treatment Options
- Vancomycin is the recommended standard therapy for Staphylococcus epidermidis infections, as indicated in the guidelines 1.
- Alternative therapies, such as linezolid, may be considered in certain cases, but vancomycin remains the primary choice.
Important Factors
- The ability of Staphylococcus epidermidis to form biofilms on medical devices can make these infections challenging to treat, often requiring device removal in addition to antibiotic therapy.
- The increasing resistance of Staphylococcus epidermidis to antibiotics highlights the need for careful selection of antimicrobial agents and consideration of susceptibility testing results 1.
From the Research
Staphylococcus Epidermidis Characteristics
- Staphylococcus epidermidis is considered the most frequent cause of nosocomial infections and indwelling medical device-associated infections 2.
- One of the key features contributing to its success as a pathogen is its ability to form biofilms, which makes cells more resistant to antimicrobials 2, 3.
- S. epidermidis is the leading cause of infection related to implanted medical devices (IMDs) due to its capability to establish multilayered, highly structured biofilms on artificial surfaces 3.
Treatment and Management
- Vancomycin is often the treatment of choice for infections caused by methicillin-resistant staphylococci, including S. epidermidis, and for serious gram-positive infections in penicillin-allergic patients 4, 5.
- Other treatment options may include teicoplanin, daptomycin, oxazolidinones, long-acting lipoglycopeptides, and ceftaroline, depending on the clinical setting 5.
- For patients with S. epidermidis infections associated with an indwelling device, assessing whether the device warrants removal is an important component of management 5.
Resistance and Challenges
- Methicillin-resistant S. epidermidis infections are a significant concern, with the proportion of methicillin resistance reported to be as high as 92% 5.
- Decreased vancomycin susceptibility in S. epidermidis isolates has been observed, making therapy challenging, especially in fragile patients such as those in neonatal intensive care units 6.
- Understanding the distinction between colonization and bloodstream infection caused by S. epidermidis remains a challenge for clinicians, requiring consideration of various parameters such as symptoms, comorbidities, and the presence of medical devices 5.