Infective endocarditis despite advances in diagnosis remains a common cause of hospitalization, with high morbidity and mortality rates. Through literature review it is possible to conclude that polymicrobial endocarditis occurs mainly in intravenous drug abusers with predominance in the right side of the heart, often with tricuspid valve involvement. This fact can be associated with the type of drug used by the patients; therefore, knowledge of the patient's history is critical for adjustment of the therapy. It is also important to emphasize that the most common combinations of organisms in polymicrobial infective endocarditis are: Staphylococcus aureus, Streptococcus pneumonia and Pseudomonas aeruginosa, as well as mixed cultures of Candida spp. and bacteria. A better understanding of the epidemiology and associated risk factors are required in order to develop an efficient therapy, although PE studies are difficult to perform due to the rarity of cases and lack of prospective cohorts.

The aim of the present study was to compare the ability of eight Staphylococcus epidermidis strains to adhere to acrylic and silicone, two polymers normally used in medical devices manufacture. Furthermore, it was tried to correlate that with the surface properties of substrata and cells. Therefore, hydrophobicity and surface tension components were calculated through contact angle measurements. Surface roughness of substrata was also assessed by atomic force microscopy (AFM). No relationship was found between microbial surface hydrophobicity and adhesion capability. Nevertheless, Staphylococcus epidermidis IE214 showed very unique adhesion behaviour, with cells highly aggregated between them, which is a consequence of their specific surface features. All strains, determined as being hydrophilic, adhered at a higher extent to silicone than to acrylic, most likely due to its more hydrophobic character and higher roughness. This demonstrates the importance of biomaterial surface characteristics for bacterial adhesion.

As a result of their hydrophobicity, the extended wear silicone-hydrogel lenses (lotrafilcon A and balafilcon A) may carry higher risk of microbial contamination than both the hydrophilic daily wear silicone-hydrogel lens, galyfilcon A and the conventional hydrogel lens, etafilcon A.