Staphylococcus epidermidis is a commensal bacterium of human skin and mucous membranes (1). The ability to establish biofilms on the surfaces of indwelling medical devices is a major virulence mechanism of this bacterium, which is the most commonly isolated etiological agent of nosocomial infections (2). S. epidermidis biofilm formation involves initial cellular adherence to a surface, followed by intercellular aggregation and accumulation in multilayer cell clusters (1). This process is dependent on adhesive extracellular molecules (3) such as poly-N-acetylglucosamine (PNAG). PNAG is a major factor mediating cell-to-cell adhesion in staphylococci (4, 5), and its production depends on genes encoded within the intercellular adhesion (ica) locus (6). The final stage of the biofilm life cycle comprises cell disassembly and subsequent growth in a planktonic mode, a process contributing to S. epidermidis biofilm pathogenesis by disseminating infection (7).S. epidermidis strains with impaired PNAG production display attenuated virulence in foreign body infection models (8, 9), while the production of this polysaccharide conferred a survival advantage on this bacterium infecting the nematode host Caenorhabditis elegans (10). Moreover, ica mutants display growth attenuation when competing in vivo with the corresponding wild-type (WT) strains (11) and commensal ica-negative strains became invasive when transformed with a plasmid containing the ica locus (12). In the clinical setting, the presence of icaA/D genes was associated with therapeutic failure in device-related infections with coagulase-negative staphylococci (13). Despite the observed association of PNAG production with S. epidermidis virulence, it is not entirely clear how this polysaccharide may affect the host immune response. Previous reports have shown that PNAG stimulates the production of proinflammatory mediators (14, 15) but also that it impairs phagocytosis and phagocyte-mediated bacterial killing (16-18). Additionally, little is known about the effects of this polysaccharide on acquired immunity. Here, by using the PNAG-producing S. epidermidis 9142 strain and a PNAG-negative isogenic M10 mutant, we have addressed in the murine model how this polysaccharide affected the host inflammatory response. The results obtained show that mice infected with a PNAG-producing S. epidermidis strain exhibited a more intense inflammatory response than mice infected with an isogenic PNAG-negative mutant.
MATERIALS AND METHODSBacteria and growth conditions. Biofilm-forming S. epidermidis strain 9142 (19) and the isogenic PNAG-negative M10 mutant (5) were used. Absence of growth defects in the M10 strain was confirmed, as the two strains had similar generation times, as determined by growing 9142 and M10 bacteria in tryptic soy broth (TSB; Merck, Darmstadt, Germany).