Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Mar 10;12(3):554.
doi: 10.3390/antibiotics12030554.

The Role of Coagulase-Negative Staphylococci Biofilms on Late-Onset Sepsis: Current Challenges and Emerging Diagnostics and Therapies

Angela França  1   2
Affiliations
Review

The Role of Coagulase-Negative Staphylococci Biofilms on Late-Onset Sepsis: Current Challenges and Emerging Diagnostics and Therapies

Angela França. Antibiotics (Basel). .

Abstract

Infections are one of the most significant complications of neonates, especially those born preterm, with sepsis as one of the principal causes of mortality. Coagulase-negative staphylococci (CoNS), a group of staphylococcal species that naturally inhabit healthy human skin and mucosa, are the most common cause of late-onset sepsis, especially in preterms. One of the risk factors for the development of CoNS infections is the presence of implanted biomedical devices, which are frequently used for medications and/or nutrient delivery, as they serve as a scaffold for biofilm formation. The major concerns related to CoNS infections have to do with the increasing resistance to multiple antibiotics observed among this bacterial group and biofilm cells' increased tolerance to antibiotics. As such, the treatment of CoNS biofilm-associated infections with antibiotics is increasingly challenging and considering that antibiotics remain the primary form of treatment, this issue will likely persist in upcoming years. For that reason, the development of innovative and efficient therapeutic measures is of utmost importance. This narrative review assesses the current challenges and emerging diagnostic tools and therapies for the treatment of CoNS biofilm-associated infections, with a special focus on late-onset sepsis.

Keywords: antibiotic resistance; antibiotic tolerance; biofilms; coagulase-negative staphylococci; diagnosis; late-onset sepsis; neonatal sepsis; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Summary of the several aspects contributing to the development of CoNS-caused infections in preterm infants. MSCRAMMS, microbial surface components recognizing matrix molecules; Atl, autolysins; TA, teichoic acids; eDNA, extracellular DNA; PNAG, poly-N-acetylglucosamine; HTG, horizontal gene transfer.
Figure 2
Figure 2
Schematics representing CoNS biofilm formation main steps and molecules involved. HTG, horizontal gene transfer; AMPs, antimicrobial peptides; MSCRAMMS, microbial surface components recognizing matrix molecules; Atl, autolysins; Embp, extracellular matrix binding protein; TA, teichoic acids; PNAG, poly-N-acetylglucosamine; eDNA, extracellular DNA; PSMs, phenol-soluble modulins.
Figure 3
Figure 3
Summary of some of the currently used methods used for diagnosis of LOS, along with advanced and under-development methods. Of note, the list of techniques detailed under “current diagnostic methods” includes methods that are normally used alone, such as blood culture and those that are used as “add-on” tests, such as biomarkers.
Figure 4
Figure 4
Summary of the current and under-development therapeutic methods for CoNS-associated infections, including LOS. The use of nanoparticles, as well as photoinactivation, which involves the use of visible light, a photosensitizer and oxygen to produce reactive oxygen species and free radicals that create oxidative stress in bacteria [158], have shown promising results in staphylococci biofilms, including methicillin-resistant S. aureus [268,269,270,276], but more studies are necessary to investigate their consequences on host cells.
See this image and copyright information in PMC

References

    1. Preterm Birth. [(accessed on 1 November 2022)]. Available online: https://www.who.int/news-room/fact-sheets/detail/preterm-birth.
    1. Liu L., Oza S., Hogan D., Chu Y., Perin J., Zhu J., Lawn J.E., Cousens S., Mathers C., Black R.E. Global, Regional, and National Causes of under-5 Mortality in 2000–15: An Updated Systematic Analysis with Implications for the Sustainable Development Goals. Lancet. 2016;388:3027–3035. doi: 10.1016/S0140-6736(16)31593-8. - DOI - PMC - PubMed
    1. Schlapbach L.J., Aebischer M., Adams M., Natalucci G., Bonhoeffer J., Latzin P., Nelle M., Bucher H.U., Latal B., Zeilinger G., et al. Impact of Sepsis on Neurodevelopmental Outcome in a Swiss National Cohort of Extremely Premature Infants. Pediatrics. 2011;128:e348–e357. doi: 10.1542/peds.2010-3338. - DOI - PubMed
    1. Fleischmann-Struzek C., Goldfarb D.M., Schlattmann P., Schlapbach L.J., Reinhart K., Kissoon N. The Global Burden of Paediatric and Neonatal Sepsis: A Systematic Review. Lancet. Respir. Med. 2018;6:223–230. doi: 10.1016/S2213-2600(18)30063-8. - DOI - PubMed
    1. James S.L., Abate D., Abate K.H., Abay S.M., Abbafati C., Abbasi N., Abbastabar H., Abd-Allah F., Abdela J., Abdelalim A., et al. Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 354 Diseases and Injuries for 195 Countries and Territories, 1990-2017: A Systematic Analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789–1858. doi: 10.1016/S0140-6736(18)32279-7. - DOI - PMC - PubMed