Pathogenesis and management of Staphylococcus epidermidis 'plastic' foreign body infections.

Staphylococcus epidermidis infections on foreign bodies made of plastic are caused by special and complex mechanisms. The staphylococcal cells are able to adhere to and grow on polymer surfaces in vivo and in vitro. In the course of colonization they produce an extracellular substance ('slime') which eventually covers them. It is thought that the staphylococcal slime has several biological functions, including promoting adhesion and protection against both antibiotics and host defence mechanisms. In patients, the removal of a colonized device should be accompanied by the parenteral administration of highly effective antistaphylococcal drugs, such as vancomycin.