SdrF, a Staphylococcus epidermidis Surface Protein, Contributes to the Initiation of Ventricular Assist Device Driveline–Related Infections

PLoS Pathogens

Yoshifumi Naka¹  Hirokazu Akashi¹  Mario C. Deng²  Manuel von Bayern²  Faustino A. Toba³  Carlos Arrecubieta³  Franklin D. Lowy³ 

[1]Department of Surgery, New York Presbyterian Hospital, Columbia University, New York, New York, United States of America

[2]Division of Cardiology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America

[3]Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America

关键词: Staphylococcus epidermidis;    Lactococcus lactis;    Animal models of infection;    Prosthetic device infections;    Staphylococcal infection;    Collagens;    Polystyrene;    Recombinant proteins;   

DOI  :  10.1371/journal.ppat.1000411

学科分类：生物科学（综合）

来源: Public Library of Science

【 摘 要 】

Staphylococcus epidermidis remains the predominant pathogen in prosthetic-device infections. Ventricular assist devices, a recently developed form of therapy for end-stage congestive heart failure, have had considerable success. However, infections, most often caused by Staphylococcus epidermidis, have limited their long-term use. The transcutaneous driveline entry site acts as a potential portal of entry for bacteria, allowing development of either localized or systemic infections. A novel in vitro binding assay using explanted drivelines obtained from patients undergoing transplantation and a heterologous lactococcal system of surface protein expression were used to identify S. epidermidis surface components involved in the pathogenesis of driveline infections. Of the four components tested, SdrF, SdrG, PIA, and GehD, SdrF was identified as the primary ligand. SdrF adherence was mediated via its B domain attaching to host collagen deposited on the surface of the driveline. Antibodies directed against SdrF reduced adherence of S. epidermidis to the drivelines. SdrF was also found to adhere with high affinity to Dacron, the hydrophobic polymeric outer surface of drivelines. Solid phase binding assays showed that SdrF was also able to adhere to other hydrophobic artificial materials such as polystyrene. A murine model of infection was developed and used to test the role of SdrF during in vivo driveline infection. SdrF alone was able to mediate bacterial adherence to implanted drivelines. Anti-SdrF antibodies reduced S. epidermidis colonization of implanted drivelines. SdrF appears to play a key role in the initiation of ventricular assist device driveline infections caused by S. epidermidis. This pluripotential adherence capacity provides a potential pathway to infection with SdrF-positive commensal staphylococci first adhering to the external Dacron-coated driveline at the transcutaneous entry site, then spreading along the collagen-coated internal portion of the driveline to establish a localized infection. This capacity may also have relevance for other prosthetic device–related infections.

【 授权许可】

CC BY