User:Kjudith13/Staphylococcus epidermidis

Role in Skin Health
Staphylococcus Epidermidis is an essential part of a healthy skin microbiota. It contributes through supporting a healthy skin barrier, healing cuts of the skin, protecting the skin microbiota from colonization of skin pathogens, and acting as an immune system modulator.

Skin Barrier Reinforcement
Commensal S. epidermidis also has been shown to contribute to skin barrier homeostasis through the generation of protective ceramides, which helps maintain the integrity of the skin barrier. By modulating the moist, inner lining of some organs and body cavities and their specific immune defense mechanisms, skin commensals interact with infectious agents like pathogens. Sphingomyelin phosphodiesterase is the main driver in the S. epidermidis production of ceramides - a lipid that includes sphingosine and sphingosine-1-phosphate. This lipid, both obtains nutrients essential for bacteria and helps the host in the production of ceramides. Ceramides are important components of the epithelial barrier, and they play a key role in preventing skin from losing moisture; this acts as a protectant and averts against both dehydration and aging of the skin.

Metabolic Pathway Interaction
S. epidermidis plays a key role in metabolic processes that influence skin conditions. The bacterium can affect biochemical pathways within skin cells, which can impact skin health and disease states. Specifically, this is seen in the modulation of the Aryl Hydrocarbon Receptor (AHR).

In non-atopic skin, S. epidermidis will help communicate the activation of the AHR pathway, which both enhances the skin barrier function and helps reduce inflammation. Atopic skin will usually have the inverse effect by acting as a blocker of this pathway and possibly making the skin issue worse.

Immune Response
Commensal S. epidermidis also influences the skin’s immune response. Through interacting with a host’s immune cells, the skin’s mucosal immune defense against various pathogens is strengthened. The skin commensal will directly interfere with harmful pathogens.

In the case of S. aureus, S. epidermidis may amplify the innate immune response by causing a reaction of keratinocytes (the most prominent cells within the epidermis) toward this pathogen.

S. epidermidis produces molecules such as lipoteichoic acid (LTA), cell wall polysaccharides, peptidoglycan and aldehyde dipeptides which are recognized by toll-like receptors (TLRs) as molecules that modulate the immune response. These immunomodulatory molecules create a relationship between bacteria and keratinocytes and have a significant impact in the modulation of the innate immune response, mainly because of their interactions with TLRs.

Diagnostic Methods and Technologies
Over time, there have been different diagnostic methods or technologies used for detecting Staphylococcus epidermidis infections to improve the overall accuracy and timeliness of detection ranging from more traditional methods to more recent strategies involving technology.

Traditional Methods
Some traditional methods related to laboratory diagnoses are bacterial colony identification, microbiological culture, biochemical tests, and Gram staining. Along with that, there are also molecular diagnostic approaches such as PCR and nucleic acid hybridization which are widely used in modern diagnostic laboratories, point-of-care assays which includes assays for detecting S. epidermidis infections at the bedside or in outpatient environments, and multiplex PCR assays allowing for simultaneous detection of multiple pathogens and leading to improved efficiency and sensitivity. Through these conventional diagnostic methods and detection systems, valuable information is provided about the presence of S. epidermidis and aid in identifying the strain causing the infection. Furthermore, this information is also significant in determining the appropriate treatment strategy, as various types of strains have differing reactions to antibiotics.

Recent Advancements
Over time, as technology has become more advanced, some recent detection systems have emerged rendering the detection process to become more convenient and effective. One process involves the usage of biosensors and point-of-care devices which have led to the development of rapid diagnostic tests for detecting infections at the point of care. With these devices, specific biomarkers or antibodies are used for detection and can produce results within a short period of time, thus proving beneficial for timely clinical decisions.

Furthermore, other devices such as microfluidic devices are also utilized in some processes, offering automated systems conducive for processing and analyzing samples. With these microfluidic devices, it is possible to streamline diagnostic workflows, improve specificity and sensitivity for detecting infections, and reduce sample volumes. Approaches related to artificial intelligence and machine learning are also used which are beneficial in interpreting diagnostic test results and analyzing datasets to identify patterns and predict outcomes. With the usage of these technologies, it can lead to an improved sense of accuracy and efficiency within the overall detection process. These advancements also have the potential to enhance patient care through a more rapid and accurate diagnosis and resulting in a timely decision for treatment.

In Situ Hybridization
An in situ hybridization technique is a recent advancement within detection systems involving targeting particular microbial RNA sequences and aiding in a direct visualization process of staphylococci within tissue samples. This system detects biofilm-forming staphylococci and small-colony phenotypes thus demonstrating its potential to help diagnose cases of medical device-associated infections that may be more challenging to identify with other methods. Through this process, identification of staphylococcal species such as Staphylococcus epidermidis, especially within tissue samples, can be improved. Recent advancements aided by technology such as this technique provide opportunities for improving the overall efficiency and accuracy of detecting Staphylococcus epidermidis infections especially in situations where more conventional microbiological methods may have vague or inconclusive outcomes.

Public Health Implications
Staphylococcus epidermidis is closely related to infective endocarditis, which affects both prosthetic and natural heart valves, as it is one of most commonly known culprits for infective endocarditis. Close to 40% of prosthetic valve endocarditis are attributed to coagulase-negative staphylococci. Once infected, symptoms such as: fever, cardiac murmurs, splinter hemorrhages, chills, night sweats, etc.

Economic and Healthcare Impacts
On patients with medical implants, specifically those who were infected with a biofilm-associated infection, it was most likely that the infection had been due to Staphylococcus epidermidis. . These cases of infection due to S. epidermidis have been seen often in healthcare settings as it is considered a significant nosocomial pathogen in healthcare settings for more than 30 years. It is believed that the extent to which S. epidermidis is undermined and causes a negligence on enforcing better quality in health care settings. Furthermore, the effects of S. epidermidis does not stop there as patients who are infected have to surgically removed the infected device or tissue. This treatment has cost up to $2 billion dollars in the US alone per year for treatment on these kinds of infections.

Ultimately, these effects from S. epidermidis are often overlooked and will continue to do so unless measures are put in place to ensure that these kinds of cases of infections due to S. epidermidis go down.