Virulence factors of biotypes of Staphylococcus epidermidis from clinical sources.

The biotyping scheme of Baird-Parker was applied to cultures of Staphylococcus epidermidis from patients. In all, 63.6% of 228 cultures belonged to biotype 1, followed by biotypes 4, 3, and 2 in decreasing order of incidence. When classified according to clinical source of isolation, cultures of S. epidermidis were most frequently isolated from urine, with 39.5% of 228 cultures from this source. Each of the four biotypes was distributed throughout all nine catagories of clinical sources. The production of virulence factors was based on the results of three groups of tests: (i) deoxyribonuclease, urease, gelatinase, caseinase, and lysozyme production; (ii) lipolytic activity on the tweens; and (iii) hemolysin production. Enzymatic activity was highest for organisms in biotypes 1, followed by biotypes 3, 4, and 2 in decreasing order. Of the 228 cultures, 76.3% were lysed by lysostaphin. Resistance to antibiotics was highest for tetracycline, ampicillin, and penicillin, with rates of 54.8, 69.3, and 81.6%, respectively. The role of S. epidermidis as an etiological agent was studied by analyzing the laboratory and clinical data of 80 patients selected at random with bacteriuric S. epidermidis. Organisms in biotype 1 were most commonly associated with urinary tract infection. The significance of certain biotypes of S. epidermidis as opportunistic pathogens among compromised hosts in a hospital environment is discussed.