New considerations in the pathogenesis of coagulase-negative staphylococcal foreign body infections.

Coagulase-negative staphylococci are the predominant cause of foreign body infections. The pathogenesis is related to the ability of these staphylococci to adhere to and grow on polymer surfaces and to produce an extracellular slime substance. The exact chemical nature of this extracellular slime substance is still not known, although there is some evidence that it may be a complex glycoconjugate. On the basis of in-vitro and animal data, the extracellular slime substance seems to interfere with various host-protective mechanisms and with the action of antistaphylococcal antibiotics. These factors can explain several clinical characteristics of coagulase-negative staphylococcal foreign body infections.