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Staphylococcus aureus
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===Medical implant infections=== ''Staphylococcus aureus'' is often found in [[biofilm]]s formed on medical devices implanted in the body or on human tissue. It is commonly found with another pathogen, ''[[Candida albicans]]'', forming multispecies biofilms. The latter is suspected to help ''S. aureus'' penetrate human tissue.<ref name="pmid25332378"/> A higher mortality is linked with multispecies biofilms.<ref>{{cite journal | vauthors = Zago CE, Silva S, SanitΓ‘ PV, Barbugli PA, Dias CM, Lordello VB, Vergani CE | title = Dynamics of biofilm formation and the interaction between Candida albicans and methicillin-susceptible (MSSA) and -resistant ''Staphylococcus aureus'' (MRSA) | journal = PLOS ONE | volume = 10 | issue = 4 | pages = e0123206 | year = 2015 | pmid = 25875834 | pmc = 4395328 | doi = 10.1371/journal.pone.0123206 | doi-access = free | bibcode = 2015PLoSO..1023206Z }}</ref> ''Staphylococcus aureus'' biofilm is the predominant cause of orthopedic implant-related infections, but is also found on cardiac implants, [[Vascular bypass|vascular grafts]], various [[catheter]]s, and cosmetic surgical implants.<ref name=":1">{{cite journal | vauthors = Nandakumar V, Chittaranjan S, Kurian VM, Doble M | date = 2013 | title = Characteristics of bacterial biofilm associated with implant material in clinical practice |journal=Polymer Journal|volume=45|issue=2|pages=137β152|doi=10.1038/pj.2012.130 | doi-access = free }}</ref><ref name="Archer_2011">{{cite journal | vauthors = Archer NK, Mazaitis MJ, Costerton JW, Leid JG, Powers ME, Shirtliff ME | title = ''Staphylococcus aureus'' biofilms: properties, regulation, and roles in human disease | journal = Virulence | volume = 2 | issue = 5 | pages = 445β459 | date = 1 September 2011 | pmid = 21921685 | pmc = 3322633 | doi = 10.4161/viru.2.5.17724 }}</ref> After implantation, the surface of these devices becomes coated with host proteins, which provide a rich surface for bacterial attachment and biofilm formation. Once the device becomes infected, it must be completely removed, since ''S. aureus'' biofilm cannot be destroyed by antibiotic treatments.<ref name="Archer_2011"/> Current therapy for ''S. aureus'' biofilm-mediated infections involves surgical removal of the infected device followed by antibiotic treatment. Conventional antibiotic treatment alone is not effective in eradicating such infections.<ref name=":1" /> An alternative to postsurgical antibiotic treatment is using antibiotic-loaded, dissolvable calcium sulfate beads, which are implanted with the medical device. These beads can release high doses of antibiotics at the desired site to prevent the initial infection.<ref name="Archer_2011"/> Novel treatments for ''S. aureus'' biofilm involving nano silver particles, [[bacteriophage]]s, and plant-derived antibiotic agents are being studied. These agents have shown inhibitory effects against ''S. aureus'' embedded in biofilms.<ref>{{cite journal | vauthors = Chung PY, Toh YS | title = Anti-biofilm agents: recent breakthrough against multi-drug resistant ''Staphylococcus aureus'' | journal = Pathogens and Disease | volume = 70 | issue = 3 | pages = 231β9 | date = April 2014 | pmid = 24453168 | doi = 10.1111/2049-632x.12141 | doi-access = free }}</ref> A class of [[Enzyme|enzym]]es have been found to have biofilm matrix-degrading ability, thus may be used as biofilm dispersal agents in combination with antibiotics.<ref>{{cite journal | vauthors = Hogan S, Zapotoczna M, Stevens NT, Humphreys H, O'Gara JP, O'Neill E | title = Potential use of targeted enzymatic agents in the treatment of ''Staphylococcus aureus'' biofilm-related infections | journal = The Journal of Hospital Infection | volume = 96 | issue = 2 | pages = 177β182 | date = June 2017 | pmid = 28351512 | doi = 10.1016/j.jhin.2017.02.008 }}</ref>
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