The organism produces slime layers, which forms a hydrophobic biofilm. This film is adhesive to hydrophobic biopolymers of prosthetics, creating diseases such as endocarditis. The gene icaADBC has been found to code for both the polysaccharide capsule and the polysaccharide intracellular adhesin used in biofilm formation. The biofilm of S. epidermidis consists of clusters of cells that are embedded in extracellular slime substance that is up to 160 micrometers thick, exceeding 50 cells. Biofilms as such act as a diffusion barrier to antibiotics and host defense. (Nilsson, et al. 1998)
Another potential virulence factor that’s currently being researched is the fibrinogen binding of S. epidermidis. The complete gene, termed fbe, was found to consist of an open reading frame of 3,276 nucleotides encoding a protein, called Fbe, with a deduced molecular mass of ~119 kDa. (Nilsson, et al. 1998) Implant biomaterials are instantly covered by circulating plasma components, like Fibrinogen, promoting adhesion of host cells. One complication that may arise is when contaminating bacteria adhere to the same components on the biomaterial surfaces, leading to infection. (Nilsson, et al. 1998)
While there is much research regarding S. epidermidis’ virulence factor, little has been done to understand its mode of action.