Current perspectives on the regulation of the Ica operon and biofilm formation in Staphylococcus epidermidis

Staphylococcus epidermidis is a ubiquitous commensal found on the skin of humans and other mammals. However, due to an increase in invasive medical practices, S. epidermidis has become the most common pathogen isolated from blood in intensive care unit patients in the United States (1,2). The noted increase of S. epidermidis infections in seriously ill patients can be attributed to the ability of this organism to adhere to and form biofilm on the surface of biomaterials, including catheters. The molecular structure of staphylococcal biofilm and the genetics behind its production and regulation have been an active area of research since the early 1980s. This review will focus on loci that have recently been demonstrated to regulate the ica operon, the four gene operon that produces enzymes that synthesize staphylococcal biofilm, or polysaccharide intercellular adhesin (PIA).