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Staphylococcus epidermidis and its dual lifestyle in skin health and infection

Nature Reviews Microbiology volume 21, pages 97–111 (2023)Cite this article

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Abstract

The coagulase-negative bacterium Staphylococcus epidermidis is a member of the human skin microbiota. S. epidermidis is not merely a passive resident on skin but actively primes the cutaneous immune response, maintains skin homeostasis and prevents opportunistic pathogens from causing disease via colonization resistance. However, it is now appreciated that S. epidermidis and its interactions with the host exist on a spectrum of potential pathogenicity derived from its high strain-level heterogeneity. S. epidermidis is the most common cause of implant-associated infections and is a canonical opportunistic biofilm former. Additional emerging evidence suggests that some strains of S. epidermidis may contribute to the pathogenesis of common skin diseases. Here, we highlight new developments in our understanding of S. epidermidis strain diversity, skin colonization dynamics and its multifaceted interactions with the host and other members of the skin microbiota.

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Fig. 1: The commensal lifestyle of Staphylococcus epidermidis.
Fig. 2: Staphylococcus epidermidis adhesion and biofilm formation.
Fig. 3: Staphylococcus epidermidis mediates skin homeostasis, barrier repair after injury and colonization resistance.
Fig. 4: Staphylococcus epidermidis competes with Cutibacterium acnes in the hair follicle.

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Acknowledgements

M.M.S. was supported by the National Institute of Allergy and Infectious Diseases (NIAID) Ruth L. Kirschstein National Research Award Predoctoral Fellowship AI157052. A.R.H. was supported by the NIAID grants AI153185 and AI162964 and the US Department of Veteran Affairs grant BX002711.

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  1. Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO, USA

    Morgan M. Severn & Alexander R. Horswill

  2. Department of Veterans Affairs, Eastern Colorado Healthcare System, Aurora, CO, USA

    Alexander R. Horswill

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M.M.S. researched data for the article. A.R.H. and M.M.S. contributed substantially to discussion of the content, wrote the article and reviewed and/or edited the manuscript before submission.

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Glossary

Stratum corneum

The topmost layer of the epidermis, composed of dead keratinocytes linked together in a ‘brick and mortar’ structure by extracellular lipids.

Coagulase

A polypeptide secreted by Staphylococcus aureus that promotes blood clotting and was historically used to distinguish this organism from less pathogenic coagulase-negative staphylococci (CoNS) for clinical identification.

Sortase

An enzyme that links surface proteins to the Gram-positive cell wall.

Corneocytes

Dead keratinocytes that compose the topmost layer of the epidermis.

Extracellular matrix

A structural support system within the dermal skin layer composed of various proteins including collagen and elastin.

Sphingomyelinase

A bacterial esterase, often implicated in virulence, that cleaves sphingomyelin.

Pangenome

The entire set of genes within a species, including conserved, core genes found in every strain and variable genes not conserved in every strain.

KEGG modules

Families of genes that are linked to specific cellular functions.

Phase variation

The reversible, heterogeneous switch in gene expression profiles within a clonal population of bacterial cells.

Plasmacytoid dendritic cells

(pDCs). A specialized subpopulation of dendritic cells involved in immunosurveillance and antigen recognition.

Corneodesmosomes

The major intercellular adhesives within the stratum corneum.

Netherton syndrome

A rare genetic disorder characterized by a mutation in a serine protease inhibitor that leads to severe, often life-threatening, skin abnormalities.

Bacteriocins

Ribosomally synthesized peptides made by many types of bacteria with varying mechanisms of antimicrobial activity.

Kin selection

The theory that genetic relatedness of a population of cells should lead to more cooperativity and increased fitness of that specific population.

Probiotics

Live microorganisms applied to re-regulate a dysbiotic community or actively exclude an opportunistic pathogen.

Prebiotics

Nutrients or other substrates added to alter species composition that favour select microbial growth and exclude opportunistic pathogens.

Postbiotic

Dead or otherwise inanimate bacteria or a bacterial product applied to promote skin barrier function.

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Severn, M.M., Horswill, A.R. Staphylococcus epidermidis and its dual lifestyle in skin health and infection. Nat Rev Microbiol 21, 97–111 (2023). https://doi.org/10.1038/s41579-022-00780-3

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