{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:19:26Z","timestamp":1790893166391,"version":"4.1.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>Medical device-associated infections represent a significant healthcare challenge, as sterilization of the biomaterial often necessitates device removal. The most frequently isolated microorganism in these infections is <jats:italic>Staphylococcus epidermidis<\/jats:italic>, a skin commensal capable of causing a wide range of nosocomial infections. The primary virulence factor of <jats:italic>S. epidermidis<\/jats:italic> is biofilm formation, which decreases antibiotic efficacy and host immune response. However, additional factors play crucial roles in infection establishment. Understanding the interplay between virulence factors is essential to developing preventive strategies that inhibit microbial adhesion and biofilm development. In this study, we analyzed the presence of genes associated with adhesion and biofilm formation (<jats:italic>ica<\/jats:italic>-dependent and <jats:italic>ica<\/jats:italic>-independent pathways) in 25 clinical isolates of <jats:italic>S. epidermidis<\/jats:italic> and four control strains: ATCC 12228, ATCC 35983, ATCC 35984, and the HAM 892 mutant. Resistance profile was determined, and biofilm quantification and composition of matrix was performed using multiple methodologies. Additionally, parameters associated with initial adherence as cell surface hydrophobicity (CSH) were investigated. A strong correlation was observed among different methods for measuring biofilm formation and matrix composition. The 14 <jats:italic>icaADBC<\/jats:italic>+ isolates exhibited higher prevalence of the <jats:italic>aap<\/jats:italic>, <jats:italic>bhp<\/jats:italic>, <jats:italic>mecA<\/jats:italic>, and <jats:italic>IS256<\/jats:italic> genes, with polysaccharide intercellular adhesin (PIA) identified as the main matrix component. In contrast, <jats:italic>icaADBC<\/jats:italic>\u2212 biofilm-producing strains formed biofilms rich in other polysaccharides and proteins. The 15 non-biofilm-producing isolates showed significantly higher hydrophobicity levels, suggesting that this factor plays a critical role in initial adhesion and colonization. This study highlights the diverse mechanisms underlying biofilm formation in <jats:italic>S. epidermidis<\/jats:italic> and identifies hydrophobicity as a potential pathogenicity factor contributing to its virulence.<\/jats:p>","DOI":"10.3389\/fcimb.2025.1630341","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T05:31:33Z","timestamp":1754458293000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Biofilm formation and role of other pathogenic factors in the virulence of Staphylococcus epidermidis clinical isolates"],"prefix":"10.3389","volume":"15","author":[{"given":"Mar\u00eda Coronada","family":"Fern\u00e1ndez-Calder\u00f3n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Fern\u00e1ndez-Babiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Luisa","family":"Navarro-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Pazos-Pacheco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Calvo-Cano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.18683\/germs.2019.1159","article-title":"Frequency of icaA and icaD determinants and biofilm formation among coagulase-negative staphylococci associated with nasal carriage in neonatal intensive care units","volume":"9","author":"Ahmed","year":"2019","journal-title":"Germs"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4117","DOI":"10.1016\/j.biomaterials.2003.11.027","article-title":"Search for the insertion element IS256 within the ica locus of Staphylococcus epidermidis clinical isolates collected from biomaterial-associated infections","volume":"25","author":"Arciola","year":"2004","journal-title":"Biomaterials"},{"key":"B3","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1007\/s10096-006-0130-2","article-title":"Coagulase-negative staphylococci in very-low-birth-weight infants: inability of genetic markers to distinguish invasive strains from blood culture contaminants","volume":"25","author":"Bradford","year":"2006","journal-title":"Eur. 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