Potential Role of Coagulase-negative Staphylococcus Infection in Preterm Brain Injury

Abstract

Bacterial infection induces inflammatory responses that can be protective but may also lead to host tissue injury. Indeed, in animal models direct introduction of bacteria to the central nervous system induces inflammation, apoptosis and neurologic sequelae. Preterm newborns are at particular risk of neurologic injury. The most common cause of bloodstream infection (bacteremia) in preterm newborns are coagulase-negative staphylococci (CONS), especially Staphylococcus epidermidis (SE). SE expresses multiple Toll-like receptor 2 (TLR2) agonists and systemic TLR2 activation can result in brain injury in newborn mice. Herein we summarize evidence based on epidemiologic and immunologic studies that raise the hypothesis that SE infection and associated systemic inflammation may contribute to neonatal brain injury.