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Staphylococcus aureus  is an important pathogen that forms biofilms on the surfaces of medical implants. Biofilm formation by  S .  aureus  is associated with the production of poly  N -acetylglucosamine (PNAG), also referred to as polysaccharide intercellular adhesin (PIA), which mediates bacterial adhesion, leading to the accumulation of bacteria on solid surfaces. This study shows that the ability of  S .  aureus  SA113 to adhere to nasal epithelial cells is reduced after the deletion of the  ica  operon, which contains genes encoding PIA/PNAG synthesis. However, this ability is restored after a plasmid carrying the entire  ica  operon is transformed into the mutant strain,  S .  aureus  SA113Δ ica , showing that the synthesis of PIA/PNAG is important for adhesion to epithelial cells. Additionally,  S .  carnosus  TM300, which does not produce PIA/PNAG, forms a biofilm and adheres to epithelial cells after the bacteria are transformed with a PIA/PNAG-expressing plasmid, pTX icaADBC . The adhesion of  S .  carnosus  TM300 to epithelial cells is also demonstrated by adding purified exopolysaccharide (EPS), which contains PIA/PNAG, to the bacteria. In addition, using a mouse model, we find that the abscess lesions and bacterial burden in lung tissues is higher in mice infected with  S .  aureus  SA113 than in those infected with the mutant strain,  S .  aureus  SA113Δ ica . The results indicate that PIA/PNAG promotes the adhesion of  S .  aureus  to human nasal epithelial cells and lung infections in a mouse model. This study elucidates a mechanism that is important to the pathogenesis of  S .  aureus  infections.

Elucidating the Crucial Role of Poly N-Acetylglucosamine from Staphylococcus aureus in Cellular Adhesion and Pathogenesis