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=== Virulence factors ===
[[File:Stained Staphylococcus epidermidis.jpg|thumb|''Staphylococcus epidermidis'' stained by safranin.(x1000)]]

==== Biofilm formation ====
''S. epidermidis'' causes biofilms to grow on plastic devices placed within the body.<ref name="Otto">{{cite journal | vauthors = Otto M | title = Staphylococcus epidermidis--the 'accidental' pathogen | journal = Nature Reviews. Microbiology | volume = 7 | issue = 8 | pages = 555–567 | date = August 2009 | pmid = 19609257 | pmc = 2807625 | doi = 10.1038/nrmicro2182 }}</ref> This occurs most commonly on intravenous [[catheter]]s and on medical [[prostheses]].<ref>{{cite journal | vauthors = Hedin G | title = Staphylococcus epidermidis--hospital epidemiology and the detection of methicillin resistance | journal = Scandinavian Journal of Infectious Diseases. Supplementum | volume = 90 | pages = 1–59 | date = 1993 | pmid = 8303217 }}</ref> Infection can also occur in dialysis patients or anyone with an implanted plastic device that may have been contaminated. It also causes [[endocarditis]], most often in patients with defective heart valves. In some other cases, [[sepsis]] can occur in hospital patients. {{citation needed|date=November 2013}}

The ability to form [[biofilm]]s on plastic devices is a major virulence factor for ''S. epidermidis''. One probable cause is surface proteins that bind blood and extracellular matrix proteins. It produces an extracellular material known as polysaccharide intercellular adhesin (PIA), which is made up of sulfated [[polysaccharide]]s. It allows other bacteria to bind to the already existing biofilm, creating a multilayer biofilm. Such biofilms decrease the metabolic activity of bacteria within them. This decreased metabolism, in combination with impaired diffusion of antibiotics, makes it difficult for antibiotics to effectively clear this type of infection.<ref name="Salyers" />

Antibiotics are largely ineffective in clearing biofilms. The most common treatment for these infections is to remove or replace the infected implant, though in all cases, prevention is ideal. The drug of choice is often [[vancomycin]], to which [[rifampin]] or an [[aminoglycoside]] can be added.{{Citation needed|date=July 2011}} Hand washing has been shown to reduce the spread of infection.

==== Antibiotic resistance ====
''S. epidermidis'' strains are often [[Antimicrobial resistance|resistant to antibiotics]], including [[rifamycin]], [[fluoroquinolones]], [[gentamicin]], [[tetracycline]], [[clindamycin]], and [[sulfonamide]]s.<ref name="Otto" /> [[Methicillin]] resistance is particularly widespread, with 75-90% of hospital isolates resistance to methicillin.<ref name="Otto" /> Resistant organisms are most commonly found in the intestine, but organisms living on the skin can also become resistant due to routine exposure to antibiotics secreted in sweat.{{citation needed|date=February 2023}}