A 1-Year-Old Boy Is Brought to the Emergency Department by His

A 1-year-old boy is brought to the emergency department by his mother because of high fever, irritability, and photophobia.  He recently underwent ventriculoperitoneal shunt placement for congenital hydrocephalus.  On physical examination, his temperature is 38.3° C (101° F) , and passive flexion of the neck results in spontaneous flexion of the hips and knees.  Blood cultures grow coagulase-negative Staphylococcus.  Which of the following is the most important virulence mechanism by which this bacterium causes disease?

A) Intracellular existence
B) Outer polysaccharide capsule
C) Presence of protein A on the cell wall
D) Release of exotoxins
E) Synthesis of an extracellular polysaccharide matrix

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