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Abstract
Background Biofilms are considered the key factor in the development of implant-related infections. However, only a few reports have dealt with the ability of organisms isolated from such infections to develop biofilms in vitro.
Methods We evaluated different phenotypic techniques (2 microtiter plate assays and confocal laser scanning microscopy (CLSM) and genotypic techniques (detection of the ica operon) related to biofilm development by clinical isolates of Staphylococcus spp.
Results All 26 strains tested (from 23 specimens) were biofilm producers. Stepanovic test detected biofilm formation in 85% of the strains, microtiter plate assay in 65%, and CLSM in 39%. The ica operon was detected in 73% of all strains (all 13 S. aureus strains and 6 of the 13 coagulase-negative Staphylococcus strains). 7 ica-negative strains were biofilm-positive by phenotypic methods.
Interpretation The detection of ica genes could not be related to the phenotypic ability of the strains to develop a biofilm in vitro, so both studies (genetic and phenotypic) are required for a better evaluation of the biofilm-producing ability of clinical strains of Staphylococcus isolated from orthopedic infections.
JE designed and coordinated the study, and participated in both analysis of the results and editing of the manuscript. DMM performed the phenotypic characterization and participated in editing of the manuscript. IS designed the genetic study, evaluated the results, and participated in editing of the manuscript. JCA and EGB diagnosed the patients, performed the surgery, and collaborated in the data analysis and in the editing of the manuscript. RFR participated in analysis of the results and in editing of the manuscript. AF performed the genetic characterization study.
This work was funded by grants from the CICyT (MAT2006-12603-CO2-O2), Comunidad de Madrid (S-0505/MAT/0324), and from the CONSOLIDER-INGENIO program (FUNCOAT-CSD2008-00023). DMM was funded by a grant from the Fundación Conchita Rábago de Jiménez Díaz.
No competing interests declared.