# Biology and Regulation of Staphylococcusococcal Biofilm  
[PERSON]  
1 Genomic Research Laboratory, Service of Infectious Diseases, Geneva and University Hospitals, 1205 Geneva, Switzerland 12B  
growth rates and metabolic activity, yielding a limited efficiency of the antibiotics that target cell-wall biosynthesis while the reduced oxidative metabolism limits the access of aminoglycos to their target [18]. Biomaterials implanted for a prolonged period of time, such as durable catheters and orthopedic implants, are frequent sources of sepsis and infections, mainly due to slime-producing and biofilm-forming bacteria. Thus, a question arose with respect to the development of materials that demonstrate a reduced incidence of biofilm formation. It was rapidly noticed that bacterial adhesion (attachment) is the first step in biofilm formation, and various methods have been developed to assess adherence and biofilm formation on a given polymer surface. A brief overview was presented in the review by [PERSON] and [PERSON] [19]. Here, the authors showed that coagulase-negative staphylococci and _S. aureus_ can bind to almost any implanted material composed of plastic, stainless steel, or titanium (see Table 1). Bacterial adhesion is not dependent on surface type, whether smooth or textured; or on the polymeric composition of the implant material, whether silicone or polyurethane; nor is it dependent on the presence or absence of slime. Bacterial adhesion to biomaterials is a general process that is most likely due to many surface components. With the help of a green fluorescent protein (gfp) reporter plasmid in _S. aureus_[20], adhesion and biofilm formation were investigated on various surfaces (Figure 1). Glass slides were coated with three different materials used as medical devices: titanium, cobalt, and Teflon [21]. As shown, _S. aureus_ adhered and formed a biofilm even on titanium, the most frequently used material for hip prosthesis. It also adhered and formed a film on cobalt surfaces, while the adherence to Teflon was less pronounced. \begin{table}
\begin{tabular}{c c} \hline \hline
**Materials of Prosthetic Devices** & **References** \\ \hline Poly-ethylenetetraphtalate, poly-propylene amorphous. silicone rubber, poly-tetrafluoroethylene, poly-propylene crystalline, poly-vinylidine fluoride, polyester urethane, polyethylene, cellulose acetate, polycarbonate, polyester urethane & [22] \\ \hline Pacemaker lead & [23] \\ \hline Cyanoacrylate (n-butyl-2-cyanoacrylate) & [24] \\ Tissue adhesive/Robbins device & [25] \\ \hline Surgical-grade biomaterials: stainless steel, aluminum ceramic, methyl methacrylate and high-density polyethylene & [25] \\ \hline Intravascular catheters: thermoplastic polyurethane, silicone elastomer & [26] \\ polyurethane coated with hydromer, serum coating of catheters & \\ \hline Breast prostheses: silicone; silicone and polyurethane foam; silicone breast implant & [27; 28; 29] \\ \hline Teflon catheter & [30] \\ \hline Poly(methyl methacrylate) & [31] \\ \hline Silk threads & [32] \\ \hline Contact lenses: polymacon, etafilcon A, vifilcon A & [33] \\ \hline Stainless steel, orthopedic nuts & [34] \\ \hline Dentures & [35] \\ \hline Polystyrene & [36] \\ \hline Titanium: stainless steel; cortical bone surfaces & [37] \\ \hline Glass & [38; 39; 40] \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Staphylococcus can colonize nearly any material. Biofilm formation appears to be genetically programmed and finely regulated [41; 42; 43; 44], allowing bacteria to control their microenvironment [2; 17; 45; 46] and to actively detach from the biofilm matrix to generate metastatic infectious foci [47]. Genetic analyses were used to reveal the diversity of genetic factors contributing to biofilm formation, and it appears clearly that multiple pathways are involved in building bacterial biofilm [48; 49; 50].