Adhesion and biofilm formation by Staphylococcus aureus clinical isolates under conditions relevant to the host: relationship with macrolide resistance and clonal lineages

Giovanni Di Bonaventura, Arianna Pompilio, Monica Monaco, Fernanda Pimentel de Araujo, Lucilla Baldassarri, Annalisa Pantosti, Giovanni Gherardi

Research output: Contribution to journalArticlepeer-review


PURPOSE: Staphylococcus aureus isolates, collected from various clinical samples, were analysed to evaluate the contribution of the genetic background of both erythromycin-resistant (ERSA) and -susceptible (ESSA) S. aureus strains to biofilm formation.

METHODS: A total of 66 ESSA and 43 ERSA clinical isolates were studied for adhesiveness and biofilm formation under different atmospheres. All isolates were evaluated for phenotypic and genotypic macrolide resistance, and for clonal relatedness by pulsed-field gel electrophoresis (PFGE), and by spa typing on representative isolates.

RESULTS: A high genetic heterogeneity was encountered, although 10 major PFGE types accounted for 86 % with a few small spatially and temporally related clusters. Overall, biofilm formation under anoxia was significantly lower than under oxic and micro-aerophilic atmospheres. Biofilm formation by ESSA was significantly higher compared to ERSA under oxic and micro-aerophilic conditions. Adhesiveness to plastic was significantly higher among respiratory tract infection isolates under micro-aerophilic conditions, while surgical site infection isolates formed significantly higher biomass of biofilm under oxic and micro-aerophilic atmospheres compared to anoxia. Pulsotype 2 and 4 strains formed significantly higher biofilm biomass than pulsotype 1, with strains belonging to CC8 forming significantly more compared to those belonging to CC5, under both oxic and micro-aerophilic atmospheres.

CONCLUSIONS: S. aureus biofilm formation appears to be more efficient in ESSA than ERSA, associated with specific S. aureus lineages, mainly CC8 and CC15, and affected by atmosphere. Further studies investigating the relationship between antibiotic resistance and biofilm formation could prove useful in the development of new strategies for the management of S. aureus infections.

Original languageEnglish
Pages (from-to)148-160
Number of pages13
JournalJournal of Medical Microbiology
Issue number2
Publication statusPublished - Feb 2019


  • A549 Cells
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents/pharmacology
  • Bacterial Adhesion/drug effects
  • Bacterial Proteins/genetics
  • Biofilms/growth & development
  • Clindamycin/pharmacology
  • Drug Resistance, Bacterial/genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Erythromycin/pharmacology
  • Female
  • Genotype
  • Humans
  • Ketolides/pharmacology
  • Macrolides/pharmacology
  • Male
  • Methicillin-Resistant Staphylococcus aureus/classification
  • Middle Aged
  • Multilocus Sequence Typing
  • Penicillin-Binding Proteins/genetics
  • Phenotype
  • Staphylococcal Infections/epidemiology
  • Staphylococcus aureus/classification
  • Young Adult


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