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Antimicrobial Agents and Chemotherapy, January 2006, p. 55-61, Vol. 50, No. 1
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.1.55-61.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Multiple Combination Bactericidal Testing of Staphylococcal Biofilms from Implant-Associated Infections

Raphael Saginur,1,2* Melissa StDenis,2,3 Wendy Ferris,2,3 Shawn D. Aaron,1,2 Francis Chan,2,3 Craig Lee,1,2 and Karam Ramotar1,2

The Ottawa Hospital,1 University of Ottawa,2 Children's Hospital of Eastern Ontario, Ontario, Canada3

Received 11 April 2005/ Returned for modification 5 May 2005/ Accepted 10 October 2005

Standardized susceptibility testing fails to predict in vivo resistance of device-related infections to antimicrobials. We assessed agents and combinations of antimicrobials against clinical isolates of Staphylococcus epidermidis and S. aureus (methicillin-resistant S. aureus and methicillin-sensitive S. aureus) retrieved from device-associated infections. Isolates were grown planktonically and as biofilms. Biofilm cultures of the organisms were found to be much more resistant to inhibitory and bactericidal effects of single and combination antibiotics than planktonic cultures (P < 0.001). Rifampin was the most common constituent of antibiotic combinations active against staphylococcal biofilms. Other frequently effective antimicrobials were vancomycin and fusidic acid. Susceptibility testing involving biofilm-associated bacteria suggests new options for combination antibiotic therapy.

* Corresponding author. Mailing address: Department of Medicine, CPC 470, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9. Phone: (613) 798-5555, ext. 14155. Fax: (613) 761-5260. E-mail: rsaginur{at}ohri.ca.

Antimicrobial Agents and Chemotherapy, January 2006, p. 55-61, Vol. 50, No. 1
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.1.55-61.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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