Description
Staphylococcus epidermidis is an important cause of nosocomial infections. Virulence is attributable to
elaboration of biofilms on medical surfaces that protect the organisms from immune system clearance. Even
though leukocytes can penetrate biofilms, they fail to phagocytose and kill bacteria. The properties that make
biofilm bacteria resistant to the immune system are not well characterized. In order to better understand the
mechanisms of resistance of bacteria in biofilms to the immune system, we evaluated antibody penetration
throughout the biofilm and antibody-mediated phagocytic killing of planktonic versus biofilm cells of S.
epidermidis by using a rabbit antibody to poly-N-acetylglucosamine (PNAG). These antibodies are opsonic and
protect against infection with planktonic cells of PNAG-positive Staphylococcus aureus and S. epidermidis.
Antibody to PNAG readily penetrated the biofilm and bound to the same areas in the biofilm as did wheat germ
agglutinin, a lectin known to bind to components of staphylococcal biofilms. However, biofilm cells were more
resistant to opsonic killing than their planktonic counterparts in spite of producing more PNAG per cell than
planktonic cells. Biofilm extracts inhibited opsonic killing mediated by antibody to PNAG, suggesting that the
PNAG antigen within the biofilm matrix prevents antibody binding close to the bacterial cell surface, which is
needed for efficient opsonic killing. Increased resistance of biofilm cells to opsonic killing mediated by an
otherwise protective antibody was due not to a biofilm-specific phenotype but rather to high levels of antigen
within the biofilm that prevented bacterial opsonization by the antibody.