AUTHOR=Águila-Arcos Sandra , Álvarez-Rodríguez Itxaso , Garaiyurrebaso Olatz , Garbisu Carlos , Grohmann Elisabeth , Alkorta Itziar 

TITLE=Biofilm-Forming Clinical Staphylococcus Isolates Harbor Horizontal Transfer and Antibiotic Resistance Genes

JOURNAL=Frontiers in Microbiology

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2017.02018

DOI=10.3389/fmicb.2017.02018

ISSN=1664-302X

ABSTRACT=Staphylococci, mainly Staphylococcus aureus and S. epidermidis, are well-known causative agents of a large number of human infectious diseases, including skin, soft tissue, respiratory tract, bone, joint and endovascular infections, as well as infections related to implanted medical devices (Le et al., 2014; Otto, 2012). Their pathogenicity is due not only to the virulence factors that they express, but also to the ability of these bacteria to form biofilms (i.e., deeply seated microbial communities attached to inert or living surfaces) (Costerton et al., 1999; Otto, 2008). The treatment of biofilm-associated infections is considered a challenging task owing to their inherent resistance to (i) antimicrobial agents and (ii) the host immune system (Hoiby et al., 2010). Moreover, nowadays, the incidence of antibiotic resistant pathogenic bacteria in clinical settings is dramatically increasing, making treatment of bacterial infections one of our most serious health threats (Guridi et al., 2015). This problem arises from the resistance phenotype of bacteria that harbor resistance genes in their chromosomal and/or plasmid DNA. 
Bacteria can acquire resistance genes by horizontal gene transfer (HGT). Actually, conjugative plasmid-mediated HGT is considered the most important process in the emergence of new resistant pathogens (Schiwon et al., 2013). It is well documented that bacterial conjugation can occur within biofilms since they provide an ideal situation for the exchange of genetic material of various origins (Christensen et al., 1998; Hausner and Wuertz, 1999). On the other hand, bacterial conjugation can induce biofilm formation since the cell-to-cell contact established for gene exchange favors the close proximity of bacteria required for biofilm formation (D’Alvise et al., 2010; Ghigo, 2001; Molin and Tolker-Nielsen, 2003; Reisner et al., 2006; Yang et al., 2008). This link between biofilms and bacterial conjugation increases both the risk of biofilm-related infections and the conjugative spread of virulence factors. 
In this work, we studied 25 staphylococcal biofilm-forming clinical isolates belonging to the following species: S. aureus, S. epidermidis, S. hominis and S. capitis. These species are commonly found on human skin and can cause biofilm-forming healthcare-associated infections. Both horizontal transfer and antibiotic resistance genes were detected in these staphylococcal clinical isolates. This