Susceptibility of Staphylococcus aureus growing on fibronectin-coated surfaces to bactericidal antibiotics.

Several recent studies have shown that bacteria either grown in vitro as adherent biofilms or recovered from infected prosthetic devices have decreased susceptibilities to antimicrobial killing. To further study the microbial and environmental factors responsible for this decreased antibiotic susceptibility, we developed an in vitro model of surface-adherent Staphylococcus aureus growing on polymethylmethacrylate coverslips coated with pure fibronectin. After exponential growth for 4 h, the population of fibronectin-attached S. aureus remained constant for a further 48-h period, as evaluated by CFU counts of organisms quantitatively removed from the coverslips. At selected time points, surface-bound organisms were exposed to bactericidal concentrations of either oxacillin, vancomycin, fleroxacin, or gentamicin in short-term (0.5 to 2 h) or long-term (24 h) killing assays. Whereas at 2 h surface-growing organisms were still optimally killed by all antimicrobial agents, at 4 and 24 h attached bacteria expressed markedly altered susceptibilities to these agents. The decrease in susceptibility was moderate for fleroxacin, more important for oxacillin and vancomycin, and extensive for gentamicin. When surface-attached S. aureus was compared with bacteria grown in a fluid phase, both populations showed a parallel time-dependent decrease in their susceptibilities to either oxacillin, vancomycin, or fleroxacin. In contrast, attached organisms became considerably more resistance to gentamicin than suspended bacteria did. Subpopulations of organisms spontaneously released from coverslips during antibiotic exposure also showed markedly reduced susceptibilities to antimicrobial killing. This simple model of S. aureus colonization of in vitro fibronectin-coated surfaces might represent a useful approach to the study of the physiological and biochemical changes that underlie the decreased antibiotic susceptibilities of biomaterial-attached organisms.