|Bacterial biofilm formation during infection establishment also leads to reduced susceptibility of quiescent cells embedded within the biofilm and antibiotic treatment failure. Insusceptibility to combined antibiotics, bacterial persistence in the face of an immune response, and enhanced transfer of resistance elements are also key problems associated with biofilm infection. Initial bacterial adhesion to the host plasma-conditioned prosthesis and surrounding tissue mediated by bacterial-binding proteins is a primary event in biofilm formation, followed by intercellular adhesion and formation of multi-cellular layers (biofilm). Binding to fibronectin appears to be an extremely important mechanism during S. aureus infection, evidenced by the duplicity of binding protein expression (FnBP-A, FnBP-B), the multiplicity of Fnbinding domains and functions of each protein.
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