The production of biofilms is a critical factor in facilitating the survival of Staphylococcus spp. in vivo and in protecting against various environmental noxa. The possible relationship between the antibiotic-resistant phenotype and biofilm-forming capacity has raised considerable interest. The purpose of the study was to assess the interdependence between biofilm-forming capacity and the antibiotic-resistant phenotype in 299 Staphylococcus spp. (S. aureus n = 143, non-aureus staphylococci [NAS] n = 156) of environmental origin. Antimicrobial susceptibility testing and detection of methicillin resistance (MR) was performed. The capacity of isolates to produce biofilms was assessed using Congo red agar (CRA) plates and a crystal violet microtiter-plate-based (CV-MTP) method. MR was identified in 46.9% of S. aureus and 53.8% of NAS isolates (p > 0.05), with resistance to most commonly used drugs being significantly higher in MR isolates compared to methicillin-susceptible isolates. Resistance rates were highest for clindamycin (57.9%), erythromycin (52.2%) and trimethoprim-sulfamethoxazole (51.1%), while susceptibility was retained for most last-resort drugs. Based on the CRA plates, biofilm was produced by 30.8% of S. aureus and 44.9% of NAS (p = 0.014), while based on the CV-MTP method, 51.7% of S. aureus and 62.8% of NAS were identified as strong biofilm producers, respectively (mean OD570 values: S. aureus: 0.779±0.471 vs. NAS: 1.053±0.551; p < 0.001). No significant differences in biofilm formation were observed based on MR (susceptible: 0.824 ± 0.325 vs. resistant: 0.896 ± 0.367; p = 0.101). However, pronounced differences in biofilm formation were identified based on rifampicin susceptibility (S: 0.784 ± 0.281 vs. R: 1.239 ± 0.286; p = 0.011). The mechanistic understanding of the mechanisms Staphylococcus spp. use to withstand harsh environmental and in vivo conditions is crucial to appropriately address the therapy and eradication of these pathogens.

Archaea Physiology and Biotechnology Group Department of Functional and Evolutionary Ecology Universität Wien 1090 Wien Austria

Department of Biomedical Sciences University of Sassari 07100 Sassari Italy

Department of Experimental Biology Faculty of Science Masaryk University 62500 Brno Czech Republic

Department of Medical Microbiology and Immunology University of Pécs Medical School Szigeti út 12 7624 Pécs Hungary

Department of Oral Biology and Experimental Dental Research Faculty of Dentistry University of Szeged Tisza Lajos krt 63 6720 Szeged Hungary

Department of Periodontology Faculty of Dentistry University of Szeged Tisza Lajos körút 62 64 6720 Szeged Hungary

Department of Prosthodontics Faculty of Dentistry University of Szeged Tisza Lajos körút 62 64 6720 Szeged Hungary

Hospital Pharmacy Azienda Ospedaliero Universitaria di Sassari 07100 Sassari Italy

Institute of Medical Microbiology Faculty of Medicine Semmelweis University Nagyvárad tér 4 1089 Budapest Hungary

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Smoothie Drinks: Possible Source of Resistant and Biofilm-Forming Microorganisms