Convergence of Staphylococcus aureus Persister and Biofilm Research: Can Biofilms Be Defined as Communities of Adherent Persister Cells?

The remarkable tolerance of bacterial biofilms to antimicrobial drugs underpins their role in chronic and recurring infections. Staphylococcus aureus biofilms are embedded in an extracellular matrix composed of self-produced extracellular polysaccharides, DNA, and proteins or host-derived matrices such as fibrin, prompting speculation that limited drug diffusion into biofilms contributes to tolerance. However, the slow-and non-growing phenotypes of biofilm cells resemble those observed in the stationary growth phase, which is known to enrich for the highly antibiotic-tolerant persister phenotype. Indeed, recent studies have revealed that the antibiotic tolerance phenotypes of S. aureus biofilm and persister cells are strikingly similar Here, we will explore the idea that biofilms are enriched with adherent persister cells and that research into the biofilm and persister phenotypes has converged.