Author summary
Osteomyelitic bone can be plagued by extensive bacterial growth in adherent biofilms,
which can be observed by direct scanning electron microscropy, and may even obscure
the entire infected bone surface. Through synchronized production of exopolysaccharide
polymers, microcolony formation and surface adhesion is mediated, and a fibrous matrix
is formed which is readily visible by transmission electron microscopy. Multiple bacterial
morphotypes may be present simultaneously in these biofilms. The result is an infection
that may be very resistant to either antibiotic therapy or host clearance in the damaged
tissue or bone, leading to persistent infection unless the compromised material is
removed.
