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Is there a role for quorum sensing signals in bacterial biofilms?


Staffan Kjelleberg* and Soeren Molin†
Bacteria form multicellular biofilm communities on most development regulators in a stringently controlled
surfaces. Genetic analysis of biofilm formation has led to the differentiation process.
proposal that extracellular signals and quorum-sensing
regulatory systems are essential for differentiated biofilms. The aim of this review is to assess the merit of the recently
Although such a model fits the concept of density-driven proposed model for QS-mediated biofilm formation. We
cell–cell communication and appear to describe biofilm compare and evaluate observations and data that involve
development in several bacterial species and conditions, not only the QS model but also the notion that biofilm
biofilm formation is multifactorial and complex. Hydrodynamics, formation and differentiation are multifactorial processes and
nutrient load and intracellular carbon flux have major impacts, reflect the activation of additional genetic control systems.
presumably by altering the expression of cellular traits essential Moreover, we identify questions that, if experimentally
for bacterial adaptation during the different stages of biofilm addressed, provide a guide for further exploring the impact
formation. Hence, differentiated biofilms may also be the net of QS-based regulation of bacterial biofilm development.
result of many independent interactions, rather than being
determined by a particular global quorum sensing system. The AHL-based quorum sensing system and
biofilm formation
Addresses In bacteria, the regulation of many important changes in
*Department of Microbiology and Immunology, School of gene expression is mediated by systems of signalling
Biotechnology and Biomolecular Sciences, Centre for Marine between cells known as QS cells [6]. Cells in a population
Biofouling and Bio-Innovation, The University of New South Wales,
Sydney 2052, Australia; e-mail: S.Kjelleberg@unsw.edu.au
will sense their density and number through the presence
† Section of Molecular Microbiology, BioCentrum-DTU, The Technical of signals that diffuse freely across cell membranes and
University of Denmark, Building 301, DK-2800 Kongens Lyngby, between cells. Via an autoinduced positive feedback
Denmark; e-mail: imsm@pop.dtu.dk mechanism, a population of cells can quickly induce the
Current Opinion in Microbiology 2002, 5:254–258 appropriate phenotypes required for responding to a
particular environmental condition or for proceeding with
1369-5274/02/$ — see front matter the differentiation process of the population. A limited
© 2002 Elsevier Science Ltd. All rights reserved.
number of QS systems, mainly the acylhomoserine lactone
Published online 13 May 2002 (AHL) system of several Gram-negative bacteria [7], the
autoinducer 2 (AI2) system of a range of both Gram-
Abbreviations
AHL acylhomoserine lactone negative and Gram-positive bacteria [8], and the peptide-
QS quorum sensing mediated QS signalling system in several Gram-positive
species [9], have been characterised in some detail.
Introduction — is biofilm development
a genetically controlled pathway? In contrast to the other QS systems, the AHL-mediated
The realisation that, to a large extent, bacterial life in most QS signalling system appears to control genes essential for
natural environments involves surface attachment and colonisation of eukaryotes across a large number of bacterial
development of biofilms has stimulated considerable species. This process is facilitated by a high density of
interest among many groups of microbiologists, initially cells, such as in bacterial biofilms [10]. The notion that
in connection with the engineering of bioprocesses in signal-producing cells in close proximity to each other
reactors of different types and in the field of microbial would acquire a higher intracellular concentration of the
ecology, and lately as a new research field for microbiologists QS signal and, hence, allow for induction of signalling-
with special interest in microbial physiology, differentiation controlled genes led to the first detailed set of experiments
and global gene control. Much interest and rapid progress that showed that the formation of differentiated multicellular
in biofilm research followed the publication of a paper by microcolonies in bacterial biofilms can be mediated by AHLs
Davies et al. [1], in which a correlation between biofilm [1]. A functional Las QS regulatory switch in P. aeruginosa
development and cell–cell signalling in Pseudomonas was found to be essential for formation of a highly structured
aeruginosa was demonstrated. Subsequently, an increasing biofilm community. Recently, the AHL-dependent QS system
number of reports on the dissection of genomic functions in P. aeruginosa was also found to govern biofilm formation
affecting biofilm performance and properties (see, for on living surfaces, as evaluated in a murine model of
example, [2–5]) have led a majority of scientists studying corneal infection ([11]; H Zhu, personal communication).
bacterial biofilms to adopt a consensus model that proposes
that: first, microbial community development on surfaces is Concurrent with and apparently in support of such
a step-wise process involving adhesion, growth, motility and findings, reports in the literature also provided evidence for
EPS formation; and second, quorum sensing (QS)-mediated the presence of AHLs in both mixed- and monoculture
controlling signals are directly involved as biofilm species biofilms on inanimate surfaces [12–14]. Also, claims
Is there a role for quorum sensing signals in bacterial biofilms? Kjelleberg and Molin 255

Figure 1

(a) (b)

(c) (d)

Current Opinion in Microbiology

Scanning confocal microscope images of a 72-hour flow cell biofilm coverage. Vertically positioned cells filament to approximately 12 µm
formed by (a) the Serratia liquefaciens wild-type strain and (b) the and aggregate bacteria at their tip. Filament cells ranging from
AHL mutant strain. Diagrammatic representations are given below 50–200 µm associate with the aggregates and septate to form cell
for (c) the wild-type strain and (d) the AHL mutant strain (swrI–). chains. The AHL mutant is unable to form aggregates at the vertically
A difference is observed with respect to morphology, biofilm structure positioned filaments and is stalled at this stage of development.
and differentiation under flow cell conditions. The wild-type strain coats Addition of BHL to the flow cell medium rescues the AHL mutant
the surface and bacteria position themselves vertically above this biofilm to that of the wild-type (Bar = 10 µm).

for the role of AHLs in affecting several aspects of biofilm biofilm formation, halogenated furanones, which are
dynamics, such as heterogeneity, architecture, stress produced by a marine red alga to protect the surface against
resistance, maintenance and sloughing, have been made colonisation by bacteria and higher sessile organisms and
[1,15–18]. Comparisons between wild-type and mutant specifically interfere with AHL systems in bacteria [22–24],
strains lacking AHL signals have demonstrated that have been shown to penetrate biofilms, shut down the
multicluster-containing biofilms on inanimate surfaces in signalling system and induce sloughing of biofilms both on
Aeromonas hydrophila [19•], Burkholderia cepacia [20•] and inanimate surfaces [25•] and in vivo in the lung tissue
Serratia liquefaciens [16] also require an intact AHL system. (M Givskov, personal communication).
Moreover, a detailed analysis of cell differentiation in
S. liquefaciens revealed dramatic differences in intercell These observations suggest that, for several organisms
arrangements and differentiation into cellular morphotypes known to produce AHLs, it is often possible to identify
for anchoring the biofilm and assembling cells at specific differences between biofilm development and performance,
sites (Figure 1). In S. liquefaciens, the requirement of the QS when comparing the wild-type strain with isogenic variants
system for the regulation of all key steps in surface coloni- deficient in the synthesis of the QS signal molecules. The
sation appears to be met. AHL-controlled genes essential suggested connection between QS regulation and biofilm
for adhesion, swarming and biofilm cluster formation were properties is appealing, considering that, in natural environ-
found in this species ([16]; M Labbate, personal communi- ments, biofilms would be the dominant setting in which
cation). Interestingly, expression of the cytotoxic lectins QS regulation plays a significant role.
PA-IL and PA-IIL in P. aeruginosa is also controlled by the
QS system [21]. In support of these findings, which portray It appears, however, that although the mechanism of
a key role for AHL regulation in colonisation events and regulation exerted by QS systems is relatively conserved
256 Ecology and industrial microbiology

Figure 2

(a) 1.0 (b) 0.7

0.6
0.8
0.5

Roughness
Roughness

0.6 0.4

0.3
0.4

0.2
0.2
0.1

0.0 0.0
2 4 6 8 10 12 14 16 18 20 0 5 10 15 20 25 30
Average thickness (µm) Average thickness (µm)

Quantification of flow cell biofilm structures for four strains of quantified by the computer program COMSTAT. In each of the three
Pseudomonas aeruginosa using the COMSTAT programme [38]. rounds, 18 image stacks were acquired from two flow-channels totalling
Roughness versus average thickness of (a) 98-hour- and (b) 146-hour-old 54 image stacks for each strain at each time-point. Each spot represents
biofilms of P. aeruginosa wild-type (black circle), P. aeruginosa rpoS a single stack of images. It is clearly seen from these quantifications that
(white inverted triangle), P. aeruginosa ∆pilHIJK (type IV pili mutant, the wild-type strain and the lasI mutant form biofilms with identical
black square) and P. aeruginosa las I (white diamond). Images were structures, whereas the rpoS and type IV pili mutants show significantly
acquired by CLSM in three independent biofilm experiments and different biofilm development. Adapted, with permission, from [27•].

across the different QS-containing bacterial species, Biofilm development — the processes and
different bacterial species employ the QS control system their regulation
as a global regulator of operons encoding different The attention created by the report by Davies et al. [1] is in
functionalities, including a series of non-household traits striking contrast to the apparent lack of attention created by
[26]. Hence, mutations in the QS control system will have a number of publications that arrived at the one general
pleiotropic effects with potentially complex consequences conclusion that biofilm development (understood as formation
for the expression of many genes. Although these effects of heterogeneous communities and structures, as demon-
will be different in different species, given the many strated by Davies et al. [1]) is a predictable consequence of
genes and pathways involved, it is possible that they will the physicochemical conditions in the biofilm environment
be different also for the same strain grown under different [31,32]. The latter publications concluded that employment
sets of conditions. Thus, since the first reports on of relatively simple mathematical models, such as the
AHL-mediated formation of differentiated biofilms and “cellular automaton” [33], combined with changing nutrient
the presence of AHLs in biofilms, conflicting data on the conditions would lead to predictions of biofilm behaviour
role of extracellular signals and QS in governing the and development. In other words, biofilm differentiation
formation and function of biofilms have been published into mature biofilms of “organized communities with
[27•,28,29,30•]. Common to these studies is the fact that functional heterogeneity” [10] does not necessarily require a
significant differences between wild-type and isogenic genetic programme, but may in fact constitute the sum of a
AHL mutants with respect to biofilm development could large number of cellular adaptations and growth cycles influ-
not be detected within the chosen experimental framework. enced by the nutrient diffusion conditions in the community.
The role of QS in biofilm development and maintenance, Moreover, by varying the nutritional and flow-dynamic
which require a series of genes for behavioural responses conditions, biofilm development should follow different
such as adhesion, motility, chemotaxis, exopolysaccharide routes. In this model, the bacterial cells do not perceive
or capsule production and stress resistance, is therefore that they are within a biofilm — they simply respond to
difficult to ascertain. These experiments further lead to local environmental conditions (such as stress and nutrient
the suggestion that a clear-cut case for the role of QS gradients) as would planktonic cells.
systems in biofilms requires a high-level regulatory function
and that the QS circuit always controls the expression of From a physiological point of view, it should be recalled
biofilm-essential genes. that bacteria possess genetically determined response
Is there a role for quorum sensing signals in bacterial biofilms? Kjelleberg and Molin 257

pathways enabling them to survive and even thrive under Box 1


conditions of nutrient limitation or deficiency and other Important questions to be resolved.
kinds of stress conditions (such as osmotic stress, anoxia
and pH changes). Many complex regulatory pathways, Is it the case that biofilms develop in discrete steps? If so, how are
such as those governing catabolite repression [34], stationary- these defined functionally and at the level of genetic control?
phase gene expression [27•,35], motility and chemotaxis If QS is shown to have an impact on biofilm development, which
[36], have been shown to play important roles for biofilm- target genes are directly involved in discrete events in the
associated bacteria and for biofilm performance and development of the biofilm?
development, even though these control systems are
Is QS-mediated control of biofilm performance for a given organism
probably not exclusively evolved for biofilm development unconditional, or are there experimental conditions under which no
(Figure 2). In a recent report [37••], the CsrA regulator apparent correlation exists?
responsible for controlling carbon flux and storage in
Escherichia coli was shown to be a major determinant of What proportion of QS-regulated genes in specific organisms is
controlled directly (for example, indicated by the presence of a ‘lux’
biofilm formation and resolution under a variety of cultivation
box), and how many of the genes may be indirectly controlled
conditions. Thus, the challenges of the diverse and because of pleiotropic effects?
complex environmental conditions, most often associated
with biofilm life, require that the bacteria exploit their Are there any examples of biofilm development that resemble that
entire repertoire of regulatory systems when adapting to of P. aeruginosa and of others that are completely independent of
QS or any other global regulation?
these changing conditions. It is likely, therefore, that more
than one control system is needed to develop stable and
physiologically optimal communities, which prevail regulatory factor for the structure/function relationship
because of the regulatory flexibility. of the community.

Is quorum sensing regulation a niche-specific Acknowledgements


biofilm control circuit? The constant inspiration from our colleagues at the University of
New South Wales and the Technical University of Denmark has been
Biofilm establishment and development is a complex instrumental in this writing and, in particular, we wish to thank Michael
multifactorial process, which is governed by a combination Givskov and Peter Steinberg.
of the environmental conditions and the resulting cellular
household functions, as well as a range of specifically References and recommended reading
controlled activities that are highly influenced by genetic Papers of particular interest, published within the annual period of review,
have been highlighted as:
control systems operating under high-cell-density condi-
tions. In many cases, QS regulation has evolved as niche- • of special interest
•• of outstanding interest
specific control circuits operating, in particular, in biofilm
1. Davies DG, Parsek MR, Pearson JP, Iglewski BH, Costerton JW,
scenarios in which cell densities are high. In addition to Greenberg EP: The involvement of cell-to-cell signals in the
controlling the expression of niche-related factors (for development of a bacterial biofilm. Science 1998, 280:295-298.
example, those related to host–microbe interactions), QS 2. O’Toole GA, Kolter R: Initiation of biofilm formation in
systems may also have direct impacts on the quality and Pseudomonas fluorescens WCS365 proceeds via multiple,
convergent signaling pathways: a genetic analysis. Mol Microbiol
properties of the community that produces the signals, that 1998, 28:449-461.
is, as a feedback loop operating at the community level 3. O’Toole GA, Gibbs KA, Hager PW, Phibbs PV Jr, Kolter R: The global
to ensure a stable and robust continuation of related carbon metabolism regulator CRC is a component of a single
functionalities. However, it may be an oversimplification transduction pathway required for biofilm development by
Pseudomonas aeruginosa. J Mol Biol 2000, 182:425-431.
to interpret this control as the dominant, let alone exclusive,
4. Whiteley M, Lee KM, Greenberg EP: Identification of genes
route for biofilm development. It is, therefore, pertinent to controlled by quorum sensing in Pseudomonas aeruginosa. Proc
address some of the important questions, outlined in Natl Acad Sci USA 1999, 96:13904-13909.
Box 1, that are still unresolved. 5. Prigent-Combaret C, Vidal O, Dorel C, Lejeune P: Abiotic surface
sensing and biofilm-dependent regulation of gene expression in
Escherichia coli. J Bacteriol 1999, 181:5993-6002.
Conclusions
6. Swift S, Downie JA, Whitehead NA, Barnard AML, Salmond GPC,
The title of this review poses the question: is there a role Williams P: Quorum sensing as a population-density-dependent
for QS signals in bacterial biofilms? The current state-of- determinant of bacterial physiology. Adv Microb Physiol 2001,
the-art in biofilm research suggests that it is highly likely 45:199-270.

that QS regulation is important for biofilm development 7. Swift S, William P, Stewart GSAB: N-Acylhomoserine lactones and
quorum sensing in proteobacteria. In Cell–Cell Signaling in
for several organisms under certain sets of conditions, but Bacteria. Edited by Dunny GM, Winans SC. Washington, DC:
that there is no reason to assume that this type of regulation ASM Press; 1999:291-314.
is the only important effector. In a given setting, the 8. Bassler BL: A multichannel two-component signaling relay
biofilm-associated community will exploit all available controls quorum sensing in Vibrio harveyi. In Cell–Cell Signaling in
Bacteria. Edited by Dunny GM, Winans SC. Washington, DC:
adaptive mechanisms and the corresponding network ASM Press; 1999:259-273.
of regulatory activities (including QS), and it is not 9. Dunny GM, Winans SC (Eds): Cell–Cell Signaling in Bacteria.
possible to unequivocally assign a specific determining Washington, DC: ASM Press; 1999.
258 Ecology and industrial microbiology

10. Costerton JW, Stewart PS, Greenberg EP: Bacterial biofilms: 25. Hentzer M, Riedel K, Rasmussen TB, Heydorn A, Andersen JB,
a common cause of persistent infections. Science 1999, • Parsek MR, Rice SA, Eberl L, Molin S, Hoiby N et al.: Inhibition of
284:1318-1322. quorum sensing in Pseudomonas aeruginosa biofilm bacteria by
a halogenated furanone compound. Microbiology 2002,
11. Zhu H, Thuruthyil SJ, Rice S, Kjelleberg S, Givskov M, Willcox MDP: 148:87-102.
Contribution of quorum-sensing systems to the virulence of This report demonstrates how QS antagonists penetrate a biofilm, specifically
Pseudomonas aeruginosa during corneal infections [abstract]. shut down the QS system and, as a consequence, destabilise and induce
Invest Ophthalmol Vis Sci 2002, 42:S514. sloughing of the biofilm. Hence, this is also the first report to show how QS
12. McLean RJC, Whiteley M, Stickler DJ, Fuqua WC: Evidence of antagonists may be useful in combating microbial infections that develop
autoinducer activity in naturally occurring biofilms. FEMS through biofilm formation.
Microbiol Lett 1997, 154:259-263. 26. Fuqua C, Parsek MR, Greenberg EP: Regulation of gene
13. Stickler DJ, Morris NS, McLean RJC, Fuqua C: Biofilms on expression by cell-to-cell communication: acyl-homoserine
indwelling urethral catheters produce quorum-sensing signal lactone quorum sensing. Ann Rev Genet 2001, 35:439-468.
molecules in situ and in vitro. Appl Environ Microbiol 1998, 27. Heydorn A, Ersbøll B, Kato J, Hentzer M, Parsek MR, Tolker-Nielsen T,
64:3486-3490. • Givskov M, Molin S: A statistical analysis of Pseudomonas
aeruginosa biofilm development: impact of mutations in genes
14. Charlton TS, de Nys R, Netting A, Kumar N, Hentzer M, Givskov M,
involved in twitching motility, cell-to-cell signalling and stationary
Kjelleberg S: A novel and sensitive method for the quantification
phase gene expression. Appl Environ Microbiol 2002, 68:2008-2017.
of N-3-oxoacyl homoserine lactones using gas chromatography-
This paper clearly documents the significance of objective and quantitative
mass spectrometry: application to a model bacterial biofilm.
determinations of biofilm characteristics when comparing performance of
Environ Microbiol 2000, 2:530-541.
isogenic variants of an organism. In addition, it introduces an element of
15. Kline T, Bowman J, Iglewski BH, de Kievit T, Kakai Y, Passador L: caution against generalisations in the biofilm area.
Novel synthetic analogs of the Pseudomonas autoinducer. Bioorg
28. Brooun A, Liu S, Lewis K: A dose-response study of antibiotic
Med Chem Lett 1999, 9:3447-3452.
resistance in Pseudomonas aeruginosa biofilms. Antimicrob
16. Labbate M, Rice SA, Queck J, Givskov M, Kjelleberg S: Attachment Agents Chemother 2000, 44:640-646.
and formation of biofilm structures in S. liquefaciens MG1 is
29. Stoodley P, Jørgensen F, Williams P, Lappin-Scott HM: The role of
regulated by N-butanoyl-l-homoserine lactone. Abstract MO.042
hydrodynamics and AHL signalling molecules as determinants of
of the Ninth International Symposium on Microbial Ecology, 2001
the structure of Pseudomonas aeruginosa biofilms. In Biofilms:
August 26–31, Amsterdam.
The Good, The Bad, and The Ugly. Edited by Wimpenny J, Gilbert P,
17. Allison DG, Ruiz B, SanJose C, Jaspe A, Gilbert P: Extracellular Walker J, Brading M, Bayston R. Cardiff: BioLine; 1999:223-230.
products as mediators of the formation and detachment of 30. Stoodley P, Hall-Stoodley L, Boyle JD, Jorgensen F, Lappin-Scott HM:
Pseudomonas fluorescens. FEMS Microbiol Lett 1998, • Environmental and genetic factors influencing biofilm structure. In
167:179-184. Society for General Microbiology Symposium 59: Community
18. llison DG, Heys SJD, Willcock L, Holah J, Gilbert P: Cellular Structure and Co-operation in Biofilm. Edited by Allison D, Gilbert P,
detachment and dispersal from bacterial biofilms: a role for Lappin-Scott H, Wilson M. Cambridge: Cambridge University Press;
quorum sensing? In Biofilms: The Good, The Bad, and The Ugly. 2000:53-64.
Edited by Wimpenny J, Gilbert P, Walker J, Brading M, Bayston R. This report is one of several detailed accounts by Stoodley and co-workers
Cardiff: BioLine; 1999:276-286. that provides evidence for the role of hydrodynamics and other environmental
factors in determining the formation of seemingly differentiated biofilms.
19. Lynch MJ, Swift S, Kirke DF, Keevil CW, Dodd CER, Williams P:
• The regulation of biofilm development by quorum sensing in 31. Wimpenny JWT, Colasanti R: A unifying hypothesis for the
Aeromonas hydrophila. Environ Microbiol 2002, 4:18-28. structure of microbial biofilms based on cellular automaton
This is one of only two publications that provides evidence, in bacterial models. FEMS Microbiol Ecol 1997, 22:1-16.
species other than P. aeruginosa, for the original notion proposed by Davies 32. Van Loosdrecht MCM, Picioreanu C, Heinen JJ: A more unifying
et al. in [1] on the role of cell–cell communication in the formation of biofilms. hypothesis for biofilm structures. FEMS Microbiol Ecol 1997,
20. Huber B, Reidel K, Hentzer M, Heydorn A, Gotschlich A, Givskov M, 24:181-183.
• Molin S, Eberl L: The cep quorum-sensing system of Burkholderia 33. Wolfram S: Cellular automata as models of complexity. Nature
cepacia H111 controls biofilm formation and swarming motility. 1984, 311:419-424.
Microbiology 2001, 147:2517-2528.
This is the other one of the two publications (see the annotation to [19•]) 34. O’Toole GA, Gibbs KA, Hager PW, Phibbs PV Jr, Kolter R: The global
that provides evidence, in bacterial species other than P. aeruginosa, for the carbon metabolism regulator CRC is a component of a single
original notion proposed by Davies et al. [1] on the role of cell–cell commu- transduction pathway required for biofilm development by
nication in the formation of biofilms. Pseudomonas aeruginosa. J Mol Biol 2000, 182:425-431.
21. Winzer K, Falconer C, Garber NC, Diggle SP, Camara M, William P: 35. Whiteley M, Parsek MR, Greenberg EP: Regulation of quorum
The Pseudomonas aeruginosa Lectins PA-IL and PA-IIL are sensing by RpoS in Pseudomonas aeruginosa. J Bacteriol 2000,
controlled by quorum sensing and by RpoSJ. J Bacteriol 2000, 182:4356-4360.
182:6401-6411.
36. Pratt LA, Kolter R: Genetic analysis of Eschericia coli biofilm
22. Givskov M, de Nys R, Manefield M, Gram L, Maximilien M, Eberl L, formation: defining the roles of flagella, motility, chemotaxis and
Molin S, Steinberg PD, Kjelleberg S: Eukaryotic interference with type I pili. Mol Microbiol 1998, 30:285-294.
homoserine lactone-mediated procaryotic signalling. J Bacteriol
1996, 178:6618-6622. 37. Jackson DW, Suzuki K, Lawrence O, Simecka JW, Hart ME, Romeo T:
•• Biofilm formation and dispersal under the influence of the global
23. Manefield M, de Nys R, Kumar N, Givskov M, Steinberg P, regulator CsrA of Escherichia coli. J Bacteriol 2002, 184:290-301.
Kjelleberg S: Evidence that halogenated furanones from Delisea This is an excellent account of the role of cellular metabolism and the
pulchra inhibit acylated homoserine lactone (AHL)-mediated gene complexity of biofilm development. It highlights how nutritional cues and the
expression by displacing the AHL signal from its receptor protein. intracellular flux of carbon into various intermediates control biofilm formation
Microbiology 1999, 145:283-291. and dispersal.
24. Manefield, M, Rasmussen T, Kumar N, Hentzer M, Andersen JB, 38. Heydorn A, Nielsen AT, Hentzer M, Sternberg C, Giskov M,
Steinberg P, Kjelleberg S, Givskov M: Halogenated furanones Ersboll BK, Molin S: Quantification of biofilm structures by the
inhibit quorum sensing through accelerated LuxR turnover. novel computer program COMSTAT. Microbiology 2000,
Microbiology 2002, 148:1119-1127. 146:2395-2407.

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