[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-453912-105":59,"doc-detail-453912-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","staphylococcal-persistence-and-biofilm-resistance-in-bone-anchored-hearing-systems-clinical-impact","Staphylococcal persistence and biofilm resistance in bone-anchored hearing systems - Clinical impact","","Persistent inflammation and infection linked to staphylococcal colonization affect outcomes of bone-anchored hearing systems (BAHS). Although antibiotics are commonly used for skin complications, the clinical roles of biofilms and antimicrobial resistance (AMR) are not well defined. This prospective clinical study investigated biofilm formation and antibiotic resistance in Staphylococcus spp. from BAHS patients, and assessed associations with inflammation, pain, and hygiene. Adults were enrolled at a Swedish tertiary hospital (2014–2015) with follow-up at surgery, 3 and 12 months, culturing abutment and soft-tissue samples. Biofilm phenotyping, MIC/MBEC testing, and whole-genome sequencing showed persistent clones, inflammation-linked S. aureus, pain-linked S. epidermidis, and biofilm-driven AMR. ",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/staphylococcal-persistence-and-biofilm-resistance-in-bone-anchored-hearing-systems-clinical-impact/453912/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/staphylococcal-persistence-and-biofilm-resistance-in-bone-anchored-hearing-systems-clinical-impact/453912.png","ImageObject",300,407,{"name":92,"@type":93},"Mia  ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical outcomes does staphylococcal colonization affect in BAHS patients?","Question",{"text":113,"@type":114},"Persistent inflammation and infection linked to staphylococcal colonization affect BAHS outcomes, including issues such as inflammation, pain, and hygiene-related complications.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was biofilm formation and antimicrobial resistance measured in the study?",{"text":118,"@type":114},"Biofilm phenotyping used Crystal Violet and Congo Red assays, antimicrobial susceptibility used MIC and MBEC, and whole-genome sequencing assessed lineage plus AMR and virulence genes.",{"name":120,"@type":111,"acceptedAnswer":121},"Which staphylococcal species were associated with inflammation and pain?",{"text":122,"@type":114},"S. aureus was more prevalent in patients with inflammation (Holgers score > 0), while S. epidermidis correlated with pain.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},453912,1790764958,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},687207024478,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Bioϧlm 11 (2026) 100342  \nContents lists available at ScienceDirect  \nBiofilm  \n[journal homepage:](journal homepage: www.sciencedirect.com/journal/biofilm)[ www.sciencedirect.com/journal/biofilm](journal homepage: www.sciencedirect.com/journal/biofilm)  \nStaphylococcal persistence and biofilm resistance in bone-anchored hearing systems: Clinical impact  \nMarsel Ganeyeva,b,c, Liliana Morales-Laverdea,c, Maria Hoffman a, Malou Hultcrantzd,  \nAnders Palmquista, Peter Thomsen a,e, Martin L. Johansson a,b,c,* , Margarita Trobos a,c,**   \na Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden b Oticon Medical AB, Research & Technology, Askim, Sweden  \nc Centre for Antibiotic Resistance Research in Gothenburg (CARe), Gothenburg, Sweden d Institution CLINTEC, Karolinska Institutet, Stockholm, Sweden  \ne Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia  \nA R T I C L E I N F O  \nKeywords:  \nBone-anchored hearing systems (BAHS) Staphyloccocus aureus  \nStaphyloccocus epidermidis, biofilm formation Antimicrobial resistance (AMR)  \nA B S T R A C T  \nPersistent inflammation and infection, often linked to staphylococcal colonization, affect bone-anchored hearing system (BAHS) outcomes. Although antibiotics are often used to treat skin complications, the roles of biofilms and antimicrobial resistance (AMR) in clinical success remain unclear. This clinical prospective study characterized biofilm formation and antibiotic resistance in Staphylococcus spp. from BAHS patients, and examined associations with inflammation, pain, and hygiene. Adults eligible for BAHS were prospectively enrolled at a tertiary university hospital in Sweden during 2014–2015. Fifteen patients were followed clinically and microbiologically at surgery, 3- and 12- months. Abutment, peri-abutment exudate and soft-tissue samples were cultured. Fifty-seven Staphylococcus spp. isolates underwent biofilm phenotyping (Crystal Violet, Congo Red), antimicrobial susceptibility testing (minimum inhibitory concentration [MIC], minimum biofilm eradication concentration [MBEC]) and whole-genome sequencing (lineage, AMR and virulence genes). Clinical status was scored (Holgers, pain, debris). Individual patients harbored the same staphylococcal clone on abutment, exudate, and tissue for 12 months. S. aureus was more prevalent in patients with inflammation (Holgers score >0), S. epidermidis correlated with pain, and slime production was associated with debris accumulation. Overall, 56 % of isolates showed resistance to fusidic acid, and 11–34 % carried tetracycline resistance genes. S. epidermidis carried multidrug resistance genes (beta-lactams, tetracycline, sulfamethoxazole, fosfomycin), and resistance increased under biofilm conditions (MBEC > MIC). The ica operon was detected in all S. aureus and S. epidermidis ST7, ST297, ST749 and ST278. These findings indicate that staphylococci from BAHS exhibit persistent colonization, diverse clonal lineages, and high biofilm-associated AMR. Early microbial diagnostics and biofilmtargeted strategies, alongside cautious use of topical antibiotics, may improve outcomes.  \n1. Introduction  \nBone-anchored hearing systems (BAHS) offer a reliable solution for patients with conductive or mixed hearing loss and unilateral deafness by bypassing the outer or middle ear and transmitting sound via a titanium fixture anchored in the temporal bone [1]. Despite their benefits, complications such as inflammation, infection, abutment loss, pain and numbness remain and can lead to surgical interventions or implant loss [2,3].  \nCalon TGA et al. (2019) described the microbiome associated with BAHS at 12 weeks and during inflammation [4]. Staphylococcus epidermidis and Staphylococcus aureus were found to be the most prevalent species in patients with and without signs of inflammation [4–8]. However, their specific rol","cbCaigXGs9yDYmAO","https://ap.wps.com/l/cbCaigXGs9yDYmAO","pdf",3537000,"English","# Introduction\n## BAHS complications and need for clinical biofilm/AMR evidence\n## Staphylococcus species in BAHS and gaps in knowledge\n## Biofilm formation as virulence and protection from antibiotics","[{\"question\":\"What clinical outcomes does staphylococcal colonization affect in BAHS patients?\",\"answer\":\"Persistent inflammation and infection linked to staphylococcal colonization affect BAHS outcomes, including issues such as inflammation, pain, and hygiene-related complications.\"},{\"question\":\"How was biofilm formation and antimicrobial resistance measured in the study?\",\"answer\":\"Biofilm phenotyping used Crystal Violet and Congo Red assays, antimicrobial susceptibility used MIC and MBEC, and whole-genome sequencing assessed lineage plus AMR and virulence genes.\"},{\"question\":\"Which staphylococcal species were associated with inflammation and pain?\",\"answer\":\"S. aureus was more prevalent in patients with inflammation (Holgers score \\u003e 0), while S. epidermidis correlated with pain.\"}]","Staphylococcal persistence and biofilm resistance in bone-anchored hearing systems - Clinical impact | PDF",1790739804,23]