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Neisseria meningitidis is the etiologic agent of meningococcal meningitis. Carriage of the organism is approximately 10% while active disease occurs at a rate of 1:100,000. Recent publications demonstrate that N. meningitidis has the ability to form biofilms on glass, plastic or cultured human bronchial epithelial cells. Microcolony-like structures are also observed in histological sections from patients with active meningococcal disease. This review investigates the possible role of meningococcal biofilms in carriage and active disease, based on the laboratory and clinical aspects of the disease. Keywordsbiofilm; capsule; HrpA; Neisseria meningitidis; two-partner secretion Bacterial biofilmsBiofilm research has gained considerable attention in the last 10-15 years in both the clinical and research communities. A biofilm is a community of microorganisms attached to a surface and encased in an exopolymeric matrix. Biofilms are formed under conditions of environmental stress, and are often associated with shear forces. The members of the biofilm are afforded more protection from environmental factors than if they were in an individual planktonic state. This includes protection from antimicrobials, changes in osmolarity, predation, UV light, reactive oxygen species and dehydration [1]. This added protection allows the bacteria living in the biofilm to persist in environs such as water pipes in industrial settings, as well as in the human host in chronic infections. A model organism for biofilm development is Pseudomonas aeruginosa, which forms biofilms in the lungs of cystic fibrosis patients. For this organism, biofilm formation occurs in five stages:• Loose association of the bacterium with a surface;• Tight bacterial adherence and transcriptional changes to adapt to the new environment; †Author for correspondence: Department of Microbiology, 3-401 BSB,

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Neisseria meningitidisis an organism whose environmental niche is limited to the human host. It can frequently colonize the human nasopharynx and has the ability to cause severe systemic infections. These infections can be sporadic, endemic or occur in outbreaks associated with more virulent meningococcal strains. Studies have demonstrated that the meningococcus can form biofilms both in vivo and ex vivo. In this chapter, we discuss methods to establish biofilms in the laboratory for in-depth biochemical, genetic, or microscopic studies.