We have developed a method for visualizing Escherichia coli cells that are exposed to tetracycline in a biofilm, based on a previous report that liposomes containing the E. coli TetR(B) protein fluoresce when exposed to this antibiotic. By our method, cells devoid of TetR(B) also exhibited tetracycline-dependent fluorescence. At 50 g of tetracycline ml؊1 , planktonic cells of a uropathogenic E. coli (UPEC) strain developed maximal fluorescence after 7.5 to 10 min of exposure. A similar behavior was exhibited by cells in a 24-or 48-h UPEC biofilm, as examined by confocal laser microscopy, regardless of whether they lined empty spaces or occupied densely packed regions. Further, a comparison of phase-contrast and fluorescent images of corresponding biofilm zones showed that all the cells fluoresced. Thus, all the biofilm cells were exposed to tetracycline and there were no pockets within the biofilm where the antibiotic failed to reach. It also appeared unlikely that niches of reduced exposure to the antibiotic existed within the biofilms.Diseases involving bacterial biofilms are generally chronic and difficult to treat, because bacteria in biofilms are more resistant to antimicrobial agents than their planktonic (freeliving) counterparts. Biofilms contribute to several serious diseases, such as endocarditis, cystitis, cystic fibrosis, and infections of prosthetic devices (4-6a).It is not known why biofilms possess greater resistance. The possibility that this might be due to a lack of penetration of antibiotics has received considerable attention. Although several studies suggest that biofilms permit antibiotic penetration (1,6,8,9,10,12,14), it was not ascertained in these studies if this involved exposure of all constituent cells to the antibiotic.We have developed a method to directly visualize cells coming in contact with tetracycline, based on the report that in the presence of the TetR(B) protein in liposomes (see http:// biosafety.ihe.be/AR/Tetracycline/Menu_Tet for tetracycline resistance determinant nomenclature), this antibiotic fluoresces when activated by UV light (13). TetR(B) is constitutively synthesized in bacteria containing Tn10 and regulates the expression of the tetA(B) gene that encodes the tetracycline efflux pump (2). We report here that the biofilms of uropathogenic Escherichia coli (UPEC) and K-12 strains of E. coli (11) are readily permeable to tetracycline and permit exposure of all the constituent cells to this antibiotic.
MATERIALS AND METHODSBacterial strains and plasmids. A clinical isolate of uropathogenic E. coli (AMG1), obtained from the Microbiology Section of the Infectious Diseases Department of the Stanford Medical Center, and our laboratory E. coli strain, AMS6 (11), were employed. A tetracycline-resistant strain of AMG1, referred to as AMG2, containing the TetR(B) protein was generated using the Tn10 transposon, and the " hop" technique; the latter employs a temperature-sensitive phage (561) as the Tn10 vehicle. Transposition was achieved as described previously (15), using...