“…Furthermore, adherence is enhanced through the production by microbial organisms, such as coagulase negative staphylococci [227,228], S. aureus [229], Pseudomonas aeruginosa [230], and Candida species [231] of an extracellular polymeric substance (EPS) consisting mostly of an exopolysaccharide that forms a microbial biofilm layer [218,232]. This biofilm matrix is enriched by divalent metallic cations, such as calcium, magnesium and iron, which make it a solid enclave in which microbial organisms can embed themselves [233][234][235]. Such a biofilm potentiates the pathogenicity of various microbes by allowing them to withstand host defense mechanisms (e.g., acting as a barrier to engulfment and killing by polymorphonuclear leukocytes) or by making them less susceptible to antimicrobial agents (e.g., forming a matrix that binds antimicrobials before their contact with the organism cell wall or providing for a population of metabolically quiescent, antimicrobial tolerant ''persister'' cells) [228,236,237].…”