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To elucidate the question of whether biofilm formedby the intercellular adhesion (ica) gene cluster has influenceson antibiotic resistance in Staphylococcus epidermidis, wecompared 124 skin strains with strains isolated from 50 bloodcultures that cause septicemic diseases. The results revealedthat the blood culture isolates were more resistant to theantibiotics tested than the saprophytic isolates. Moreover,antibiotic multiresistance was more prevalent in the clinicalisolates. In the blood culture isolates, 46% of the strains wereresistant to three or more antibiotics, whereas only 12% ofthe saprophytic isolates were resistant to three or moreantibiotics. Interestingly, these characteristics were highlycorrelated with the biofilm formed by the ica gene cluster. Inbiofilm-producing strains, 84% of the blood culture isolatesand 44% of the saprophytic isolates were antibiotic multiresistant,whereas only 22% and 9%, respectively, were antibioticmultiresistant in biofilm-nonproducing strains. Additionally,in the biofilm-producing ica-positive strains, 89% of the bloodculture isolates and 57% of the saprophytic isolates wereantibiotic multiresistant. However, the rate of the antibioticmultiresistance in the ica-negative strains was very low, thusindicating that the biofim formed by the ica gene cluster in S.epidermidis is an important pathogenic factor in associationwith the antibiotic multiresistance.

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