Detection of viable but non-culturable staphylococci in biofilms from central venous catheters negative on standard microbiological assays

To our knowledge this is the first evidence that S. epidermidis and S. aureus can enter the VBNC state. If positively documented, their ability to persist in this state could help to explain the well-known prevalence of both species in recurrent CVC-related infections [4,8,17,18]. Detection of S. epidermidis in 62% of CVCs demonstrated to contain non-culturable bacteria (removed from febrile patients, 27% of whom also had a positive blood culture) supports this hypothesis. Further research into the relationship among VBNC forms found in CVC-associated biofilms, their actual metabolic activity and recurrent infection, as well as careful recording of concurrent clinical data, are required to gain insights into the possible role of VBNC bacterial cells in indwelling medical device-related persistent infections.