This research was supported by the Main Research Program (E0210702-03) of the Korea Food Research Institute (KFRI), funded by the Ministry of Science and ICT.

1. Preparation of bacterial inoculum
<ol>
	<li>Remove the glycerol stock vial stored at -80 &#176;C.</li>
	<li>Remove the bacterial strain (2-10 &#181;L) from the vial using a sterile pipette tip. 
	NOTE: Acinetobacter strains, A. bouvetii (13-1-1), A. junii (13-1-2), A. pittii (13-2-5), A. baumannii (13-2-9), A. radioresistens (20-1), and A. ursingii (24-1) are used in this protocol.</li>
	<li>Inoculate a commercially available blood ...

Assessment of Acinetobacter Biofilm Formation and Characterization of Biofilms

<ol>
	<li>Wong, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+and+pathophysiological+overview+of+Acinetobacter+infections:+a+century+of+challenges.">Clinical and pathophysiological overview of Acinetobacter infections: a century of challenges.</a> Clinical Microbiology Reviews. 30 (1), 409-447 (2017).</li><li>Carvalheira, A., Silva, J., Teixeira, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acinetobacter+spp.+in+food+and+drinking+water+-+A+review.">Acinetobacter spp. in food and drinking water - A review.</a> Food Microbiology. 95, 103675 (2021).</li><li>Towner, K. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acinetobacter:+an+old+friend,+but+a+new+enemy.">Acinetobacter: an old friend, but a new enemy.</a> Journal of Hospital Infection. 73 (4), 355-363 (2009).</li><li>Weber, D. J., Rutala, W. A., Miller, M. B., Huslage, K., Sickbert-Bennett, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+hospital+surfaces+in+the+transmission+of+emerging+health+care-associated+pathogens:+Norovirus,+Clostridium+difficile,+and+Acinetobacter+species.">Role of hospital surfaces in the transmission of emerging health care-associated pathogens: Norovirus, Clostridium difficile, and Acinetobacter species.</a> American Journal of Infection Control. 38 (5), S25-S33 (2010).</li><li>Flemming, H. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+biofilm+matrix:+multitasking+in+a+shared+space.">The biofilm matrix: multitasking in a shared space.</a> Nature Reviews Microbiology. 21 (2), 70-86 (2023).</li><li>Flemming, H. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biofilms:+an+emergent+form+of+bacterial+life.">Biofilms: an emergent form of bacterial life.</a> Nature Reviews Microbiology. 14 (9), 563-575 (2016).</li><li>Yin, W., Wang, Y., Liu, L., He, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biofilms:+the+microbial+&amp;#34;protective+clothing&amp;#34;+in+extreme+environments.">Biofilms: the microbial &amp;#34;protective clothing&amp;#34; in extreme environments.</a> International Journal of Molecular Sciences. 20 (14), 3423 (2019).</li><li>Gedefie, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acinetobacter+baumannii+biofilm+formation+and+its+role+in+disease+pathogenesis:+a+review.">Acinetobacter baumannii biofilm formation and its role in disease pathogenesis: a review.</a> Infection and drug resistance. 14, 3711-3719 (2021).</li><li>Whiteway, C., Breine, A., Philippe, C., Van der Henst, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acinetobacter+baumannii.">Acinetobacter baumannii.</a> Trends in Microbiology. 30 (2), 199-200 (2022).</li><li>Longo, F., Vuotto, C., Donelli, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biofilm+formation+in+Acinetobacter+baumannii.">Biofilm formation in Acinetobacter baumannii.</a> New Microbiologica. 37 (2), 119-127 (2014).</li><li>Azeredo, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Critical+review+on+biofilm+methods.">Critical review on biofilm methods.</a> Critical Reviews in Microbiology. 43 (3), 313-351 (2017).</li><li>Jia, J., Xue, X., Guan, Y., Fan, X., Wang, Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biofilm+characteristics+and+transcriptomic+profiling+of+Acinetobacter+johnsonii+defines+signatures+for+planktonic+and+biofilm+cells.">Biofilm characteristics and transcriptomic profiling of Acinetobacter johnsonii defines signatures for planktonic and biofilm cells.</a> Environmental Research. 213, 113714 (2022).</li><li>Yang, C., Su, P., Moi, S., Chuang, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biofilm+formation+in+Acinetobacter+baumannii:+genotype-phenotype+correlation.">Biofilm formation in Acinetobacter baumannii: genotype-phenotype correlation.</a> Molecules. 24 (10), 1849 (2019).</li><li>Alamri, A. M., Alsultan, A. A., Ansari, M. A., Alnimr, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biofilm-formation+in+clonally+unrelated+multidrug-resistant+Acinetobacter+baumannii+isolates.">Biofilm-formation in clonally unrelated multidrug-resistant Acinetobacter baumannii isolates.</a> Pathogens. 9 (8), 630 (2020).</li><li>Lim, E. S., Nam, S. J., Koo, O. K., Kim, J. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Protective+role+of+Acinetobacter+and+Bacillus+for+Escherichia+coli+O157:H7+in+biofilms+against+sodium+hypochlorite+and+extracellular+matrix-degrading+enzymes.">Protective role of Acinetobacter and Bacillus for Escherichia coli O157:H7 in biofilms against sodium hypochlorite and extracellular matrix-degrading enzymes.</a> Food Microbiology. 109, 104125 (2023).</li><li>Stepanovi&#263;, S., &#262;irkovi&#263;, I., Ranin, L., Svabi&#263;-Vlahovi&#263;, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biofilm+formation+by+Salmonella+spp.+and+Listeria+monocytogenes+on+plastic+surface.">Biofilm formation by Salmonella spp. and Listeria monocytogenes on plastic surface.</a> Letters in Applied Microbiology. 38 (5), 428-432 (2004).</li><li>Boone, R. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+virulence+phenotypes+and+antibiotic+resistance+in+clinical+strains+of+Acinetobacter+baumannii+isolated+in+Nashville,+Tennessee.">Analysis of virulence phenotypes and antibiotic resistance in clinical strains of Acinetobacter baumannii isolated in Nashville, Tennessee.</a> BMC Microbiology. 21 (1), 21 (2021).</li><li>Otter, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surface-attached+cells,+biofilms+and+biocide+susceptibility:+implications+for+hospital+cleaning+and+disinfection.">Surface-attached cells, biofilms and biocide susceptibility: implications for hospital cleaning and disinfection.</a> Journal of Hospital Infection. 89 (1), 16-27 (2015).</li><li>Ravishankar, S., Juneja, V. K., Yousef, A. E., Juneja, V. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adaptation+or+resistance+responses+of+microorganisms+to+stresses+in+the+food+processing+environment.">Adaptation or resistance responses of microorganisms to stresses in the food processing environment.</a> Microbial Stress Adaptation and Food Safety. , (2003).</li><li>Dewanti, R., Wong, A. C. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+culture+conditions+on+biofilm+formation+by+Escherichia+coli+O157:H7.">Influence of culture conditions on biofilm formation by Escherichia coli O157:H7.</a> International Journal of Food Microbiology. 26 (2), 147-164 (1995).</li><li>McConnell, M. J., Actis, L., Pach&#243;n, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acinetobacter+baumannii:+human+infections,+factors+contributing+to+pathogenesis+and+animal+models.">Acinetobacter baumannii: human infections, factors contributing to pathogenesis and animal models.</a> FEMS Microbiology Reviews. 37 (2), 130-155 (2013).</li><li>McQueary, C. N., Actis, L. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acinetobacter+baumannii+biofilms:+variations+among+strains+and+correlations+with+other+cell+properties.">Acinetobacter baumannii biofilms: variations among strains and correlations with other cell properties.</a> The Journal of Microbiology. 49 (2), 243-250 (2011).</li></ol>

Using the protocol described, the biofilm formation of Acinetobacter isolates with varying degrees was measured, visualized, and the viable cells in the biofilms were estimated (Figure 1, Figure 2, and Figure 3).
In this protocol, two different temperatures were used, 30 &#176;C for the growth and 25 &#176;C for the biofilm formation of Acinetobacter. 30 &#176;C was used because many stu...

Acinetobacter is known to cause nosocomial infections, and its human infection, especially in healthcare facilities, is increasingly reported1. It is widespread in hospitals, healthcare facilities, and food-associated environments2,3,4. It can survive for a long period in environments including hospital surfaces such as bed rails, bedside tables, the surface of ventilators, and sinks4. Such persistence on environmental surfaces may be one of the significant factors contributing to the nosocomial infections of Acinetobacter4.
Biofilm is a form of microbial life and is a microbial matrix composed of live microbial cells and extracellular polymeric substances (EPS) from the cells5. The microbial cells are embedded in the matrix and are often highly resistant to environmental stresses such as heat, salts, dryness, antibiotics, disinfectants, and shear forces6,7.
Acinetobacter can form biofilms on surfaces, suggesting that it may contribute to extended survival on environmental surfaces, including hospital surfaces, and enhanced resistance to antibiotic treatment8,9. In addition, the biofilm formation of Acinetobacter could be highly associated with human clinical outcomes8. Therefore, the biofilm formability of Acinetobacter strains could be one of the indicators in predicting environmental survival and human infections8,10.
The surface-attached biofilms can be quantified and visualized to assess biofilm formability. To quantify surface-attached biofilms, the biofilms are normally stained by biofilm-staining dyes such as crystal violet, and the dyes are eluted in solution and measured for optical density11. Visualization of biofilms is another good approach to assess biofilm formability11. Confocal Laser Scanning Microscopy (CLSM) visualization method employing specificity using fluorescent dyes could be more useful to characterize biofilm morphology compared to other techniques such as SEM12,13.
The viable cells in biofilms can be counted to estimate the number of viable cells in biofilms11. The viable cells embedded in biofilms are detached, diluted, spread on agar plates, incubated, and enumerated. Because the higher number of cells is likely to meet the infectious dose, it can provide more detailed information on biofilms, such as infection potentials associated with the number of cells13,14.
This article presents step-by-step protocols to (1) quantify surface-attached biofilms, (2) count viable cells in the biofilms, and (3) visualize the biofilms using CLSM of Acinetobacter. The presented protocols describe the methods to assess the biofilm formability of Acinetobacter isolates and characterize their biofilms.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>96-well cell culture plate</td>
			<td>SPL</td>
			<td>30096</td>
			<td>Polystyrene 96-well plate</td>
		</tr>
		<tr>
			<td>BHI (Brain Heart Infusion) broth</td>
			<td>Merck KGaA</td>
			<td>1.10493.0500</td>
			<td></td>
		</tr>
		<tr>
			<td>Blood Agar Base Plate</td>
			<td>KisanBio</td>
			<td>MB-B1005-P50</td>
			<td>Growth media for Acinetobacter</td>
		</tr>
		<tr>
			<td>CHROMagar Acinetobacter</td>
			<td>CHROMagar</td>
			<td>AC092</td>
			<td>Selective plate for Acinetobacter</td>
		</tr>
		<tr>
			<td>Crystal violet solution</td>
			<td>Sigma-Aldrich</td>
			<td>V5265</td>
			<td></td>
		</tr>
		<tr>
			<td>Filmtracer LIVE/DEAD biofilm viability kit</td>
			<td>Invitrogen</td>
			<td>L10316</td>
			<td>SYTO9 and propidium iodide</td>
		</tr>
		<tr>
			<td>Microplate reader</td>
			<td>Tecan</td>
			<td>Infinite M200 PRO NanoQuant</td>
			<td>Biofilm measurement</td>
		</tr>
		<tr>
			<td>RBC Glass Plating Beads</td>
			<td>RBC</td>
			<td>RG001</td>
			<td>Glass beads</td>
		</tr>
		<tr>
			<td>&#956;-Plate 96 Well Black</td>
			<td>ibidi</td>
			<td>89621</td>
			<td>Microplate intended for CLSM</td>
		</tr>
	</tbody>
</table>

quantification, viability assessment, and visualization strategies for acinetobacter biofilms

Acinetobacter causes nosocomial infections and its biofilm formation can contribute to the survival on dry surfaces such as hospital environments. Thus, biofilm quantification and visualization are important methods to assess the potential of Acinetobacter strains to cause nosocomial infections. The biofilms forming on the surface of the microplate can be quantified in terms of volume and cell numbers. Biofilm volumes can be quantified by staining using crystal violet, washing, destaining using ethanol, then measuring the solubilized dye using a microplate reader. To quantify the number of cells embedded in the biofilms, the biofilms are scrapped off using cell scrapers, harvested in the saline, vigorously agitated in the presence of glass beads, and spread on Acinetobacter agar. Then, the plates are incubated at 30 &#176;C for 24-42 h. After incubation, the red colonies are enumerated to estimate the number of cells in biofilms. This viable count method can also be useful for counting Acinetobacter cells in mixed-species biofilms. Acinetobacter biofilms can be visualized using fluorescent dyes. A commercially available microplate designed for microscopic analysis is employed to form biofilms. Then, the bottom-surface attached biofilms are stained with SYTO9 and propidium iodide dyes, washed, then visualized with confocal laser scanning microscopy.

Author Spotlight: A Comprehensive Protocol for Acinetobacter Biofilm Quantification, Assessment, and Visualization 

Quantification, Viability Assessment, and Visualization Strategies for Acinetobacter Biofilms

Biofilms are composed of live microbial cells and are difficult to remove from the surfaces. Acinetobacter strains commonly found in our environment, causing nosocomial infections, are also known to form biofilms on surfaces. So, we aim to develop methods to both quantify and visualize Acinetobacter biofilms.Our protocol provides a simple and easy method to quantify and visualize the biofilms of Acinetobacter. The viable number of cells inside the biofilms is quantified by using the viable count method. Our research findings reveal that the naturally-existing Acinetobacter vector strains have quite varying potentials for biofilm formation.Also, there will exist distinct morphological differences within the various biofilms. This paved the way for research focusing on the causes of such a large variation among Acinetobacter strains.

Following the protocol, the biofilms of Acinetobacter isolates, originally isolated from kitchen surfaces, were formed on a polystyrene 96-well plate, stained with crystal violet, and the dyes were solubilized in ethanol and measured for biofilm mass (Figure 1). The number of biofilms greatly varied depending on the strains ranging from OD 0.04 to 1.69 (Figure 1). Based on the criteria established by Stepanovi&#263; et al.16, all...

Watch this Scientific Journal Video about A Comprehensive Protocol for Acinetobacter Biofilm Quantification, Assessment, and Visualization at JoVE.com

This protocol describes the preparation of the inoculum, the biofilm quantification on microtiter plates using crystal violet dye, the viable count in biofilms, and the visualization of biofilms of Acinetobacter.

Acinetobacter causes nosocomial infections and its biofilm formation can contribute to the survival on dry surfaces such as hospital environments. Thus, ...