Fig. 6.

Cartoon depicting the shift that Staphylococcus epidermidis makes when [O₂] decreases in the growth medium. When high oxygen concentrations are found in the medium, S. epidermidis are planktonic cells and flow with the blood (top). In contrast, under micro- or anaerobic conditions cells shift to a fermentative metabolism and accumulate ATP adhering to a suitable surface (e.g. epithelia, catheters, artificial valves) and eventually forming a biofilm. In this state the cells exhibit more resistance to H₂O₂ mediated damage. Excess ATP is probably used to produce adhesion proteins and poly-N-acetylglucosamine (gray fibers in the illustration) (bottom)