Figure 1.

Scanning electron microscopy of select patient samples to illustrate the confirmed presence of biofilm. A, P18, arrow demonstrating coccoid microorganisms under a dense extracellular polymeric substance (EPS). B, P8, arrow demonstrates a small coccoid shaped microbial aggregate under a dense EPS. C, P9 demonstrates aggregates of both rod and coccoid microorganisms, DNA sequencing identifies the presence of Pseudomonas spp., Enterococcus spp., Streptococcus spp., and Staphylococcus spp. D, P5 illustrates a large dense aggregate of coccoid microorganisms interspersed with planktonic cells. P = patient