Bacterial adherence and the glycocalyx and their role in musculoskeletal infection

Orthop Clin North Am. 1984 Jul;15(3):517-35.


Bacteria produce a virulence-related polysaccharide exocellular slime (the glycocalyx), which preferentially adheres to the surfaces of biomaterials and compromised tissues. This biofilm resists antibiotic penetration and provides a degree of protection from antibodies and macrophages. Similar adhesive cell-to-substrate phenomena have been noted in natural environments and in bacterial-animal cell disease states. The adherent glycocalyx is one of the fundamental reasons for increased susceptibility to infection in the presence of biomaterials and compromised tissues and a significant factor in the persistence of such infection until the removal of the prosthetic device.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Bacteria / isolation & purification
  • Bacteria / pathogenicity*
  • Bacteria / ultrastructure
  • Bacterial Infections / etiology*
  • Bacterial Infections / microbiology
  • Biocompatible Materials
  • Bone Diseases / etiology*
  • Bone Diseases / microbiology
  • Female
  • Femoral Fractures / microbiology
  • Glycoproteins / physiology*
  • Hip Fractures / microbiology
  • Humans
  • Male
  • Microscopy, Electron
  • Microscopy, Electron, Scanning
  • Middle Aged
  • Muscular Diseases / etiology*
  • Muscular Diseases / microbiology
  • Osteomyelitis / microbiology
  • Polysaccharides / physiology*


  • Biocompatible Materials
  • Glycoproteins
  • Polysaccharides