From Koch’s postulates to biofilm theory. The lesson of Bill Costerton

ABSTRACT The clinical diagnoses of implant infections pose insurmountable difficulties for cultural methods because of their frequent failure when bacteria are growing in biofilms. In 1978 Bill Costerton warned that chronic infections in patients with indwelling medical devices were caused by bacteria growing in welldeveloped glycocalyx-enclosed biofilms and that bacteria within biofilms resist antibiotic therapies and immune host defenses. Costerton’s “biofilm theory” opened two lines of scientific endeavor: the study of the biochemistry and genetics of biofilm formation and function; and, on the other side, the search for new methods for medical diagnosis and treatment of biofilm-centered implant infections. This Editorial and the entire 2012 issue “Focus on Implant Infections” are dedicated to the memory of Bill Costerton, recognized worldwide as the Father of Biofilms for his innovation and body of work on infections caused by sessile bacteria. Bill Costerton was a great scientist, heedful both to the biological aspects of biofilms and to the medical challenges of new diagnostic methods and modern therapeutic approaches to implant infections. But, most of all, he was a charming Maestro for the large number of colleagues and students whose enthusiasm for the science he was able to nourish. Bill passed away on May 12th, 2012 and the entire science community mourns the death of a friend and a leader.