{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:51:51Z","timestamp":1791298311089,"version":"4.1.0"},"reference-count":74,"publisher":"American Association for the Advancement of Science (AAAS)","issue":"816","content-domain":{"domain":["www.science.org"],"crossmark-restriction":true},"short-container-title":["Sci. Transl. Med."],"published-print":{"date-parts":[[2025,9,17]]},"abstract":"<jats:p>\n            Biofilm infections on indwelling medical devices are a major cause of health care\u2013associated infection and mortality. Most of these infections are caused by staphylococci. Biofilm formation presents a continued clinical challenge because of the association with dramatically increased nonspecific antimicrobial resistance. Unlike most antibiotics, rifampicin is active against staphylococcal biofilm infections; however, the mechanism is unknown. Using in vitro assays and mouse models of biofilm infection, we show here that rifampicin is more effective than other antibiotics against staphylococcal\n            <jats:italic toggle=\"yes\">agr<\/jats:italic>\n            mutants, which are linked to serious biofilm infections because they produce extended biofilms. We found that this superiority results from an Agr-controlled rifampicin efflux system, which makes\n            <jats:italic toggle=\"yes\">agr<\/jats:italic>\n            mutant biofilms less resistant to rifampicin, rather than more resistant, than they are to other antibiotics. Our study provides a scientific rationale supporting the use of rifampicin in staphylococcal biofilm infections and emphasizes the importance of understanding genetic adaptations during infection for the use and development of biofilm therapeutics.\n          <\/jats:p>","DOI":"10.1126\/scitranslmed.adq8328","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T18:00:33Z","timestamp":1758132033000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":6,"title":["Export by a quorum sensing\u2013controlled drug exporter underlies rifampicin\u2019s strong activity against staphylococcal biofilms"],"prefix":"10.1126","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8385-4922","authenticated-orcid":true,"given":"Yao","family":"Liu","sequence":"first","affiliation":[{"name":"Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious 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