Here we focus on biofilm "colonization resistance" utilizing newer, nontraditional microbiology assays and measure the MBEC (ug/mL) (Minimal Biofilm Eradication Concentration) utilizing:
confocal scanning laser microscopy (CLSM) and
a modified Calgary Biofilm Device (CBC).
Considerable effort is evolving to control biofilm diseases of "microbial imbalance" via immunomodulation; we are investigating the chemically modified tetracycline (CMTs) as primary mediators of immunomodulation and azithromycin, without development of microbial resistance.
Finally, we are using the largest US electronic antibiotic resistance database (TSN, Focus Technologies Inc., Herndon, VA) to constantly reevaluate the links of resistance, establishing a "microbial signature" based on unique phenotypes and compare these MICs to MBECs. This data has also been used to direct the WVUH formulary and introduce cyclic antibiotic profiles in ICU, BMTU, and ED.