DISCUSSION
Wounds that are infected with S. pyogenes often fail to
respond to treatment. This is not always the consequence
of factors that confer antibiotic resistance and a growing
body of evidence strongly suggests that this phenomenon is
attributed to the tendency of S. pyogenes to grow as a
biofilm during infection. Over 90 % of invasive and noninvasive
strains readily form biofilms, and despite information
regarding biofilm formation in S. pyogenes being
limited, it is becoming apparent that this characteristic is
both strain- and serotype-dependent (Baldassarri et al.,
2006; Maddocks et al., 2011). S. pyogenes strains routinely
isolated from patients who have experienced treatment
failure are all prolific biofilm formers (Lembke et al., 2006)
that do not necessarily exhibit resistance to commonly used
systemic antibiotics; it is the biofilm community itself that
appears to confer resistance (Conley et al., 2003).