Paper Title
Combatting Biofilm Mediated Antimicrobial Resistance using Efflux Pump Inhibitor and Deoxyribonuclease

Abstract
Enterococcal biofilms have emerged recently as of grave concern due to implicated clinical, nosocomial infections and compromised food safety. The biofilm is a consortium of socially coordinated niches of microbes enclosed in self-produced polymeric matrix containing protein, lipopolysaccharide, fatty acids, carbohydrates, exopolymeric substance (EPS) and nucleic acids. The latter is also known as extracellular DNA constitutes only 10% of the matrix but plays a pivotal role in biofilm initiation, establishment and maturation. In addition it chelates antimicrobial and increases the cohesivity of matrix, thereby decreasing the penetrability of antimicrobials. Moreover the inhabitants of biofilm efflux the antimicrobials rendering the biofilm resistant to disinfection and removal by conventional antibiotics and biocides, often used to maintain the hygiene in food processing area, and rinsing solutions for catheters, dialysis tubings, Dentures and other prosthetics used in clinical setup. In view of above, the present study was considered to evaluate the efficacy of Deoxyribonuclease and efflux inhibitor Reserpine in enhancing the biofilm removal effect of ciprofloxacin (a broad spectrum antibiotic) and Benzalkonium chloride (Biocide) using loewe and Bliss model in statistical software Combenefit. Strong Synergism was observed with DNase-Ciprofloxacin, DNase-Biocide, Reserpine resulted in neutral. Index Terms - Bio film, enterococci, efflux pump, antimicrobial resistance, ciprofloxacin, reserpine, DNase, Combenifit.