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The research revealed that decreasing TCA activity by fluorocitrate would cause an increase in the concentration of polysaccharide intracellular adhesin (PIA), an important protein necessary for the development of biofilm. Besides fluorocitrate, any other factor, such as low level of oxygen, lack of iron, affecting TCA activity would increase the level of PIA. As a result, researchers have concluded that increasing TCA cycle activity would cause a decrease in PIA production, thus triggering removal of biofilms on the surface of medical devices..

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