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Background  Staphylococci belong to the most important pathogens causing implant-associated infections. Colonization of the implanted medical devices by the formation of a three-dimensional structure made of bacteria and host material called biofilm is considered the most critical factor in these infections. To form a biofilm, bacteria first attach to the surface of the medical device, and then proliferate and accumulate into multilayered cell clusters. Biofilm accumulation may be mediated by polysaccharide and protein factors.    Methology/Principal Findings  The information on  Staphylococcus aureus  protein factors involved in biofilm accumulation is limited, therefore, we searched the  S. aureus  Col genome for LPXTG-motif containing potential surface proteins and chose the so far uncharacterized  S. aureus  surface protein C (SasC) for further investigation. The deduced SasC sequence consists of 2186 amino acids with a molecular mass of 238 kDa and has features typical of Gram-positive surface proteins, such as an N-terminal signal peptide, a C-terminal LPXTG cell wall anchorage motif, and a repeat region consisting of 17 repeats similar to the  d omain of  u nknown  f unction 1542 (DUF1542). We heterologously expressed  sasC  in  Staphylococcus carnosus , which led to the formation of huge cell aggregates indicative of intercellular adhesion and biofilm accumulation. To localize the domain conferring cell aggregation, we expressed two subclones of  sasC  encoding either the N-terminal domain including a motif that is  f ound  i n  v arious  ar chitectures (FIVAR) or 8 of the DUF1542 repeats. SasC or its N-terminal domain, but not the DUF1542 repeat region conferred production of huge cell aggregates, higher attachment to polystyrene, and enhanced biofilm formation to  S. carnosus  and  S. aureus . SasC does not mediate binding to fibrinogen, thrombospondin-1, von Willebrand factor, or platelets as determined by flow cytometry.    Conclusions/Significance  Thus, SasC represents a novel  S. aureus  protein factor involved in cell aggregation and biofilm formation, which may play an important role in colonization during infection with this important pathogen.

Molecular Characterization of a Novel Staphylococcus Aureus Surface Protein (SasC) Involved in Cell Aggregation and Biofilm Accumulation