The role of the ica locus-encoded polysaccharide intercellular adhesin (PIA/PNAG) has contributed a lot to the pathogenesis of device-related infections of staphylococcal biofilm. Understanding of how the ica locus and PIA/PNAG biosynthesis are regulated is not enough. Another biofilm formation mechanism of ica-independent in both Staphylococcus aureus and Staphylococcus epidermidis exists. The cell surface associated proteins are capable of mediating biofilm formation. Future research about their potential role in biofilm development will be very important.