Abstract
Recognition of the fact that bacterial biofilm may play a role in the pathogenesis of disease has led to an increased focus on identifying diseases that may be biofilm-related. Biofilm infections are typically chronic in nature, as biofilm-residing bacteria can be resilient to both the immune system, antibiotics, and other treatments. This is a comprehensive review describing biofilm diseases in the auditory, the cardiovascular, the digestive, the integumentary, the reproductive, the respiratory, and the urinary system. In most cases reviewed, the biofilms were identified through various imaging technics, in addition to other study approaches. The current knowledge on how biofilm may contribute to the pathogenesis of disease indicates a number of different mechanisms. This spans from biofilm being a mere reservoir of pathogenic bacteria, to playing a more active role, e.g., by contributing to inflammation. Observations also indicate that biofilm does not exclusively occur extracellularly, but may also be formed inside living cells. Furthermore, the presence of biofilm may contribute to development of cancer. In conclusion, this review shows that biofilm is part of many, probably most chronic infections. This is important knowledge for development of effective treatment strategies for such infections.
Highlights
Bacteria form biofilms as part of their survival mechanisms, and biofilms are ubiquitous in nature
In a study on 54 patients with sialolithiasis, biofilm was observed on 71% of the removed stones by fluorescence microscopy, and common oral bacteria were found on half of the stones [60]
The observation that bacterial biofilms were found in 75–100% of patients with clinical post-operative infections, recurrent sialadenitis or pus drainage, indicates that the presence of bacterial biofilms may contribute to more severe cases of sialadenitis
Summary
Bacteria form biofilms as part of their survival mechanisms, and biofilms are ubiquitous in nature. The bacteria adapt to environmental anoxia and nutrient limitation by exhibiting an altered metabolism, gene expression, and protein production, which can lead to a lower metabolic rate and a reduced rate of cell division [3,5]. These adaptations make the bacteria more resistant to antimicrobial therapy by inactivating the antimicrobial targets or reducing the requirements for the cellular function that the antimicrobials interfere with. A growing amount of research deals with ways of combating such biofilms This is not considered to be within the scope of this review
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