Abstract
Biofilm formation in healthcare is an issue of considerable concern, as it results in increased morbidity and mortality, imposing a significant financial burden on the healthcare system. Biofilms are highly resistant to conventional antimicrobial therapies and lead to persistent infections. Hence, there is a high demand for novel strategies other than conventional antibiotic therapies to control biofilm-based infections. There are two approaches which have been employed so far to control biofilm formation in healthcare settings: one is the development of biofilm inhibitors based on the understanding of the molecular mechanism of biofilm formation, and the other is to modify the biomaterials which are used in medical devices to prevent biofilm formation. This review will focus on the recent advances in anti-biofilm approaches by interrupting the quorum-sensing cellular communication system and the multidrug efflux pumps which play an important role in biofilm formation. Research efforts directed towards these promising strategies could eventually lead to the development of better anti-biofilm therapies than the conventional treatments.
Highlights
Biofilms are surface-attached groups of microbial cells that are embedded in a self-produced extracellular matrix and are highly resistant to antimicrobial agents [1,2,3]
The various approaches for modulating biofilm formation on medical devices are addressed in detail, with special emphasis on quorum-quenching strategies
Significant advances have been made in understanding the role of quorum sensing in biofilm formation in the past few years
Summary
Biofilms are surface-attached groups of microbial cells that are embedded in a self-produced extracellular matrix and are highly resistant to antimicrobial agents [1,2,3]. Biofilms can attach to all kinds of surfaces, including metals, plastics, plant and body tissue, medical devices and implant materials [4]. Among the biofilm-forming bacteria, S. aureus and S. epidermidis are predominantly isolated from cardiovascular devices [8,9]. It has been estimated that S. aureus and S. epidermidis contribute to 40–50% of prosthetic heart valve infections and 50–70% of the catheter biofilm infections [10]. The Acinetobacter spp. have the ability to colonize and form biofilms on medical devices such as implants, cardiac valves, artificial joints, catheters, etc. Biofilm formation is initiated when the cells attach and adhere to surfaces. This review will discuss the most successful antibiofilm approaches so far, as well as some of the more promising prospects for the control of these biofilm-based infections
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