Abstract
Bacterial biofilms are a serious public-health problem worldwide. In recent years, the rates of antibiotic-resistant Gram-negative bacteria associated with biofilm-forming activity have increased worrisomely, particularly among healthcare-associated pathogens. Acinetobacter baumannii is a critically opportunistic pathogen, due to the high rates of antibiotic resistant strains causing healthcare-acquired infections (HAIs). The clinical isolates of A. baumannii can form biofilms on both biotic and abiotic surfaces; hospital settings and medical devices are the ideal environments for A. baumannii biofilms, thereby representing the main source of patient infections. However, the paucity of therapeutic options poses major concerns for human health infections caused by A. baumannii strains. The increasing number of multidrug-resistant A. baumannii biofilm-forming isolates in association with the limited number of biofilm-eradicating treatments intensify the need for effective antibiofilm approaches. This review discusses the mechanisms used by this opportunistic pathogen to form biofilms, describes their clinical impact, and summarizes the current and emerging treatment options available, both to prevent their formation and to disrupt preformed A. baumannii biofilms.
Highlights
Bacteria are fascinating microscopic cells that can live by themselves or be extremely social
MBIC, minimum concentration of drug that exhibits greater than 50% of biofilm inhibition without affecting growth; CSH, cell surface hydrophobicity; EPS, extracellular polymeric substance; CLSM, confocal laser scanning microscopy; CFS, cell-free supernatant; MDR, multidrug resistant; QS, quorum sensing; MIC, minimum inhibitory concentration; acyl homoserine lactone (AHL), N-acyl-homoserine lactone; QQ, quorum quenching; NPs, nanoparticles; Photodynamic inactivation (PDI), photodynamic inactivation; AZM, azithromycin; RIF, rifampicin; XDR, extensively drug resistant; IMP, imipenem; MRP, meropenem; TIG, tigecycline; POL, polymyxin B; antimicrobial peptides (AMPs), ampicillin; CVC, central venous catheter; NS, not specified
MBIC, minimum concentration of drug that exhibits greater than 50% of biofilm inhibition without affecting growth; CSH, cell surface hydrophobicity; MIC, minimum inhibitory concentration; minimal biofilm eradication concentration (MBEC), minimum concentration eradicating preformed biofilm; MBEC-50, minimum concentration that kills 50% of cells in preformed biofilm; MBEC-80, minimum concentration that kills 80% of cells in preformed biofilm; CFS, cell-free supernatant; MDR, multidrug resistant; QS, quorum sensing; AHL, N-acyl homoserine lactone; EPS, extracellular polymeric substance; PDI, photodynamic inactivation; QQ, quorum quenching; CLSM, confocal laser scanning microscopy; AFM, atomic force microscopy; NPs, nanoparticles; SEM, scanning electron microscopy; NS, not specified; MOI, multiplicity of infection; CIP, ciprofloxacin; SXT, cotrimoxazole; GN, gentamicin; TOB, tobramycin; IMP, imipenem; MRP, meropenem; FE-SEM, field-emission scanning electron microscopy
Summary
Bacteria are fascinating microscopic cells that can live by themselves or be extremely social They can establish social interactions with other microorganisms to form highly organized communities known as biofilms. Microorganisms 2021, 9, 1353 biofilms have been found useful in food fermentation, the production of many bio-based materials, bioremediation, wastewater treatment and microbial fuel cells [6,7,8,9,10] Despite these beneficial and useful roles, biofilms represent a significant threat for public health, being responsible for persistent infections with relevant economic and health impacts. Survival even in dried environmental conditions is tightly connected with its ability to form biofilm This feature in conjunction with the overuse of antibiotics has allowed A. baumannii to perfectly adapt to healthcare environments, thereby representing a source of spread of this opportunistic pathogen. The mechanisms underlying biofilm formation, the burden of antibiotic resistance, the clinical impact of the biofilm-related infections, and the therapeutic strategies for their treatment and prevention, are discussed
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