Innovative strategies for combating biofilm-based infections.

Abstract

Biofilms, defined as a surface attached community of bacteria embedded in a matrix of extracellular polymeric substances, are a significant global health problem, causing considerable patient morbidity and mortality and contributing to the economic burden of infectious disease. Conventional antibiotics are largely ineffective against bacteria residing with a biofilm, necessitating alternative strategies to combat biofilms. Such strategies, which either inhibit biofilm formation or disperse existing biofilms, are ideally based upon a non-microbicidal approach, which avoids placing direct evolutionary pressure on the bacteria to develop resistance. Several such approaches are discussed in this chapter and range from the design of small molecules to interfere with the bacterial communication and signaling pathways that control biofilm formation and maintenance, such as quorum sensing and two-component signal transduction systems, to macromolecular approaches to biofilm eradication such as enzymatic degradation of the biofilm matrix and the development of biofilm-specific antibodies. When combined with conventional antibiotics that are effective against planktonic bacteria, the strategies discussed here have the potential to eradicate biofilm based bacterial infections and have a significant impact upon human health.