Abstract
Biofilm formation by human bacterial pathogens on implanted medical devices causes major morbidity and mortality among patients, and leads to billions of dollars in healthcare cost. Biofilm is a complex bacterial community that is highly resistant to antibiotics and human immunity. As a result, novel therapeutic solutions other than the conventional antibiotic therapies are in urgent need. In this review, we will discuss the recent research in discovery of alternative approaches to prevent or treat biofilms. Current anti-biofilm technologies could be divided into two groups. The first group focuses on targeting the biofilm forming process of bacteria based on our understanding of the molecular mechanism of biofilm formation. Small molecules and enzymes have been developed to inhibit or disrupt biofilm formation. Another group of anti-biofilm technologies focuses on modifying the biomaterials used in medical devices to make them resistant to biofilm formation. While these novel anti-biofilm approaches are still in nascent phases of development, efforts devoted to these technologies could eventually lead to anti-biofilm therapies that are superior to the current antibiotic treatment.
Highlights
Biofilm is a community of bacteria that are attached to a substratum or surface
We will discuss alternative approaches to prevent or treat biofilms focusing on S. aureus and S. epidermidis, two of the most important biofilm forming pathogens
S. epidermidis biofilm formation was significantly inhibited on a vancomycin coated titanium alloy [40]
Summary
Biofilm is a community of bacteria that are attached to a substratum or surface. Bacteria in biofilm are embedded in extracellular polymeric matrix produced by the bacteria. Biofilm formation on indwelling medical devices and implants such catheters, mechanical heart valves, pacemakers, prosthetic joints, and contact lenses pose a critical medical problem. Both Gram-negative and Gram-positive bacteria can form biofilms on indwelling medical devices. The most common biofilm-forming bacteria include Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus viridans, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa [2]. Biofilm formation is initiated when bacterial cells attach and adhere to the surfaces of implants or host tissues. The host factors could mediate bacterial attachment to implant surfaces, which is covered by host plasma and other extracellular components. The complicated structure of biofilm with extracellular polymeric matrix could prevent antibiotics from reaching the bacteria. We will discuss alternative approaches to prevent or treat biofilms focusing on S. aureus and S. epidermidis, two of the most important biofilm forming pathogens
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