Abstract

Bacterial biofilms formed by pathogens are known to be hundreds of times more resistant to antimicrobial agents than planktonic cells, making it extremely difficult to cure biofilm-based infections despite the use of antibiotics, which poses a serious threat to human health. Therefore, there is an urgent need to develop promising alternative antimicrobial therapies to reduce the burden of drug-resistant bacterial infections caused by biofilms. As natural enemies of bacteria, bacteriophages (phages) have the advantages of high specificity, safety and non-toxicity, and possess great potential in the defense and removal of pathogenic bacterial biofilms, which are considered to be alternatives to treat bacterial diseases. This work mainly reviews the composition, structure and formation process of bacterial biofilms, briefly discusses the interaction between phages and biofilms, and summarizes several strategies based on phages and their derivatives against biofilms and drug-resistant bacterial infections caused by biofilms, serving the purpose of developing novel, safe and effective treatment methods against biofilm-based infections and promoting the application of phages in maintaining human health.

Highlights

  • The increasing occurrence of antibiotic resistance in pathogenic bacteria has posed serious threats to the clinical, medical and food industries [1]

  • Recent studies have shown that phage therapy can be one of the most promising alternative treatment options for antibiotic-resistant pathogens, which is more effective than antibiotics against bacterial infections [10]

  • This paper mainly reviews the composition, architecture and formation process of bacterial biofilms, briefly introduces the classification and two major life cycles of phages, analyzes interaction mechanisms between phages and bacterial biofilms, and summarizes several phage-based applications for the control of bacterial biofilms and treatment of drug-resistant bacterial infections caused by biofilms, including phage cocktails, the use of phage-derived enzymes, and the combination of phages and/or their derivatives with antibiotics, nanoparticles as well as chemical disinfectants

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Summary

Introduction

The increasing occurrence of antibiotic resistance in pathogenic bacteria has posed serious threats to the clinical, medical and food industries [1]. Bacterial biofilm formation is considered to be one of the resistance mechanisms against antibiotics, which increases the virulence to be more pathogenic [2]. Recent studies have shown that phage therapy can be one of the most promising alternative treatment options for antibiotic-resistant pathogens, which is more effective than antibiotics against bacterial infections [10]. This paper mainly reviews the composition, architecture and formation process of bacterial biofilms, briefly introduces the classification and two major life cycles of phages, analyzes interaction mechanisms between phages and bacterial biofilms, and summarizes several phage-based applications for the control of bacterial biofilms and treatment of drug-resistant bacterial infections caused by biofilms, including phage cocktails, the use of phage-derived enzymes, and the combination of phages and/or their derivatives with antibiotics, nanoparticles as well as chemical disinfectants

The Composition and Architecture of the Bacterial Biofilm
The Formation of Bacterial Biofilm
Phage Cocktail Therapy
The Combination of Phage with Antibiotics
Genetically Engineered Phages
Phage-Derived Enzymes
The Combination of Phage with Other Strategies
Findings
Conclusions and Perspectives

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