Abstract
Biofilms refer to complex bacterial communities that are attached to the surface of animate or inanimate objects, which highly resist the antibiotics or the host immune defense mechanisms. Pathogenic biofilms in medicine are general, chronic, and even costly, especially on medical devices and orthopedic implants. Bacteria within biofilms are the cause of many persistent infections, which are almost impossible to eradicate. Though some progress has been made in comprehending the mechanisms of biofilm formation and persistence, novel alternative compounds or strategies and effective anti-biofilm antibiotics are still lacking. Smart materials of nano size which are able to respond to an external stimulus or internal environment have a great range of applications in clinic. Recently, smart nanomaterials with or without carriage of antibiotics, targeting specific bacteria and biofilm under some stimuli, have shown great potential for pathogenic biofilm and resident bacteria eradication. First, this review briefly summarizes and describes the significance of biofilms and the process of biofilm formation. Then, we focus on some of the latest research studies involving biofilm elimination, which probably could be applied in orthopedic implants. Finally, some outstanding challenges and limitations that need to be settled urgently in order to make smart nanomaterials effectively target and treat implant biofilms are also discussed. It is hoped that there will be more novel anti-biofilm strategies for biofilm infection in the prospective future.
Highlights
Biofilm formation, an ancient and indispensable feature of microorganisms, represents a protected mode of growth (Hall-Stoodley et al, 2004)
Biofilms can be regarded as layered aggregates of microbial cells and cellular products (Costerton et al, 1978; Rodríguez et al, 2011) with a three-dimensional polymer (Koo et al, 2017) network clinging to solid surfaces (Kumar et al, 2019), which can provide important structural support and protection for microbial communities (Flemming et al, 2007; Flemming and Wingender, 2010) and an environment for the exchange of genetic material between microbial individuals (Rodríguez et al, 2011)
Magnetic fields can penetrate body tissues, so they are commonly used in MRI for body imaging; in addition to that, external magnetic stimulation can control the magnetic responsive nanomaterials for treating biofilm infection (Yang et al, 2018)
Summary
Pathogenic biofilms in medicine are general, chronic, and even costly, especially on medical devices and orthopedic implants. Bacteria within biofilms are the cause of many persistent infections, which are almost impossible to eradicate. Though some progress has been made in comprehending the mechanisms of biofilm formation and persistence, novel alternative compounds or strategies and effective anti-biofilm antibiotics are still lacking. Smart nanomaterials with or without carriage of antibiotics, targeting specific bacteria and biofilm under some stimuli, have shown great potential for pathogenic biofilm and resident bacteria eradication. Some outstanding challenges and limitations that need to be settled urgently in order to make smart nanomaterials effectively target and treat implant biofilms are discussed. It is hoped that there will be more novel anti-biofilm strategies for biofilm infection in the prospective future
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