Abstract
Biofilm formation is a complicated microbiological process and one of the distinctive features of pathogenic bacteria. Biofilms are a cluster of bacterial cells enclosed in extra polymeric substances and irreversibly attached onto a surface. Biofilms have a major impact on public health as biofilm associated bacteria are able to survive and populate in indwelling medical devices, causing severe nosocomial and recurrent infections. Biofilm-embedded bacteria have unique characteristics which are harder to destroy than the planktonic forms. Especially biofilm bacteria are highly resistant to antimicrobial agents. Treating patients undergoing long term urinary catheterization is becoming complicated by encrustation and blockage due to crystalline biofilm formation inside the lumen of catheters. Further, all types of indwelling catheters including silver or nitrofurazone‐coated devices are vulnerable to biofilm formation. Therefore, there is an urgent requirement to develop either urinary catheters with other alternative coatings or new urinary drainage systems which may lead to reduction of infections and morbidity. Other than that, controlling biofilm formation is a necessary requirement during both manufacturing and usage of catheters. Antifouling and biocidal coatings on the catheters are currently being investigated and it is proved that herbal products also express anti-biofilm activity. This review is largely based on previous literature describing biofilm formation and their role in catheter associated urinary tract infection. Further, mechanism of biofilm formation in indwelling urinary catheters, antibiotic resistance patterns, and the detection methods of biofilm are briefly described. Understanding the mechanisms of biofilm formation and the antibiotic resistance patterns is of utmost importance which will result in the development of new remedies for biofilm infection.
Highlights
The Structure and Formation of Microbial BiofilmsBiofilm is defined as accumulation of the microbial organisms that is permanently attached to biotic and abiotic surface and generally enclosed in self-produced extracellular polysaccharide substances (EPS) (Sayal et al, 2014; Wijesinghe et al, 2019)
When the bacterial colonies attach to surfaces, the bacterial cells upregulate genes which are specific for adhesion
Urinary tract infections play a major part in hospitalized infections and nearly 97 % of the cases were related to urinary catheters
Summary
Biofilm is defined as accumulation of the microbial organisms that is permanently attached to biotic and abiotic surface and generally enclosed in self-produced extracellular polysaccharide substances (EPS) (Sayal et al, 2014; Wijesinghe et al, 2019). Biofilm production is a complicated microbiological process which is a major pathogenic event in the infection It involves a sequence of steps, including irreversible attachment, accumulation, and maturation (Alves et al, 2014; Tiwari & Ghnawate, 2017). Among the medical devices, indwelling urinary catheters are known to be the major common site of biofilm producing bacteria ( Patel et al, 2016 ; Bardoloi & Yogeesha Babu, 2017). Accumulation of the crystalline materials occurs in the urine that remains inside the catheter lumen and develop rapidly within the biofilm matrix (Broomfield et al, 2009; Stickler, 2014; Tiwari & Ghnawate, 2017). High morbidity and the mortality rates of catheter associated urinary tract infection increase the hospital stay and cost of the treatment (Maharjan et al, 2018)
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