microbial biofilms: challenges for treatment and public health

Biofilms are organized communities of microorganisms that adhere to various surfaces, including medical devices, natural tissues, and industrial equipment and are embedded in a self-produced exopolysaccharide matrix. biofilm formation is a multifaceted process that encompasses adsorption, adhesion, microcolony formation, maturation, and dispersion. this process is influenced by various external factors, including temperature, ph, oxygen levels, and nutrient availability, as well as host-related factors like immune response, health issues, and genetics. additionally, gravitational and hydrodynamic forces, brownian motion, surface characteristics, quorum sensing, and other signaling molecules significantly contribute to formation and persistence of biofilms. conservative estimates indicate that about 70% of bacterial infections, including dental plaque, osteomyelitis, otitis media, native valve endocarditis, and cystic fibrosis as are associated with biofilm. biofilms facilitate infectious diseases by enabling the detachment of cells into the bloodstream, promoting plasmid exchange that confers antibiotic resistance, reducing susceptibility to antimicrobial agents, producing endotoxins, and evading the host immune response. medical devices including prosthetic heart valves, central venous catheters, contact lenses, and intrauterine devices are also significant contributors to biofilm-related diseases. interactions among different bacterial species within biofilms markedly influence their pathogenicity and virulence, enhancing their infectious potential. these interspecies interactions can stimulate the production of virulence factors, including toxins and enzymes that individual species typically do not produce, resulting in tissue damage and a compromised immune response. antibiotic resistance, the evasion of the body s immune system by microbes, persistent infections, biofilm-related fatalities, and food spoilage, present the biofilm a significant challenge to human health, veterinary practices, and the food processing industry. to combat mature biofilms, various strategies, including physical (ultrasound and thermal shock), biological (like anti-pathogenic biofilms and phages), chemical (using enzymes such as nucleases and proteases), complementary (combining enzymes with phages or disinfectants) and change in environmental factors (disrupt nutrient supply and quorum sensing systems) are employed.