Biofilm formation – what we can learn from recent developments

• Published in: Journal of internal medicine 2018-10, Vol.284 (4), p.332-345
• Main Authors: Bjarnsholt, T., Buhlin, K., Dufrêne, Y. F., Gomelsky, M., Moroni, A., Ramstedt, M., Rumbaugh, K. P., Schulte, T., Sun, L., Åkerlund, B., Römling, U.
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents - therapeutic use; Antibiotics; Antimicrobial agents; antimicrobial strategies; Bacterial Infections - microbiology; Bacterial Infections - therapy; biofilm formation; Biofilms; Biofilms - drug effects; Biofilms - growth & development; Biomedical Research; Cancer; Combined Modality Therapy; Crosstalk; Culture Media; cyclic di-nucleotide second messengers; Dental caries; Dental hygiene; Dental materials; Dental prosthetics; Diabetes mellitus; Extracellular matrix; Extracellular Matrix - physiology; Humans; Hygiene; Infections; Medicin och hälsovetenskap; Microorganisms; Morbidity; Opportunistic Infections - microbiology; Opportunistic Infections - therapy; Periodontitis; Pseudomonas aeruginosa - growth & development; Pseudomonas Infections - microbiology; Pseudomonas Infections - therapy; Quality of life; Receptors; Second messengers; Staphylococcal Infections - microbiology; Staphylococcal Infections - therapy; Surgical implants; underlying diseases; Wound Infection - microbiology; Wound Infection - therapy
• ISSN: 0954-6820; 1365-2796; 1365-2796
• DOI: 10.1111/joim.12782

Although biofilms have been observed early in the history of microbial research, their impact has only recently been fully recognized. Biofilm infections, which contribute to up to 80% of human microbial infections, are associated with common human disorders, such as diabetes mellitus and poor dental hygiene, but also with medical implants. The associated chronic infections such as wound infections, dental caries and periodontitis significantly enhance morbidity, affect quality of life and can aid development of follow‐up diseases such as cancer. Biofilm infections remain challenging to treat and antibiotic monotherapy is often insufficient, although some rediscovered traditional compounds have shown surprising efficiency. Innovative anti‐biofilm strategies include application of anti‐biofilm small molecules, intrinsic or external stimulation of production of reactive molecules, utilization of materials with antimicrobial properties and dispersion of biofilms by digestion of the extracellular matrix, also in combination with physical biofilm breakdown. Although basic principles of biofilm formation have been deciphered, the molecular understanding of the formation and structural organization of various types of biofilms has just begun to emerge. Basic studies of biofilm physiology have also resulted in an unexpected discovery of cyclic dinucleotide second messengers that are involved in interkingdom crosstalk via specific mammalian receptors. These findings even open up new venues for exploring novel anti‐biofilm strategies.