Biomedical Engineering Reference
In-Depth Information
Current and Emergent Control Strategies
for Medical Biofilms
Mohd Sajjad Ahmad Khan, Iqbal Ahmad, Mohammad Sajid,
and Swaranjit Singh Cameotra
Abstract
In nature, microorganisms prefer to live in structured microbial commu-
nities rather than as free-floating planktonic cells. These dynamic microbial com-
munities are termed biofilms, in which transitions between planktonic and sessile
modes of growth occur interchangeably in response to different environmental
cues. Such phenomenas are advantageous for microbial pathogens but disadvanta-
geous for human health. Due to the increased resistance/tolerance of biofilm cells to
antimicrobial treatment, it becomes difficult to eradicate pathogens, which results
in relapses of infections even after appropriate therapy. In clinically relevant
biofilms,
Pseudomonas
spp.,
Staphylococcus
spp., and
Candida
spp. are the most
frequently isolated microorganisms. These microorganisms are able to adhere to
and colonize surfaces of medical devices such as central venous catheters, intra-
uterine devices, voice prostheses, and prosthetic joints, resulting in the develop-
ment of a biofilm. Many antimicrobial agents are now being used against microbial
biofilms. However, inappropriate use of conventional antibiotic therapy may also
contribute to inefficient biofilm control and to the dissemination of resistance.
Consequently, new control strategies are constantly emerging to control biofilm-
associated infections, such as the antifungal lock therapy, improved drug delivery,
penetration of matrix-attacking extracellular polymetric substances, and regulation
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