Next Article in Journal
Unveiling a Listeria monocytogenes Outbreak in a Rabbit Farm: Clinical Manifestation, Antimicrobial Resistance, Genomic Insights and Environmental Investigation
Previous Article in Journal
The Combination of Biochar and Bacillus subtilis Biological Agent Reduced the Relative Abundance of Pathogenic Bacteria in the Rhizosphere Soil of Panax notoginseng
Previous Article in Special Issue
Larval Therapy and Larval Excretions/Secretions: A Potential Treatment for Biofilm in Chronic Wounds? A Systematic Review
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Editorial

Biofilm-Related Infections in Healthcare: Moving towards New Horizons

by
Enea Gino Di Domenico
1,
Alessandra Oliva
2 and
María Guembe
3,4,*
1
Department of Biology and Biotechnology “C. Darwin”, Sapienza University of Rome, 00185 Rome, Italy
2
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
3
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
4
Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
*
Author to whom correspondence should be addressed.
Microorganisms 2024, 12(4), 784; https://doi.org/10.3390/microorganisms12040784
Submission received: 18 December 2023 / Accepted: 26 March 2024 / Published: 12 April 2024
(This article belongs to the Special Issue Biofilm-Related Infections in Healthcare)
In this Special Issue, titled “Biofilm-Related Infections in Healthcare”, we have reported considerable progress in understanding the physiology and pathology of biofilms. However, our current diagnostic and therapeutic capabilities lag behind this knowledge, primarily due to a deficit in standardized microbiological tests for identifying biofilm producers and assessing antibiotic susceptibility in these complex bacterial communities.
The inherent metabolic diversity and the shielded microenvironments within biofilms undermine the efficacy of traditional susceptibility assays, often leading to suboptimal clinical decision making and patient outcomes [1,2]. This challenge is further compounded by clinical guidelines that lack the necessary precision for managing biofilm infections effectively, highlighting an urgent need to inspire clinical trials that could foster improved diagnostic and treatment modalities [3]. The refinement of these guidelines should be predicated upon a stringent evaluation of the literature and solid evidence from clinical studies [4].
We advocate for innovative diagnostics and treatment strategies in response to these clinical contingencies. The development and standardization of biofilm susceptibility assays, such as the minimal biofilm eradication concentration (MBEC) and the minimal biofilm inhibitory concentration (MBIC), demand harmonization across research and clinical practice to unlock their full potential [5].
Looking ahead and embracing novel methodologies in biofilm detection and characterization is imperative. Pioneering imaging techniques, cutting-edge molecular diagnostics, and identifying new biomarkers must be expedited, focusing on translating these advances into practical applications within clinical microbiology laboratories. The timely and accurate detection of biofilms is critical in improving therapeutic outcomes, as early interventions are often associated with better patient prognoses. However, the absence of reliable in vivo imaging techniques for biofilm detection presents a significant obstacle in treating these complex infections. Traditional diagnostic systems, such as X-ray imaging and the use of radiolabeled white blood cells, are hampered by the need for invasive sample collection and are prone to failure due to sampling errors, as seen in orthopedic implant-associated infections [6,7]. There exists an imperative need for innovative imaging methods that can non-invasively quantify biofilm presence in real-time. This development would substantially transform the clinical management of biofilm-associated infections. The quest for such a diagnostic tool has led to the exploration of targeted probes for medical imaging capable of specifically detecting bacterial biofilms. Emerging technologies, like the PET tracer 18F-fluorodeoxysorbitol [8], have shown promise in acute infection settings but fall short in addressing the unique challenges posed by chronic biofilm infections. The use of antibiotic-based imaging probes is also being explored [9,10], but these are often limited by their specificity to particular bacterial classes and an unverified ability to infiltrate biofilms and target bacterial cells effectively [11]. More recently, fluorescently labeled peptides have been proposed as promising candidates in biofilm-specific in vivo imaging agents that would improve the diagnosis of several clinical infections [12]. However, a key challenge in this domain is the delivery of adequate amounts of the imaging probe to biofilm sites. This underscores the necessity for groundbreaking imaging probe design and delivery mechanism advancements.
In terms of combatting biofilm, new developments are particularly exciting. Innovative approaches, such as using bacteriophage therapy [13], antimicrobial peptides [14], and the interruption of quorum sensing pathways [15], offer novel means to disrupt and eradicate biofilms. These strategies, combined with traditional antimicrobial therapies, are paving the way for combinatorial treatments that can address the multifaceted challenges presented by biofilms [16].
For implant-related and non-implant-related infections, the future holds the potential for creating anti-adhesive surfaces and materials that resist biofilm formation [17]. Such advances would have profound implications for medical device manufacturing and patient care protocols.
One of the most promising avenues for advancing our understanding of biofilms lies in studying the microbiome’s complex ecosystems, particularly the multispecies and multikingdom interactions that govern chronic conditions [18]. This research holds the potential to yield innovative diagnostic and therapeutic approaches, fundamentally altering the management of biofilm-related infections.
In the collaborative spirit that defines our field, we must ensure that research objectives are intimately aligned with clinical demands. Establishing clear and clinically relevant criteria for biofilm-related infections is paramount, as is the need for integrated efforts among microbiologists, clinicians, and researchers to solidify the clinical support infrastructure.
This Special Issue proves the progress in understanding biofilm-related infections and is a clarion call to action. Through continued innovation and standardization of diagnostic and treatment protocols, we aim to refine and enhance healthcare solutions, ultimately elevating the standard of care for patients grappling with biofilm-associated infections.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Sauer, K.; Stoodley, P.; Goeres, D.M.; Hall-Stoodley, L.; Burmølle, M.; Stewart, P.S.; Bjarnsholt, T. The biofilm life cycle: Expanding the conceptual model of biofilm formation. Nat. Rev. Microbiol. 2022, 20, 608–620. [Google Scholar] [CrossRef] [PubMed]
  2. Di Domenico, E.G.; Oliva, A.; Guembe, M. The Current Knowledge on the Pathogenesis of Tissue and Medical Device-Related Biofilm Infections. Microorganisms 2022, 10, 1259. [Google Scholar] [CrossRef] [PubMed]
  3. Høiby, N.; Bjarnsholt, T.; Moser, C.; Bassi, G.L.; Coenye, T.; Donelli, G.; Hall-Stoodley, L.; Holá, V.; Imbert, C.; Kirketerp-Møller, K.; et al. ESCMID guideline for the diagnosis and treatment of biofilm infections 2014. Clin. Microbiol. Infect. 2015, 21, S1–S25. [Google Scholar] [CrossRef] [PubMed]
  4. Høiby, N.; Moser, C.; Oliver, A.; Williams, C.; Ramage, G.; Borghi, E.; Azeredo, J.; Macia, M.D. To update or not to update the ESCMID guidelines for the diagnosis and treatment of biofilm infections—That is the question! The opinion of the ESGB board. Biofilm 2023, 6, 100135. [Google Scholar] [CrossRef] [PubMed]
  5. Thieme, L.; Hartung, A.; Tramm, K.; Klinger-Strobel, M.; Jandt, K.D.; Makarewicz, O.; Pletz, M.W. MBEC versus MBIC: The lack of differentiation between biofilm reducing and inhibitory effects as a current problem in biofilm methodology. Biol. Proced. Online 2019, 21, 18. [Google Scholar] [CrossRef]
  6. Høiby, N.; Bjarnsholt, T.; Moser, C.; Jensen, P.Ø.; Kolpen, M.; Qvist, T.; Aanaes, K.; Pressler, T.; Skov, M.; Ciofu, O. Diagnosis of biofilm infections in cystic fibrosis patients. APMIS 2017, 125, 339–343. [Google Scholar] [CrossRef]
  7. Jain, S.K. The Promise of Molecular Imaging in the Study and Treatment of Infectious Diseases. Mol. Imaging Biol. 2017, 19, 341–347. [Google Scholar] [CrossRef] [PubMed]
  8. Weinstein, E.A.; Ordonez, A.A.; DeMarco, V.P.; Murawski, A.M.; Pokkali, S.; MacDonald, E.M.; Klunk, M.; Mease, R.C.; Pomper, M.G.; Jain, S.K. Imaging Enterobacteriaceae infection in vivo with 18F-fluorodeoxysorbitol positron emission tomography. Sci. Transl. Med. 2014, 6, 259ra146. [Google Scholar] [CrossRef] [PubMed]
  9. van Oosten, M.; Schäfer, T.; Gazendam, J.A.C.; Ohlsen, K.; Tsompanidou, E.; de Goffau, M.C.; Harmsen, H.J.M.; Crane, L.M.; Lim, E.; Francis, K.P.; et al. Real-time in vivo imaging of invasive- and biomaterial-associated bacterial infections using fluorescently labelled vancomycin. Nat. Commun. 2013, 4, 2584. [Google Scholar] [CrossRef] [PubMed]
  10. Sellmyer, M.A.; Lee, I.; Hou, C.; Weng, C.C.; Li, S.; Lieberman, B.P.; Zeng, C.; Mankoff, D.A.; Mach, R.H. Bacterial infection imaging with [18F]fluoropropyl-trimethoprim. Proc. Natl. Acad. Sci. USA 2017, 114, 8372–8377. [Google Scholar] [CrossRef] [PubMed]
  11. Tseng, B.S.; Zhang, W.; Harrison, J.J.; Quach, T.P.; Song, J.L.; Penterman, J.; Singh, P.K.; Chopp, D.L.; Packman, A.I.; Parsek, M.R. The extracellular matrix protects Pseudomonas aeruginosa biofilms by limiting the penetration of tobramycin. Environ. Microbiol. 2013, 15, 2865–2878. [Google Scholar] [CrossRef] [PubMed]
  12. Locke, L.W.; Shankaran, K.; Gong, L.; Stoodley, P.; Vozar, S.L.; Cole, S.L.; Tweedle, M.F.; Wozniak, D.J. Evaluation of Peptide-Based Probes toward In Vivo Diagnostic Imaging of Bacterial Biofilm-Associated Infections. ACS Infect. Dis. 2020, 6, 2086–2098. [Google Scholar] [CrossRef] [PubMed]
  13. Pires, D.P.; Meneses, L.; Brandão, A.C.; Azeredo, J. An overview of the current state of phage therapy for the treatment of biofilm-related infections. Curr. Opin. Virol. 2022, 53, 101209. [Google Scholar] [CrossRef] [PubMed]
  14. Naaz, T.; Lahiri, D.; Pandit, S.; Nag, M.; Gupta, P.K.; Al-Dayan, N.; Rai, N.; Chaubey, K.K.; Gupta, A.K. Antimicrobial Peptides Against Microbial Biofilms: Efficacy, Challenges, and Future Prospect. Int. J. Pept. Res. Ther. 2023, 29, 48. [Google Scholar] [CrossRef]
  15. Paluch, E.; Rewak-Soroczyńska, J.; Jędrusik, I.; Mazurkiewicz, E.; Jermakow, K. Prevention of biofilm formation by quorum quenching. Appl. Microbiol. Biotechnol. 2020, 104, 1871–1881. [Google Scholar] [CrossRef] [PubMed]
  16. Hawas, S.; Verderosa, A.D.; Totsika, M. Combination Therapies for Biofilm Inhibition and Eradication: A Comparative Review of Laboratory and Preclinical Studies. Front. Cell. Infect. Microbiol. 2022, 12, 850030. [Google Scholar] [CrossRef] [PubMed]
  17. Uneputty, A.; Dávila-Lezama, D.; Garibo, A.; Oknianska, A.; Bogdanchikova, N.; Hernández-Sánchez, J.F.; Susarrey-Arce, A. Strategies applied to modify structured and smooth surfaces: A step closer to reduce bacterial adhesion and biofilm formation. Colloid. Interface Sci. Commun. 2022, 46, 100560. [Google Scholar] [CrossRef]
  18. Durand, B.A.R.N.; Pouget, C.; Magnan, C.; Molle, V.; Lavigne, J.P.; Dunyach-Remy, C. Bacterial Interactions in the Context of Chronic Wound Biofilm: A Review. Microorganisms 2022, 10, 1500. [Google Scholar] [CrossRef] [PubMed]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Di Domenico, E.G.; Oliva, A.; Guembe, M. Biofilm-Related Infections in Healthcare: Moving towards New Horizons. Microorganisms 2024, 12, 784. https://doi.org/10.3390/microorganisms12040784

AMA Style

Di Domenico EG, Oliva A, Guembe M. Biofilm-Related Infections in Healthcare: Moving towards New Horizons. Microorganisms. 2024; 12(4):784. https://doi.org/10.3390/microorganisms12040784

Chicago/Turabian Style

Di Domenico, Enea Gino, Alessandra Oliva, and María Guembe. 2024. "Biofilm-Related Infections in Healthcare: Moving towards New Horizons" Microorganisms 12, no. 4: 784. https://doi.org/10.3390/microorganisms12040784

APA Style

Di Domenico, E. G., Oliva, A., & Guembe, M. (2024). Biofilm-Related Infections in Healthcare: Moving towards New Horizons. Microorganisms, 12(4), 784. https://doi.org/10.3390/microorganisms12040784

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop