Microbial Biofilms and Chronic Wounds

Abstract

Background is provided on biofilms, including their formation, tolerance mechanisms, structure, and morphology within the context of chronic wounds. The features of biofilms in chronic wounds are discussed in detail, as is the impact of biofilm on wound chronicity. Difficulties associated with the use of standard susceptibility tests (minimum inhibitory concentrations or MICs) to determine appropriate treatment regimens for, or develop new treatments for use in, chronic wounds are discussed, with alternate test methods specific to biofilms being recommended. Animal models appropriate for evaluating biofilm treatments are also described. Current and potential future therapies for treatment of biofilm-containing chronic wounds, including probiotic therapy, virulence attenuation, biofilm phenotype expression attenuation, immune response suppression, and aggressive debridement combined with antimicrobial dressings, are described.

Susceptibility of monomicrobial or polymicrobial biofilms derived from infected diabetic foot ulcers to topical or systemic antibiotics in vitro

“…However, it is now widely acknowledged that bacteria form biofilms in soft tissue infections most if not all of the time [7]. This is significant because biofilms have substantially increased tolerance to antibiotics, sometimes by a factor of 1000 [12,26,27], and therefore the MIC is not a useful predictor of successful treatment [28]. There is also increasing incidence of antibiotic resistance in bacterial infections, including DFIs [29].…”

Proceeding report of the Second Symposium on Hidradenitis Suppurativa Advances (SHSA) 2017

“…Commensal organisms have been identified in tissues in either prolonged culture methods or in RNA metagenomics sequencing. Biofilm bacterial structures have been histologically detected in a high percentage of chronic lesions and in perilesional samples …”

“…Biofilm bacterial structures have been histologically detected in a high percentage of chronic lesions and in perilesional samples. [16]…”

New perspectives in the treatment of hard-to-heal wound

“…In addition pathological discharge accumulates on the bottom of the wound which additionally impairs its effective repair. 5,6 The growth and survival of microorganisms within the infected area is stabilized by formation of a biofilm defined as a bacterial matrix supplemented by polymers (polysaccharides, proteins) and nucleic acids. It creates a local microenvironment that facilitates bacterial adhesion and protects colonies against adverse external factors including loss of moisture.…”

“…It creates a local microenvironment that facilitates bacterial adhesion and protects colonies against adverse external factors including loss of moisture. In addition, it is a medium for signal transmission, transferring information responsible for drug resistance 6,7 The resorption of biofilm is crucial in the process of wound healing. As a barrier factor it hinders diffusion of respiratory gases and neutralizes penetration of antiseptics or anti-inflammatory solutions.…”