Bacterial Biofilms: Development, Dispersal, and Therapeutic Strategies in the Dawn of the Postantibiotic Era

Abstract

Biofilm formation constitutes an alternative lifestyle in which microorganisms adopt a multicellular behavior that facilitates and/or prolongs survival in diverse environmental niches.Biofilms form on biotic and abiotic surfaces both in the environment and in the healthcare setting.In hospital wards, the formation of biofilms on vents and medical equipment enables pathogens to persist as reservoirs that can readily spread to patients.Inside the host, biofilms allow pathogens to subvert innate immune defenses and are thus associated with long-term persistence.Here we provide a general review of the steps leading to biofilm formation on surfaces and within eukaryotic cells, highlighting several medically important pathogens, and discuss recent advances on novel strategies aimed at biofilm prevention and/or dissolution.B iofilm formation enables single-cell organ- isms to assume a temporary multicellular lifestyle, in which "group behavior" facilitates survival in adverse environments.What was once defined as the formation of a community of microorganisms attached to a surface has come to be recognized as a complex developmental process that is multifaceted and dynamic in nature.The transition from planktonic growth to biofilm occurs in response to environmental changes, and involves multiple reg-ulatory networks, which translate signals to concerted gene expression changes thereby mediating the spatial and temporal reorganization of the bacterial cell (Pratt and Kolter 1998;O'Toole et al. 2000;Prigent-Combaret et al. 2001;Parsek and Singh 2003;Lenz et al. 2008;Monds and O'Toole 2009).This cellular reprogramming alters the expression of surface molecules, nutrient utilization, and virulence factors and equips bacteria with an arsenal of properties that enable their survival in unfavorable 4 These authors contributed equally to this work.