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Cited by 6,644Bacterial biofilms and quorum sensingAntifungal resistance and susceptibilityInfection Control in Healthcare

Biofilms: Survival Mechanisms of Clinically Relevant Microorganisms

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Donlan, Rodney M., Costerton, J. William·2002·Clinical Microbiology Reviews
DOI 10.1128/cmr.15.2.167-193.2002PMC PMC118068
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Abstract

SUMMARY: Though biofilms were first described by Antonie van Leeuwenhoek, the theory describing the biofilm process was not developed until 1978. We now understand that biofilms are universal, occurring in aquatic and industrial water systems as well as a large number of environments and medical devices relevant for public health. Using tools such as the scanning electron microscope and, more recently, the confocal laser scanning microscope, biofilm researchers now understand that biofilms are not unstructured, homogeneous deposits of cells and accumulated slime, but complex communities of surface-associated cells enclosed in a polymer matrix containing open water channels. Further studies have shown that the biofilm phenotype can be described in terms of the genes expressed by biofilm-associated cells. Microorganisms growing in a biofilm are highly resistant to antimicrobial agents by one or more mechanisms. Biofilm-associated microorganisms have been shown to be associated with several human diseases, such as native valve endocarditis and cystic fibrosis, and to colonize a wide variety of medical devices. Though epidemiologic evidence points to biofilms as a source of several infectious diseases, the exact mechanisms by which biofilm-associated microorganisms elicit disease are poorly understood. Detachment of cells or cell aggregates, production of endotoxin, increased resistance to the host immune system, and provision of a niche for the generation of resistant organisms are all biofilm processes which could initiate the disease process. Effective strategies to prevent or control biofilms on medical devices must take into consideration the unique and tenacious nature of biofilms. Current intervention strategies are designed to prevent initial device colonization, minimize microbial cell attachment to the device, penetrate the biofilm matrix and kill the associated cells, or remove the device from the patient. In the future, treatments may be based on inhibition of genes involved in cell attachment and biofilm formation.

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  • Urinary and central venous catheters, pacemakers, mechanical heart valves, joint prostheses, contact lenses, and dentures are all susceptible to C. albicans biofilms.

    “Urinary and central venous catheters, pacemakers, mechanical heart valves, joint prostheses, contact lenses, and dentures are all susceptible to C. albicans biofilms (22, 45, 90, 175).”

    From <i>Candida albicans</i> Biofilms and Human Disease (2015) · cites this paper as [45]

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Authors
Donlan, R. M., & Costerton, J. W.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Donlan, Rodney M.
ORCID
Donlan, Rodney M.
Venue
Clinical Microbiology Reviews
Publisher
American Society for Microbiology
Published
2002-04
Volume
15
Issue
2
Pages
167-193
ISSN
  • 0893-8512 (ISSN-L)
  • 1098-6618
DOI
10.1128/cmr.15.2.167-193.2002
PMC
PMC118068
OpenAlex
W2131727615
Cited by
6,644
References
217
Citations by year
2026: 215 · 2025: 225 · 2024: 232 · 2023: 278 · 2022: 392 · 2021: 393 · 2020: 402 · 2019: 381 · 2018: 349 · 2017: 453 · 2016: 405 · 2015: 359 · 2014: 415 · 2013: 310 · 2012: 328
FWCI
5.78
Type
journal article
Language
en
Open access
Licence
journals.asm.org/non-commercial-tdm-license (tdm)
Locations
  • Clinical Microbiology Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Montana State University ScholarWorks (Montana State University) (submittedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords
biofilm, antimicrobial resistance, medical device colonization, endocarditis, cystic fibrosis, biofilm matrix, cell detachment, endotoxin, host immune evasion
MeSH terms
Bacteria, Bacterial Infections, Catheterization, Contact Lenses, Humans, Prosthesis-Related Infections, Biofilms, Prostheses and Implants

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