Biofilm - An enemy worth targeting

Summary

Biofilm is a community of microorganisms embedded in a self-produced matrix, typically found in chronic wounds, where it impedes healing. These biofilms form when free-floating bacteria attach to surfaces, multiply, and create a protective extracellular matrix. This matrix shields the bacteria from immune defenses, antimicrobials, and antibiotics, leading to persistent infections. Biofilms can evolve rapidly, becoming more resilient and difficult to remove. They can be invisible but manifest through inflammation, slough, and increased exudate. Effective wound care must target biofilm prevention to avoid reformation and ensure proper healing.

Takeaways

• 😀 Biofilm is a community of microorganisms embedded within a self-produced matrix, attached to surfaces.
• 😀 Biofilm is present in at least 78% of chronic wounds and is a primary cause of non-healing.
• 😀 Microorganisms in biofilms communicate with each other and adapt to changing conditions, making them more robust.
• 😀 The protective matrix, called extracellular polymeric substance (EPS), shields microorganisms from antimicrobials and the immune system.
• 😀 Within 24 to 48 hours, a mature biofilm can form, adapting to its environment to become more resilient.
• 😀 Mature biofilm causes delayed healing by making it difficult for immune defenses and treatments to penetrate.
• 😀 Biofilm can spread by releasing individual biofilm cells or by forming new EPS-protected colonies.
• 😀 Biofilm can reform quickly even after aggressive debridement, making it hard to remove completely.
• 😀 Clinical signs of biofilm presence include inflammation, slough formation, and elevated levels of exudate and MMPs.
• 😀 Effective biofilm-based wound care is essential to prevent biofilm reformation and promote healing.

Q & A

What is a biofilm?

A biofilm is a community of microorganisms embedded within a self-produced matrix, attached to a living or non-living surface.

Where can biofilms be found?

Biofilms are present everywhere, including in chronic wounds, where they are recognized as the primary cause of non-healing wounds.

How do microorganisms form biofilms?

Microorganisms initially attach to a surface and begin to multiply. As they grow, they secrete a protective matrix made of hydrated sugars, proteins, and DNA, known as extracellular polymeric substance (EPS).

How long does it take for a biofilm to mature?

A mature biofilm can form within 24 to 48 hours after the initial attachment of microorganisms.

What are some characteristics of mature biofilms?

Mature biofilms exhibit robustness and characteristics that can delay healing, including the ability to adapt to changing conditions.

How do microorganisms in a biofilm communicate?

Microorganisms in a biofilm can communicate with each other, for example, by sending an 'attack alarm' signal that causes certain bacteria to become dormant and more resilient to antimicrobials.

What role does EPS play in a biofilm?

EPS acts as a protective barrier, shielding microorganisms from antiseptics, antibiotics, and the host’s immune system, making the biofilm difficult to treat.

How does biofilm spread across surfaces?

Biofilm spreads by releasing individual biofilm cells or by releasing new EPS-protected colonies.

Why is biofilm difficult to remove?

Biofilm is hard to completely remove, even after aggressive debridement, and can reform within hours, making it a persistent issue.

What are some clinical signs that biofilm might be present in a wound?

Clinical signs of biofilm in a wound include inflammation, slough formation, elevated levels of exudate, and increased MMPs (matrix metalloproteinases).

How can biofilm reformation be prevented in wounds?

Effective and systematic biofilm-based wound care is essential for preventing biofilm reformation and promoting healing.