Saye Donald E
Ostomy Wound Manage. 2007 Apr;53(4):46-8, 50, 52 passim.
Micro-organisms commonly produce biofilm, a polymeric matrix that is adherent to inert or living substances and frequently forms on environmental surfaces, medical devices, and traumatized or compromised living and nonviable necrotic tissues such as wounds. The micro-organisms in a biofilm interact with each other and their environment. They are refractory to conventional therapy and resist conventional methods for culturing; their coordinated activities can lessen the effect of antimicrobials and the host's defenses. The multifactorial mechanism of resistance varies and depends, in part, on the strain of the micro-organism. A biofilm is dynamic and may shed bacteria or bacteria may be released by trauma, resulting in local or systemic infectious disease. Released bacteria lose their protection - they become responsive to appropriate levels of antimicrobials and may be cultured using conventional culturing methods. Micro-organisms in biofilms may remain dormant for weeks or years before causing local or systemic signs and symptoms of infection and are commonly responsible for recurring infections after repeated trials of antibiotics. Most biofilm infection-related research findings have not reached clinical practice yet. However, clinician knowledge about the development of and difficulties culturing micro-organisms in biofilms and their resistance to antibiotics and biocides may lead to improved clinical outcomes in soft tissue and bone infections and the treatment of wounds.
微生物通常会产生生物膜，这是一种聚合基质，可附着于惰性物质或生物物质上，且经常在环境表面、医疗设备以及创伤或受损的活体和无活力坏死组织（如伤口）上形成。生物膜中的微生物相互之间以及与它们的环境相互作用。它们对传统疗法具有抗性，并且难以用传统培养方法培养；它们的协同活动会降低抗菌药物和宿主防御的效果。抗性的多因素机制各不相同，部分取决于微生物的菌株。生物膜是动态的，可能会脱落细菌，或者细菌可能因创伤而释放，从而导致局部或全身性传染病。释放出的细菌失去了保护——它们会对抗菌药物的适当剂量产生反应，并且可以用传统培养方法进行培养。生物膜中的微生物在引起局部或全身性感染体征和症状之前可能会休眠数周或数年，并且通常是反复使用抗生素治疗后反复感染的原因。大多数与生物膜感染相关的研究结果尚未应用于临床实践。然而，临床医生对生物膜中微生物的形成、培养困难以及它们对抗生素和杀菌剂的抗性的了解，可能会改善软组织和骨感染以及伤口治疗的临床结果。
