Hall Michael R, McGillicuddy Edward, Kaplan Lewis J
1 Department of Surgery, Yale School of Medicine , New Haven, Connecticut.
Surg Infect (Larchmt). 2014 Feb;15(1):1-7. doi: 10.1089/sur.2012.129. Epub 2014 Jan 29.
Biofilm is ubiquitous throughout nature including bacteria, fungi, protozoa-associated bacteriophages, and viruses. Whereas it is adaptive for certain organisms in a variety of environments, biofilm is important in understanding and treating clinically relevant infections, especially those involving temporarily or durably implanted devices.
Review of pertinent English-language literature.
Important advances have been made in understanding biofilm structure and function that elucidate key events in biofilm-based infectious processes. Wounds, oral cavity, urinary tract, gastrointestinal tract, and device-associated biofilm-based infections dominate clinically relevant infections. Criteria have been articulated to detect and diagnose biofilm-associated infection but there are hurdles to overcome to treat effectively such infection. Native biofilm resistance mechanisms as well as incompletely effective human immune system responses impede successful infection resolution. Biofilm-appropriate education appears under-represented in standardized surgical education curriculum.
Several potential methods of enabling primary prevention as well as treatment of biofilm-associated infection are on the near horizon. There is an opportunity to enhance surgical education regarding biofilm prevention, diagnosis, and therapy.
生物膜在自然界中无处不在，包括细菌、真菌、原生动物相关的噬菌体和病毒。虽然生物膜对某些生物体在各种环境中具有适应性，但它对于理解和治疗临床相关感染很重要，尤其是那些涉及临时或持久植入装置的感染。
查阅相关英文文献。
在理解生物膜结构和功能方面取得了重要进展，这些进展阐明了基于生物膜的感染过程中的关键事件。伤口、口腔、泌尿道、胃肠道以及与装置相关的基于生物膜的感染在临床相关感染中占主导地位。已经明确了检测和诊断生物膜相关感染的标准，但有效治疗此类感染仍有障碍需要克服。天然生物膜抗性机制以及不完全有效的人体免疫系统反应阻碍了感染的成功解决。在标准化外科教育课程中，关于生物膜的适当教育似乎不足。
几种潜在的预防和治疗生物膜相关感染的方法即将出现。有机会加强关于生物膜预防、诊断和治疗的外科教育。
