Nazzari E, Torretta S, Pignataro L, Marchisio P, Esposito S
Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda no. 9, 20122, Milan, Italy.
Eur J Clin Microbiol Infect Dis. 2015 Mar;34(3):421-9. doi: 10.1007/s10096-014-2261-1. Epub 2014 Oct 16.
Recurrent respiratory tract infections (RRTIs) are very common in children and a major challenge for pediatricians. In the last few years, bacterial biofilms have been linked to RRTIs and antibiotic resistance, and have raised serious concerns regarding the therapeutic management of recurrent middle ear diseases, chronic rhinosinusitis, and recurrent pharyngotonsillitis. This paper aims to review the new insights into biofilm-related upper respiratory tract infections in children and possible therapeutic strategies. It focuses on the clinical implications for recurrent disease and on studies in pediatric patients. Analysis of the literature showed that the involvement of bacterial biofilm in recurrent upper airway tract infections is an emerging problem that may lead to serious concerns about infection control. Despite the large amount of research within this field, detailed insight into the complex structure of bacterial biofilms and the ultrastructural and biochemical mechanisms responsible for its evasion of the immune system and resistance to treatments is currently lacking. In the future, additional emphasis should be placed on biofilm management as a component of therapeutic strategies. This goal can be attained by finding feasible methods for detecting biofilms in vivo and identifying effective methods for administering treatments that eradicate preexisting bacterial biofilms or hinder bacterial adhesion to respiratory cells.
反复呼吸道感染（RRTIs）在儿童中非常常见，是儿科医生面临的一项重大挑战。在过去几年中，细菌生物被膜已与RRTIs及抗生素耐药性相关联，并引发了人们对复发性中耳疾病、慢性鼻窦炎和复发性咽扁桃体炎治疗管理的严重关切。本文旨在综述儿童生物被膜相关上呼吸道感染的新见解及可能的治疗策略。它聚焦于复发性疾病的临床意义以及儿科患者的研究。文献分析表明，细菌生物被膜参与复发性上呼吸道感染是一个新出现的问题，可能会引发对感染控制的严重关切。尽管该领域已有大量研究，但目前仍缺乏对细菌生物被膜复杂结构以及负责其逃避免疫系统和抵抗治疗的超微结构和生化机制的详细了解。未来，应进一步强调将生物被膜管理作为治疗策略的一个组成部分。这一目标可以通过找到体内检测生物被膜的可行方法以及确定根除现有细菌生物被膜或阻碍细菌粘附于呼吸道细胞的有效治疗方法来实现。
