Wu Hong, Moser Claus, Wang Heng-Zhuang, Høiby Niels, Song Zhi-Jun
1] Department of Clinical Microbiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark [2] Department of International Health, Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Microbiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
Int J Oral Sci. 2015 Mar 23;7(1):1-7. doi: 10.1038/ijos.2014.65.
Formation of biofilm is a survival strategy for bacteria and fungi to adapt to their living environment, especially in the hostile environment. Under the protection of biofilm, microbial cells in biofilm become tolerant and resistant to antibiotics and the immune responses, which increases the difficulties for the clinical treatment of biofilm infections. Clinical and laboratory investigations demonstrated a perspicuous correlation between biofilm infection and medical foreign bodies or indwelling devices. Clinical observations and experimental studies indicated clearly that antibiotic treatment alone is in most cases insufficient to eradicate biofilm infections. Therefore, to effectively treat biofilm infections with currently available antibiotics and evaluate the outcomes become important and urgent for clinicians. The review summarizes the latest progress in treatment of clinical biofilm infections and scientific investigations, discusses the diagnosis and treatment of different biofilm infections and introduces the promising laboratory progress, which may contribute to prevention or cure of biofilm infections. We conclude that, an efficient treatment of biofilm infections needs a well-established multidisciplinary collaboration, which includes removal of the infected foreign bodies, selection of biofilm-active, sensitive and well-penetrating antibiotics, systemic or topical antibiotic administration in high dosage and combinations, and administration of anti-quorum sensing or biofilm dispersal agents.
生物膜的形成是细菌和真菌适应生存环境的一种策略，尤其是在恶劣环境中。在生物膜的保护下，生物膜中的微生物细胞对抗生素和免疫反应产生耐受性和抗性，这增加了临床治疗生物膜感染的难度。临床和实验室研究表明，生物膜感染与医用异物或植入装置之间存在明显的相关性。临床观察和实验研究清楚地表明，在大多数情况下，仅用抗生素治疗不足以根除生物膜感染。因此，对于临床医生来说，利用现有抗生素有效治疗生物膜感染并评估治疗效果变得至关重要且迫在眉睫。本综述总结了临床生物膜感染治疗和科学研究的最新进展，讨论了不同生物膜感染的诊断和治疗，并介绍了有前景的实验室进展，这可能有助于预防或治愈生物膜感染。我们得出结论，有效治疗生物膜感染需要建立良好的多学科协作，包括清除感染的异物、选择具有生物膜活性、敏感且渗透性良好的抗生素、高剂量全身或局部联合使用抗生素，以及使用群体感应抑制剂或生物膜分散剂。
