Department of Periodontology, Laboratory of Oral Microbiology, School of Dental Medicine, University of Bern, Bern, Switzerland,
Monogr Oral Sci. 2021;29:38-52. doi: 10.1159/000510198. Epub 2020 Dec 21.
When analyzing the activity of antimicrobial agents, it should be considered that microorganisms mainly occur in biofilms. Data obtained for planktonic bacteria cannot be transferred non-critically to biofilms. Biofilm models should consider both the relevant microorganisms and the conditions present in the environment. The selection of the model depends on the question to be answered. In dentistry, single species, multispecies, or microcosms originating from saliva or dental biofilm are used to culture biofilms. Microorganism selection depends on the focus of the study, for example caries biofilms mostly include Streptococcus mutans, an endodontic biofilm consists mostly of Enterococcus faecalis, and defined anaerobes are used in periodontal/peri-implant biofilms. In contrast to single-species biofilm models in medicine, where the lowest concentration of the antimicrobial that kills microorganisms is measured, the common analyzed variables are counts of colony-forming units or the percentage of dead bacteria determined by confocal laser scanning microscopy after applying a differentiating stain. All the models are helpful to evaluate new antimicrobial treatment options. Conclusions regarding the antimicrobial activity tendency of the therapeutics can be drawn. However, there are limitations of the model and ultimately a new therapy has to be proven in randomized controlled clinical trials.
在分析抗菌药物的活性时，应考虑到微生物主要存在于生物膜中。不能将浮游细菌的数据不加批判地转移到生物膜中。生物膜模型应同时考虑相关微生物和环境中存在的条件。模型的选择取决于要回答的问题。在牙科中，使用来自唾液或牙菌斑的单种、多种或微宇宙来培养生物膜。微生物的选择取决于研究的重点，例如龋齿生物膜主要包括变形链球菌，牙髓生物膜主要包括粪肠球菌，而牙周/种植体周围生物膜中则使用特定的厌氧菌。与医学中单种生物膜模型不同，医学中的单种生物膜模型测量的是杀死微生物的最低抗菌药物浓度，常用的分析变量是通过应用区分染色后确定的菌落形成单位的计数或通过共聚焦激光扫描显微镜确定的死亡细菌的百分比。所有模型都有助于评估新的抗菌治疗选择。可以得出关于治疗剂的抗菌活性趋势的结论。然而，模型存在局限性，最终新的治疗方法必须经过随机对照临床试验的验证。
