Biofilm Formation in Chronic Infections: A Comprehensive Review of Pathogenesis, Clinical Implications, and Novel Therapeutic Approaches.

Biofilms are intricate microbial communities on various surfaces, including medical devices and biological tissues, encased within a protective matrix of extracellular polymeric substances. Their formation and persistence are significant factors in the pathogenesis of chronic infections, contributing to the complexity of treatment and increased resistance to antimicrobial agents. This review explores the multifaceted nature of biofilms, focusing on their formation, structure, and the genetic and environmental factors that contribute to their resilience. Biofilms are particularly problematic in chronic infections, such as those associated with medical implants and persistent wounds, due to their ability to evade both the host immune response and conventional therapeutic strategies. The review also discusses the current challenges in diagnosing biofilm-associated infections and the limitations of existing treatment options. Emerging therapeutic approaches, including novel antibiofilm agents, physical disruption techniques, and biological therapies such as phage therapy, are examined for their potential to improve treatment outcomes. Innovations in drug delivery systems and preventive measures, such as biofilm-resistant materials, are also highlighted as promising developments. This comprehensive overview aims to provide insights into the mechanisms of biofilm-related infections and to guide future research and clinical practice. This review contributes to the ongoing efforts to enhance patient care and combat the growing challenge of antimicrobial resistance by addressing the critical need for effective strategies to manage and prevent biofilm-associated chronic infections.