Biofilms in Biofilms in InfectionInfection

Dr.T.V.Rao M D

Beginning of MicrobesBeginning of Microbes Bacteria first appeared Bacteria first appeared

on earth about 3.6 on earth about 3.6 billion years ago, long billion years ago, long before the appearance before the appearance of of Homo sapiensHomo sapiens around around 100,000 years ago.. 100,000 years ago.. Van Van LeeuwenhoekLeeuwenhoek was the was the first person to visualize, first person to visualize, graphically illustrate, graphically illustrate, and label "animalcules" and label "animalcules" (bacteria) that he found (bacteria) that he found in in plaqueplaque scraped from scraped from his own teeth. his own teeth.

Bio film constitutesBio film constitutes

AA biofilmbiofilm is an aggregate of is an aggregate of microorganisms in which cells are stuck microorganisms in which cells are stuck to each other and/or to a surface. These to each other and/or to a surface. These adherent cells are frequently embedded adherent cells are frequently embedded within a self-produced matrix of within a self-produced matrix of extracellular polymeric substance (EPS). extracellular polymeric substance (EPS). Biofilm EPS, which is also referred to as Biofilm EPS, which is also referred to as "slime," is a polymeric jumble of DNA, "slime," is a polymeric jumble of DNA, proteins and polysaccharides. proteins and polysaccharides.

Biofilm is a complex Biofilm is a complex substance.substance.

A biofilm is a complex A biofilm is a complex aggregation of aggregation of microorganisms microorganisms growing on a solid growing on a solid substrate. Biofilms are substrate. Biofilms are characterized by characterized by structural structural heterogeneity, genetic heterogeneity, genetic diversity, complex diversity, complex community community interactions, and an interactions, and an extracellular matrix of extracellular matrix of polymeric substances. polymeric substances.

Biofilms found in Nature Biofilms found in Nature everywhere where is there is everywhere where is there is

moisturemoisture More properly known as More properly known as biofilmbiofilm, ,

slime cities thrive wherever there is slime cities thrive wherever there is water - in the kitchen, on contact water - in the kitchen, on contact lenses, in the gut linings of animals. lenses, in the gut linings of animals. When the urban sprawl is extensive, When the urban sprawl is extensive, bio films can be seen with the naked bio films can be seen with the naked eye, coating the inside of water pipes eye, coating the inside of water pipes or dangling slippery and green from or dangling slippery and green from plumbingplumbing." ." (Coghlan 1996)(Coghlan 1996)

Biofilm supports the Biofilm supports the Bacterial growthBacterial growth

Biofilm are a common mode of bacterial Biofilm are a common mode of bacterial growth in nature and their presence has an growth in nature and their presence has an enormous impact on many aspects of our enormous impact on many aspects of our lives, such as sewage treatment, corrosion lives, such as sewage treatment, corrosion of materials, food contamination during of materials, food contamination during processing, pipe collapse, plant-processing, pipe collapse, plant-microorganisms interaction in the microorganisms interaction in the biosphere, the formation of dental plaque, biosphere, the formation of dental plaque, the development of chronic infections in the development of chronic infections in live tissue (mastitis, Otitis, pneumonia, live tissue (mastitis, Otitis, pneumonia, urinary infections, osteomyelitis) or urinary infections, osteomyelitis) or problems related to medical implants. problems related to medical implants.

Formation of BiofilmsFormation of Biofilms

Biofilms may form Biofilms may form on living or non-on living or non-living surfaces, living surfaces, and represent a and represent a prevalent mode prevalent mode of microbial life in of microbial life in natural, industrial natural, industrial and hospital and hospital settings settings

Biofilms increases Antibiotic Biofilms increases Antibiotic resitanceresitance

With With microorganisms microorganisms are highly are highly resistant to resistant to antimicrobial antimicrobial treatment and treatment and are tenaciously are tenaciously bound to the bound to the surface surface

Mechanisims of Biofilm Mechanisims of Biofilm formationformation

Formation of a biofilm Formation of a biofilm begins with the begins with the attachment of free-attachment of free-floating microorganisms floating microorganisms to a surface. These first to a surface. These first colonists adhere to the colonists adhere to the surface initially through surface initially through weak, reversible van der weak, reversible van der Waals forces.Waals forces. If the If the colonists are not colonists are not immediately immediately separated from the separated from the surface, they can surface, they can anchor themselves anchor themselves more permanently more permanently using cell adhesion using cell adhesion structures such as pilistructures such as pili

Factors Influencing Rate and Factors Influencing Rate and Extent of Biofilm FormationExtent of Biofilm Formation

Indwelling medical device when contaminated Indwelling medical device when contaminated with microorganisms, several variables with microorganisms, several variables determine whether a biofilm develops. First determine whether a biofilm develops. First the microorganisms must adhere to the the microorganisms must adhere to the exposed surfaces of the device long enough exposed surfaces of the device long enough to become irreversibly attached. The rate of to become irreversibly attached. The rate of cell attachment depends on the number and cell attachment depends on the number and types of cells in the liquid to which the device types of cells in the liquid to which the device is exposed, the flow rate of liquid through the is exposed, the flow rate of liquid through the device, and the physicochemical device, and the physicochemical characteristics of the surface characteristics of the surface

Technology understands Technology understands Biofilms better…Biofilms better…

Technological progress Technological progress in microscopy, in microscopy, molecular genetics and molecular genetics and genome analysis has genome analysis has significantly advanced significantly advanced our understanding of the our understanding of the structural and molecular structural and molecular aspects of biofilms, aspects of biofilms, especially of extensively especially of extensively studied model studied model organisms such as organisms such as Pseudomonas Pseudomonas aeruginosaaeruginosa..

Steps in Biofilm Steps in Biofilm DevelopmentDevelopment

Biofilm development can Biofilm development can be divided into several be divided into several key steps including key steps including attachment, micro attachment, micro colony formation, biofilm colony formation, biofilm maturation and maturation and dispersion; and in each dispersion; and in each step bacteria may recruit step bacteria may recruit different components different components and molecules including and molecules including flagella, type IV pili, DNA flagella, type IV pili, DNA and exo polysaccharides. and exo polysaccharides.

Stages of biofilm Stages of biofilm developmentdevelopment. .

Steps in Biofilm Steps in Biofilm formationformation

Bacteria associated with Bacteria associated with Biofilms differBiofilms differ

Bacteria living in a biofilm can have Bacteria living in a biofilm can have significantly different properties from significantly different properties from free-floating bacteria, as the dense and free-floating bacteria, as the dense and protected environment of the film allows protected environment of the film allows them to cooperate and interact in them to cooperate and interact in various ways. One benefit of this various ways. One benefit of this environment is increased resistance to environment is increased resistance to detergents and antibiotics, as the dense detergents and antibiotics, as the dense extracellular matrix and the outer layer extracellular matrix and the outer layer of cells protect the interior of the of cells protect the interior of the community. community.

Biofilms major cause of Biofilms major cause of Nosocomial infectionsNosocomial infections

Microbial biofilms, Microbial biofilms, which often are which often are formed by formed by antimicrobial-antimicrobial-resistant resistant organisms, are organisms, are responsible for responsible for 65% of infections 65% of infections treated in the treated in the developed world.developed world.

Biofilms a Great threat to Biofilms a Great threat to ImplantsImplants

A significant number of people are A significant number of people are affected by biofilm infections which affected by biofilm infections which develop on medical devices implanted in develop on medical devices implanted in the body such as catheters (tubes used the body such as catheters (tubes used to conduct fluids in or out of the body), to conduct fluids in or out of the body), artificial joints, and mechanical heart artificial joints, and mechanical heart valves. When implanted material valves. When implanted material becomes colonized by microorganisms, a becomes colonized by microorganisms, a slow developing but persistent infection slow developing but persistent infection results. results.

Biofilms a Grwoing concern in Biofilms a Grwoing concern in Modern MedicineModern Medicine

Prosthetic device infections, such as Prosthetic device infections, such as those involving artificial heart valves, those involving artificial heart valves, intravascular catheters, or prosthetic intravascular catheters, or prosthetic joints, are prime examples of biofilm-joints, are prime examples of biofilm-associated infections. With the associated infections. With the increasing use of such devices in the increasing use of such devices in the modern practice of medicine, the modern practice of medicine, the prevalence of these infections is prevalence of these infections is expected to increase. expected to increase.

Dental plaqueDental plaque

Dental plaque is a Dental plaque is a yellowish biofilm yellowish biofilm that build up on that build up on the teeth. If not the teeth. If not removed regularly, removed regularly, it can lead to it can lead to dental caries. dental caries.

Dental plaquesDental plaques The formation of The formation of

dental plaque bio dental plaque bio films includes a films includes a series of steps that series of steps that begins with the begins with the initial colonization initial colonization of the pellicle and of the pellicle and ends with the ends with the complex formation complex formation of a mature bio film.of a mature bio film.

Formation of Dental Formation of Dental BiofilmsBiofilms

Additionally, through Additionally, through the growth process of the growth process of the plaque bio film, the the plaque bio film, the microbial composition microbial composition changes from one that changes from one that is primarily gram-is primarily gram-positive and positive and streptococcus-rich to a streptococcus-rich to a structure filled with structure filled with gram-negative gram-negative anaerobes in its more anaerobes in its more mature state. mature state.

Cell-cell signaling (ex. Cell-cell signaling (ex. quorum quorum sensingsensing), and communication with ), and communication with different bacteria enhance Biofilm different bacteria enhance Biofilm

formationformation

Biofilms everywhereBiofilms everywhere

They're everywhere: They're everywhere: on your shower on your shower curtain, on medical curtain, on medical devices implanted in devices implanted in patients, on rocks in patients, on rocks in rivers and streams, rivers and streams, and in your nose. and in your nose. While the sheer While the sheer number of different number of different organisms a biofilm organisms a biofilm may contain makes it may contain makes it a challenge to study, a challenge to study,

CDCCDC – – on Biofilmson Biofilms

Biofilms form on the surface of Biofilms form on the surface of catheter lines and contact lenses. catheter lines and contact lenses. They grow on pacemakers, heart They grow on pacemakers, heart valve replacements, artificial joints valve replacements, artificial joints and other surgical implants. The and other surgical implants. The CDC CDC ((Centers for Disease ControlCenters for Disease Control) ) estimate that over 65% of estimate that over 65% of Nosocomial (hospital-acquired) Nosocomial (hospital-acquired) infections are caused by biofilms. infections are caused by biofilms.

Biofilms interfere in Antibiotic Biofilms interfere in Antibiotic TherapyTherapy

Bacteria growing in a Bacteria growing in a biofilm are highly biofilm are highly resistant to antibiotics, resistant to antibiotics, up to 1,000 times more up to 1,000 times more resistant than the same resistant than the same bacteria not growing in bacteria not growing in a biofilm. Standard a biofilm. Standard antibiotic therapyantibiotic therapy is is often useless and the often useless and the only recourse may be only recourse may be to remove the to remove the contaminated implant. contaminated implant.

Biofilm and Antibiotic Biofilm and Antibiotic resistanceresistance

A key property of bio A key property of bio films is that individual films is that individual microorganisms are microorganisms are bound together by a bound together by a polymeric substance polymeric substance excreted by the excreted by the microorganisms.. This microorganisms.. This protective protective encapsulation is encapsulation is believed to play a role believed to play a role in some antibiotic-in some antibiotic-resistant infection. resistant infection.

Bacterial resitance and Bacterial resitance and BiofilmsBiofilms

Another area of great importance from a Another area of great importance from a public health perspective is the role of public health perspective is the role of biofilms in antimicrobial-drug resistance. biofilms in antimicrobial-drug resistance. Bacteria within biofilms are intrinsically Bacteria within biofilms are intrinsically more resistant to antimicrobial agents more resistant to antimicrobial agents than plank tonic cells because of the than plank tonic cells because of the diminished rates of mass transport of diminished rates of mass transport of antimicrobial molecules to the biofilm antimicrobial molecules to the biofilm associated cells or because biofilm cells associated cells or because biofilm cells differ physiologically from plank tonic differ physiologically from plank tonic cells cells

Biofilms in Cystic fibrosisBiofilms in Cystic fibrosis

Biofilms are Biofilms are involved in involved in numerous numerous diseases. In cystic diseases. In cystic fibrosis patients fibrosis patients have Pseudomonas have Pseudomonas infections that infections that often result in often result in antibiotic resistant antibiotic resistant biofilms. biofilms.

Endocarditis and BiofilmsEndocarditis and Biofilms Microorganisms may attach and develop Microorganisms may attach and develop

biofilms on components of mechanical biofilms on components of mechanical heart valves and surrounding tissues of the heart valves and surrounding tissues of the heart, leading to a condition known as heart, leading to a condition known as prosthetic valve endocarditis. The primary prosthetic valve endocarditis. The primary organisms responsible for this condition are organisms responsible for this condition are S. epidermidis, S. aureus, Streptococcus S. epidermidis, S. aureus, Streptococcus sppspp., ., gram-negative bacilli, diphtheroids, gram-negative bacilli, diphtheroids, enterococci, and enterococci, and Candida Candida spp. These spp. These organisms may originate from the skin, organisms may originate from the skin, other indwelling devices such as central other indwelling devices such as central venous catheters, or dental work. venous catheters, or dental work.

Eye and BiofilmsEye and Biofilms The presence of The presence of

bacterial biofilms has bacterial biofilms has been demonstrated on been demonstrated on many medical devices many medical devices including intravenous including intravenous catheters, as well as catheters, as well as materials relevant to materials relevant to the eye such as contact the eye such as contact lenses, scleral buckles, lenses, scleral buckles, suture material, and suture material, and intraocular lenses. Many intraocular lenses. Many ocular infections often ocular infections often occur when such occur when such prosthetic devices come prosthetic devices come in contact with or are in contact with or are implanted in the eye. implanted in the eye.

Biofilms and Contact lensesBiofilms and Contact lenses Bacterial biofilm Bacterial biofilm

formation on contact formation on contact lenses and contact lens lenses and contact lens storage cases may be storage cases may be a risk factor in contact a risk factor in contact lens-associated corneal lens-associated corneal infections. Studies infections. Studies have shown that have shown that contamination of lens contamination of lens cases by bacteria, cases by bacteria, fungi, and amoebae is fungi, and amoebae is common with 20% to common with 20% to 80% of lens wearers 80% of lens wearers having a contaminated having a contaminated lens case. lens case.

Urinary catheters and Urinary catheters and BiofilmsBiofilms

Urinary catheters are tubular latex or Urinary catheters are tubular latex or silicone devices, which when inserted may silicone devices, which when inserted may readily acquire biofilms on the inner or readily acquire biofilms on the inner or outer surfaces. The organisms commonly outer surfaces. The organisms commonly contaminating these devices and contaminating these devices and developing biofilms are developing biofilms are S. S. epidermidis, Enterococcus faecalis, E. epidermidis, Enterococcus faecalis, E. coli, Proteus mirabilis, P. aeruginosa, coli, Proteus mirabilis, P. aeruginosa, K. pneumoniaeK. pneumoniae, , and other gram-negative and other gram-negative organisms. The longer the urinary catheter organisms. The longer the urinary catheter remains in place, the greater the tendency remains in place, the greater the tendency of these organisms to develop biofilms and of these organisms to develop biofilms and result in urinary tract infections. result in urinary tract infections.

Biofilms and indwelling medical Biofilms and indwelling medical devicesdevices

Biofilms on indwelling medical devices may Biofilms on indwelling medical devices may be composed of gram-positive or gram-be composed of gram-positive or gram-negative bacteria or yeasts. Bacteria negative bacteria or yeasts. Bacteria commonly isolated from these devices commonly isolated from these devices include the include the gram-positive gram-positive Enterococcus Enterococcus faecalis,faecalis, Staphylococcus aureus, Staphylococcus aureus, Staphylococcus epidermidisStaphylococcus epidermidis, and , and Streptococcus Streptococcus viridiansviridians; ; and the gram-and the gram-negative negative Escherichia coli, Klebsiella Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, pneumoniae, Proteus mirabilis, and and Pseudomonas aeruginosaPseudomonas aeruginosa. .

Indwelling catheters and Indwelling catheters and BiofilmsBiofilms**

Central venous catheters, the reference Central venous catheters, the reference method for quantification of biofilms on method for quantification of biofilms on catheter tips is the roll-plate technique, in catheter tips is the roll-plate technique, in which the tip of the catheter is removed which the tip of the catheter is removed and rolled over the surface of a and rolled over the surface of a nonselective medium. Quantification of the nonselective medium. Quantification of the biofilm depends on the number of biofilm depends on the number of organisms recovered by contact with the organisms recovered by contact with the agar surface. Biofilm-associated cells on agar surface. Biofilm-associated cells on the inner lumen of the device are not the inner lumen of the device are not detected with this method, which has low detected with this method, which has low diagnostic sensitivity and low predictive diagnostic sensitivity and low predictive value for catheter-related bacteraemia. value for catheter-related bacteraemia.

Indwelling catheters and Indwelling catheters and BiofilmsBiofilms**

In addition, this method cannot In addition, this method cannot detect more than 1,000 colony-detect more than 1,000 colony-forming units (CFU) per tip. A method forming units (CFU) per tip. A method that used sonication plus vortexing that used sonication plus vortexing as a means of quantifying biofilms on as a means of quantifying biofilms on catheter tips showed that a level of catheter tips showed that a level of 104 CFU per tip is predictive of 104 CFU per tip is predictive of catheter-related septicaemia catheter-related septicaemia

** Biofilms and Device-Associated InfectionsBiofilms and Device-Associated Infections Rodney M. Donlan Centers for Disease Control and Prevention Rodney M. Donlan Centers for Disease Control and Prevention

Atlanta, Georgia, USAAtlanta, Georgia, USA

Antibiotic therapy alone may Antibiotic therapy alone may not cure ?not cure ?

Antimicrobial agents are Antimicrobial agents are administered during valve administered during valve replacement and replacement and whenever the patient has whenever the patient has dental work to prevent dental work to prevent initial attachment by initial attachment by killing all microorganisms killing all microorganisms introduced into the introduced into the bloodstream. bloodstream. As with As with biofilms on other biofilms on other indwelling devices, indwelling devices, relatively few patients relatively few patients can be cured of a can be cured of a biofilm infection by biofilm infection by antibiotic therapy antibiotic therapy alone alone

Biofilms a concern in Biofilms a concern in Antimicrobial TherapyAntimicrobial Therapy

Microbial biofilms may pose a public health Microbial biofilms may pose a public health problem for persons requiring indwelling problem for persons requiring indwelling medical devices. The microorganisms in medical devices. The microorganisms in biofilms are difficult or impossible to treat biofilms are difficult or impossible to treat with antimicrobial agents; detachment from with antimicrobial agents; detachment from the device may result in infection. Although the device may result in infection. Although medical devices may differ widely in design medical devices may differ widely in design and use characteristics, specific factors and use characteristics, specific factors determine susceptibility of a device to determine susceptibility of a device to microbial contamination and biofilm microbial contamination and biofilm formation. formation.

Biofilms need higher Biofilms need higher concentration of Antibioticsconcentration of Antibiotics

Biofilms are remarkably difficult to treat Biofilms are remarkably difficult to treat with antimicrobials. Antimicrobials may with antimicrobials. Antimicrobials may be readily inactivated or fail to penetrate be readily inactivated or fail to penetrate into the biofilm. In addition, bacteria into the biofilm. In addition, bacteria within biofilms have increased (up to within biofilms have increased (up to 1000-fold higher) resistance to 1000-fold higher) resistance to antimicrobial compounds, even though antimicrobial compounds, even though these same bacteria are sensitive to these same bacteria are sensitive to these agents if grown under plank tonic these agents if grown under plank tonic conditions. conditions.

Biofilms help Gene Biofilms help Gene transfertransfer

Biofilms increase the Biofilms increase the opportunity for gene opportunity for gene transfer transfer between/among between/among bacteria.. Gene bacteria.. Gene transfer can convert transfer can convert a previous a virulent a previous a virulent commensals commensals organism into a organism into a highly virulent highly virulent pathogen. pathogen.

Biofilms –Quorum Biofilms –Quorum sensingsensing

Certain species of Certain species of bacteria communicate bacteria communicate with each other within with each other within the biofilm. As their the biofilm. As their density increases, the density increases, the organisms secrete low organisms secrete low molecular weight molecular weight molecules that signal molecules that signal when the population when the population has reached a critical has reached a critical threshold. This threshold. This process, called process, called quorum sensingquorum sensing, is , is responsible for the responsible for the expression of virulence expression of virulence factors. factors.

Quorum sensing helps the Quorum sensing helps the survival of pathogenssurvival of pathogens

Biofilms contribute for new Biofilms contribute for new phenotypesphenotypes

Bacteria express new, and sometimes Bacteria express new, and sometimes more virulent phenotypes when growing more virulent phenotypes when growing within a biofilm. Such phenotypes may within a biofilm. Such phenotypes may not have been detected in the past not have been detected in the past because the organisms were grown on because the organisms were grown on rich nutrient media under plank tonic rich nutrient media under plank tonic conditions. The growth conditions are conditions. The growth conditions are quite different particularly in the depths quite different particularly in the depths of biofilms, of biofilms,

Biofilms protects from Biofilms protects from Immune responsesImmune responses

Bacteria embedded within biofilms Bacteria embedded within biofilms are resistant to both immunological are resistant to both immunological and non- specific defence and non- specific defence mechanisms of the body. Contact with mechanisms of the body. Contact with a solid surface triggers the expression a solid surface triggers the expression of a panel of bacterial enzymes which of a panel of bacterial enzymes which catalyze the formation of sticky catalyze the formation of sticky polysaccharides that promote polysaccharides that promote colonization and protection. colonization and protection.

Biofilms – Protects from Biofilms – Protects from PhagocytosisPhagocytosis

Phagocytes are unable to effectively Phagocytes are unable to effectively engulf a bacterium growing within a engulf a bacterium growing within a complex polysaccharide matrix complex polysaccharide matrix attached to a solid surface. This attached to a solid surface. This causes the phagocyte to release causes the phagocyte to release large amounts of pro-inflammatory large amounts of pro-inflammatory enzymes and cytokines, leading to enzymes and cytokines, leading to inflammation and destruction of inflammation and destruction of nearby tissues. nearby tissues.

Current objectives on Current objectives on Biofilm researchBiofilm research

oo Development of improved imaging of Development of improved imaging of biofilms in situ; biofilms in situ; oo Development of improved Development of improved clinically relevant in vitro and in vivo clinically relevant in vitro and in vivo models of biofilms under specific in vivo models of biofilms under specific in vivo conditions such as flow rate, nutrient conditions such as flow rate, nutrient content, and temperature; content, and temperature; oo Development of better probes Development of better probes (genetic, metabolic, and immunological) for (genetic, metabolic, and immunological) for real- time analysis; real- time analysis; o o Studies of quorum Studies of quorum sensing/signaling molecules; sensing/signaling molecules;

Current objectives on Biofilm Current objectives on Biofilm researchresearch

o o Further characterization of biofilm-specific Further characterization of biofilm-specific gene expression; gene expression; oo Studies of the exchange of genetic material Studies of the exchange of genetic material within biofilms; within biofilms; o o Studies of organic contaminants on substrata, Studies of organic contaminants on substrata, and their influence on biofilm structure; and their influence on biofilm structure; o o Development Development of novel approaches to control pathogenic of novel approaches to control pathogenic bacteria by, for example, devising strategies bacteria by, for example, devising strategies to favour growth of non-pathogenic to favour growth of non-pathogenic microorganisms in biofilm communities; microorganisms in biofilm communities;

Current objectives on Biofilm Current objectives on Biofilm researchresearch

oo Studies of pathogenic Studies of pathogenic mechanisms of mechanisms of microbes growing in microbes growing in biofilms; biofilms; oo Elucidation of Elucidation of mechanisms of mechanisms of resistance of biofilms to resistance of biofilms to antimicrobial agents; antimicrobial agents; oo Studies of Studies of host immune host immune responses, both responses, both innate and adaptive innate and adaptive to biofilmsto biofilms; ;

Current objectives on Biofilm Current objectives on Biofilm researchresearch

In studies of infectious lung disease in In studies of infectious lung disease in cystic fibrosis; cystic fibrosis; oo Studies on the potential of diagnostic Studies on the potential of diagnostic procedures such as Bronchoalveloar lavage procedures such as Bronchoalveloar lavage and bronchoscopy to disturb local biofilm and bronchoscopy to disturb local biofilm flora and inoculate distant locations; flora and inoculate distant locations; oo Development of Development of mathematical models and computer mathematical models and computer simulations of biofilms; simulations of biofilms; o o Development of the Development of the methodology for the prevention and control methodology for the prevention and control of biofilms from catheters, water unit lines, of biofilms from catheters, water unit lines, and other clinically important solid surfaces;. and other clinically important solid surfaces;.

Searching for alternativesSearching for alternatives – – Tissue engineeringTissue engineering

Role of biofilms in multiple pathologies and Role of biofilms in multiple pathologies and the difficulty in resolving these pathologies the difficulty in resolving these pathologies speaks to the importance of developing speaks to the importance of developing means of replacing or enhancing the means of replacing or enhancing the therapies already in use. The use of synthetic therapies already in use. The use of synthetic materials in the body ranges from catheters materials in the body ranges from catheters to mesh to stents to heart valves and to mesh to stents to heart valves and beyond. Until the development of viable and beyond. Until the development of viable and practical tissue engineering, then number practical tissue engineering, then number and types of applications in which synthetic and types of applications in which synthetic materials are used will continue to increase. materials are used will continue to increase.

Emerging MethodsEmerging Methods

Several researchers Several researchers are finding solutions are finding solutions for the cure of Biofilms for the cure of Biofilms , yet it is , yet it is experimental, with experimental, with advances in molecular advances in molecular biology better model biology better model treatments can be treatments can be identified to reduce identified to reduce the problem of Biofilm the problem of Biofilm interference in interference in Antibiotic therapy.Antibiotic therapy.

Created for Created for Dr.T.V.Rao MD’s ‘e’ ‘e’ learning series.learning series.

EmailEmail

doctortvrao@gmail.comdoctortvrao@gmail.com