review · The Microbe
Biofilms are structured communities of microbes that attach to living or non-living surfaces and protect themselves with a self-produced matrix of extracellular polymeric substances. This protective matrix allows bacteria to persist, withstand antibiotics, and escape destruction by the host immune response. Biofilms contribute significantly to chronic and recurring human infections, particularly in wounds, the urinary tract, the respiratory and gastrointestinal systems, and on implanted medical devices. Within these clusters, bacteria display distinct physiological traits, including altered gene expression, metabolic activity, and growth rates compared to free-floating planktonic bacteria. These functional differences severely complicate conventional interventions. Effectively managing these conditions requires addressing diagnostic limitations, deploying improved detection and characterisation technologies, and establishing novel therapeutic strategies capable of overcoming persistent antimicrobial resistance.
Biofilms cause chronic, hard-to-treat infections in vulnerable patients, particularly those with implanted medical devices or long-term wounds. Because bacteria inside these communities resist standard antibiotics and evade the body's natural defences, conventional healthcare interventions frequently fail. Understanding biofilm mechanisms and identifying improved detection tools is essential for developing targeted therapies that can safely clear persistent infections.
The findings point towards applications in clinical diagnostics, medical device coatings, and new therapeutic formulations for managing persistent infections in wounds, implants, and internal tracts. Primary users include diagnostic laboratories, medical device manufacturers, and pharmaceutical developers. Because the overview focuses on emerging detection technologies and innovative therapeutic concepts across the field, these potential solutions remain at an early to translational research stage rather than near-market deployment.
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Biofilms are structured microbial communities that form on biotic or abiotic surfaces. They are encased in a self-produced extracellular polymeric substance (EPS) matrix, which allows them to persist, resist antibiotics, and evade the host immune system. Biofilm development is linked to persistent and recurrent infections, including those related to implanted medical devices, wounds, the urinary tract, the respiratory system, and the gastrointestinal tract. Bacteria within biofilms display unique phenotypes compared to their planktonic forms, including changes in gene expression, growth patterns, and metabolic processes, further complicating treatment. Understanding how biofilms develop and are regulated, along with their impact on antimicrobial resistance, is crucial for developing effective approaches to manage and treat biofilm-associated infections. This review examines the existing knowledge about biofilms in human infections, focusing on their formation, structure, and role in antimicrobial resistance and immune evasion. We analyze diagnostic and treatment challenges, explore recent advances in detection and characterization techniques, and discuss novel therapeutic strategies.
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DOI: 10.1016/j.microb.2025.100436
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