Biofilm exacerbates antibiotic resistance: Is this a current oversight in antimicrobial stewardship?

Antimicrobial Resistance & Infection Control

Philip Bowler¹  Randall Wolcott²  Christine Murphy³ 

[1] Infection Prevention and Control, ConvaTec Ltd, Deeside, UK;Southwest Regional Wound Care Center, Lubbock, TX, USA;The Ottawa Hospital Limb Preservation Centre, Ottawa, Canada;

关键词: Biofilm;    Environment;    Antibiotic resistance;    Antibiotic tolerance;    Antimicrobial stewardship;   

DOI  :  10.1186/s13756-020-00830-6

来源: Springer

【 摘 要 】

ObjectiveTo raise awareness of the role of environmental biofilm in the emergence and spread of antibiotic resistance and its consideration in antimicrobial stewardship.BackgroundAntibiotic resistance is a major threat to public health. Overuse of antibiotics, increased international travel, and genetic promiscuity amongst bacteria have contributed to antibiotic resistance, and global containment efforts have so far met with limited success. Antibiotic resistance is a natural mechanism by which bacteria have adapted to environmental threats over billions of years and is caused either by genetic mutations or by horizontal gene transfer. Another ancient survival strategy involves bacteria existing within a self-produced polymeric matrix, which today is termed biofilm. Biofilm similarly enables bacterial tolerance to environmental threats, and also encourages the transfer of antibiotic resistance genes between bacterial species. This natural and ubiquitous mode of bacterial life has not been considered amongst strategies to tackle antibiotic resistance in healthcare facilities, despite its ability to significantly enhance bacterial survival and persistence, and to encourage antibiotic resistance.ConclusionBiofilm must be considered synonymously with antibiotic resistance because of its proficiency in transferring resistance genes as well as its innate phenotypic tolerance to antibiotics. Although biofilm falls outside of the current definition of antimicrobial stewardship, greater awareness of the existence, ubiquity, and consequences of environmental biofilm amongst healthcare practitioners is crucial to improving hygiene practices and controlling the emergence and spread of antibiotic resistance in healthcare facilities.

【 授权许可】

CC BY