[Biofilm--still a problem?]

Biofilm formation is a crucial step in the pathogenesis of many subacute and chronic bacterial infections, including foreign body-related infections. Biofilms are difficult to eradicate with conventional antimicrobial agents. Bacterial biofilms have several potential antimicrobial resistance mechanisms. Persister cells play a major role in the tolerance of biofilm bacteria to antimicrobial agents. The most common microorganisms responsible for about two thirds of infections with foreign material are biofilm-forming bacteria such as staphylococci (Staphylococcus aureus, S. epidermidis, S. lungdunensis), followed by Pseudomonas aeruginosa and Enterococcus spp, as well as fungal infections such as Candida sp. Preventing early colonisation is a good strategy for reducing morbidity and furthermore, reducing biofilm-associated infection reduces the need for antibiotic use.