Biofilm-associated infection by enterococci

Enterococci are ubiquitous members of the human gut microbiota and frequent causes of biofilm-associated opportunistic infections. Enterococci cause 25% of all catheter-associated urinary tract infections, are frequently isolated in wounds and are increasingly found in infective endocarditis, and all of these infections are associated with biofilms. Enterococcal biofilms are intrinsically tolerant to antimicrobials and thus are a serious impediment for treating infections. In this Review, we describe the spatiotemporal development of enterococcal biofilms and the factors that promote or inhibit biofilm formation. We discuss how the environment, including the host and other co-colonizing microorganisms, affects biofilm development. Finally, we provide an overview of current and future interventions to limit enterococcal biofilm-associated infections. Overall, enterococcal biofilms remain a pressing clinical problem, and there is an urgent need to better understand their development and persistence and to identify novel treatments.