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Updated: Jun 9, 2025

Establishing the Minimal Bactericidal Concentration of an Antimicrobial Agent for Planktonic Cells MBC-P and Biofilm Cells MBC-B
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Establishing the Minimal Bactericidal Concentration of an Antimicrobial Agent for Planktonic Cells MBC-P and Biofilm Cells MBC-B

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Antimicrobial resistance: Biofilms, small colony variants, and intracellular bacteria

Josina Straub1, Susanne Baertl1, Marielle Verheul2

  • 1Department of Trauma Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.

Injury
|October 31, 2024
PubMed

Insights

Musculoskeletal infections pose a significant challenge in orthopedic surgery. Understanding pathogen defense strategies like biofilms and small colony variants is crucial for developing improved treatments for bone and soft tissue infections.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Microbiology

Background:

  • Soft tissue and bone infections are significant complications in orthopedic and trauma surgery, imposing a high burden on patients and healthcare systems.
  • Current treatment relies on surgical debridement and prolonged antibiotics, but groundbreaking improvements are still needed.
  • Understanding pathogen-related factors is essential for improving treatment outcomes.

Purpose of the Study:

  • To provide an overview of pathogen-related pathophysiology in musculoskeletal infections.
  • To highlight key bacterial defense strategies contributing to treatment failure.
  • To offer an outlook on future therapeutic strategies.

Main Methods:

  • Review of current literature on musculoskeletal infections.
  • Detailed examination of pathogen defense mechanisms including biofilms, small colony variants, and intracellular bacteria.
  • Analysis of current and emerging therapeutic concepts.

Main Results:

  • Pathogens employ strategies like biofilm formation, small colony variants, and intracellular lifestyles to evade host defenses and antibiotics.
  • Biofilms present unique challenges due to their structure and resistance properties.
  • Small colony variants and intracellular bacteria represent alternative survival mechanisms within host tissues.

Conclusions:

  • A deeper understanding of these pathogen defense mechanisms is critical for advancing treatment strategies.
  • Future therapies may target biofilm disruption, eradication of small colony variants, and intracellular bacterial clearance.
  • Integrated approaches combining improved diagnostics, surgical techniques, and novel antimicrobial strategies are necessary.
Keywords:
Antimicrobial resistanceBiofilmIntracellular bacteriaSmall colony variants

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