The use of bacteriophages and bacteriophage-derived enzymes for clinically relevant biofilm control

Abstract

Biofilm formation occurs spontaneously on both inert and living systems and is an important bacterial survival strategy. Biofilms are often associated with several chronic and acute infections such as wound infections, vaginitis, upper respiratory tract infections, otitis media, and endocarditis among others. There is an inherent tolerance of cells embedded in biofilms towards antibiotics and therefore, alternative agents, such as bacteriophages have been the focus of interest. This is an overview of the phage-biofilm interaction research carried out, starting with a general introduction to biofilm structure and composition, and to clinically relevant biofilms and their inherent tolerance to antimicrobials. Then, the use of phages and phage derived enzymes as alternative biofilm control agents will be discussed in detail based on the results from a number of in vitro experiments found in literature. Although focus is almost exclusively given to the results of biofilm control and biofilm prevention experiments using phages and phage-derived enzymes, other relevant topics, such as the diffusion of phages through the matrix, and the effect of prophages, will also be addressed.