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Bacterial cells can grow in two ways, one as single cells or in the form of aggregates which normally form biofilms. Biofilms are mainly associated with the enhancement of virulence of the strains. This is because biofilms protect bacterial cells from antimicrobial agents as they are usually impermeable, while providing physical defense against the host's own immune response and allowing bacterial cells to produce pathogenic toxins in larger quantities. Bacteria in biofilms are therefore able to survive by producing cells that can survive high antibiotic concentrations.

Biofilms, Infection, and Antimicrobial Therapy

Therefore, the use of traditional antimicrobial agents solely is not considered an effective treatment for the infections caused by biofilm producing strains. Hospital-acquired and post-surgical infections, specifically due to the use of indwelling medical devices like catheters, prosthesis etc. By studying biofilms, researchers can devise treatment strategies to treat difficult and potentially life threatening bacterial infections. One such strategy is to prevent the formation of biofilms.

Biofilms, Infection, and Antimicrobial Therapy

Bacteria are able to form biofilms through a cell-cell communication process known as quorum sensing QS. Disrupting this interaction results in a decreased adhesion of bacterial cells to each other which further leads to a disruption in the biofilm formation cycle.


Unable to form a biofilm, bacteria are therefore unable to produce as much toxins while being more vulnerable to the host's defenses. Stephano, et al. The most relevant biofilm-related property is the unusual high resistance to antimicrobial therapy, although the origin of this extreme resistance is still the subject of debate.

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Besides an overview of the main characteristics of biofilms, this review discusses the different resistance mechanisms that lead to increased biofilm-related morbidity and mortality. Even in healthy immunocompetent individuals, biofilm infections are rarely resolved and usually persist until the colonized surface is removed from the body. Fundamental research aiming to develop new anti-biofilm strategies will largely depend on the availability of appropriate in vitro models for production and quantification of biofilms.

This review describes the most frequently used in vitro biofilm models with respect to the different pitfalls that can emerge from in vitro biofilm research.