TY - JOUR

T1 - Biofilm Survival Strategies in Chronic Wounds

AU - Thaarup, Ida Clement

AU - Iversen, Anne Kristine Servais

AU - Lichtenberg, Mads

AU - Bjarnsholt, Thomas

AU - Jakobsen, Tim Holm

N1 - Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022

Y1 - 2022

N2 - Bacterial biofilms residing in chronic wounds are thought to have numerous survival strate-gies, making them extremely difficult to eradicate and resulting in long-term infections. However, much of our knowledge regarding biofilm persistence stems from in vitro models and experiments performed in vivo in animal models. While the knowledge obtained from such experiments is highly valuable, its direct translation to the human clinical setting should be undertaken with caution. In this review, we highlight knowledge obtained from human clinical samples in different aspects of biofilm survival strategies. These strategies have been divided into segments of the following attributes: altered transcriptomic profiles, spatial distribution, the production of extracellular polymeric sub-stances, an altered microenvironment, inter-and intra-species interactions, and heterogeneity in the bacterial population. While all these attributes are speculated to contribute to the enhanced persistence of biofilms in chronic wounds, only some of them have been demonstrated to exist in human wounds. Some of the attributes have been observed in other clinical diseases while others have only been observed in vitro. Here, we have strived to clarify the limitations of the current knowledge in regard to this specific topic, without ignoring important in vitro and in vivo observations.

AB - Bacterial biofilms residing in chronic wounds are thought to have numerous survival strate-gies, making them extremely difficult to eradicate and resulting in long-term infections. However, much of our knowledge regarding biofilm persistence stems from in vitro models and experiments performed in vivo in animal models. While the knowledge obtained from such experiments is highly valuable, its direct translation to the human clinical setting should be undertaken with caution. In this review, we highlight knowledge obtained from human clinical samples in different aspects of biofilm survival strategies. These strategies have been divided into segments of the following attributes: altered transcriptomic profiles, spatial distribution, the production of extracellular polymeric sub-stances, an altered microenvironment, inter-and intra-species interactions, and heterogeneity in the bacterial population. While all these attributes are speculated to contribute to the enhanced persistence of biofilms in chronic wounds, only some of them have been demonstrated to exist in human wounds. Some of the attributes have been observed in other clinical diseases while others have only been observed in vitro. Here, we have strived to clarify the limitations of the current knowledge in regard to this specific topic, without ignoring important in vitro and in vivo observations.

KW - animal models

KW - bacterial biofilm

KW - extracellular polymeric substances

KW - microenvironment

KW - transcriptomics

U2 - 10.3390/microorganisms10040775

DO - 10.3390/microorganisms10040775

M3 - Review

C2 - 35456825

AN - SCOPUS:85127671454

VL - 10

JO - Microorganisms

JF - Microorganisms

SN - 2076-2607

IS - 4

M1 - 775

ER -