Multicellular resistance: Biofilms

Abstract

Introduction: In 1987, Bill Costerton and colleagues published a landmark review article that was the first to articulate the general phenomenon of biofilm resistance to antimicrobial agents 1. Fourteen years later, the question of how bacteria in biofilms manage to evade killing by antiseptics, antibiotics and antimicrobial components of the host defenses remains unanswered. Recently, Mah and O'Toole provided an excellent overview of the current hypotheses and recent data on mechanisms of biofilm resistance 2. Recognition of the significance of this problem is bound to grow as the role of biofilms in chronic infections becomes increasingly clear 3 and 4.Why has the underlying basis of reduced susceptibility of bacteria in biofilms proven to be such a difficult nut to crack? Mah and O'Toole register the possibility that multiple resistance mechanisms operate in concert within a single biofilm community. I would like to offer two further perceptions, both admittedly speculative, about the general nature of the resistance of bacterial biofilms to antimicrobial agents. Although these ideas are probably only partially correct, perhaps they can guide some fresh approaches to solving the problem of biofilm recalcitrance.