Book overview
The well-known persistence in the nosocomial environment of multidrug resistant bacterial
and fungal species, today responsible for a wide variety of healthcare-associated infections, is
believed to be greatly promoted by the ability of most of them to adhere and to grow in sessile
mode on mucosal and soft tissues of hospitalized patients, as well as on the inner and outer
surfaces of indwelling medical devices, including intravenous catheters, orthopaedic, cardiac
valves, intrauterine devices, and contact lenses.
In this regard, a large number of these microorganisms, such as Acinetobacter baumannii,
Candida albicans, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and
Staphylococcus aureus, give rise to highly organized, sessile community defined biofilms, in
which microbes grow encased in a hydrated matrix of extracellular polymeric substances
produced by themselves and are well protected from the attack of antimicrobial molecules and
from the host immune response, by resisting phagocytosis and other body's defense systems.
The great influence of the sessile growth on the effectiveness of the antibiotic therapies is due
to both the structure and function of these microbial communities, making these also 1000
times more tolerant to antibiotics and disinfectants. Thus, alternative approaches to the
common antibiotic treatments are emerging for preventing and treating both the mono-species
and the most frequent multi-species biofilms, including enzymes able to disrupt mature
biofilms and new biomaterials for the coating of medical devices to counteract microbial
adhesion and biofilm formation.
The aim of this Special Issue is to report on the state-of-art of the basic and applied research
in the field of biofilm-based nosocomial infections that can be acquired by patients in both
general hospitals and long-term care settings. Particularly, the involvement of microbial
biofilms in medical device-related infections and other healthcare-associated infections, so far
underestimated and/or scarcely investigated, has been considered, reviewed, and discussed.
