Biofilm

The correlation between bacterial biofilm formation and chronic wound healing has become the topic of intense research over the past few years. Biofilm formation has become an important challenge for wound care and requires optimal management. This article is going to discuss in detail the relationship between biofilm formations and wound healing, and its management.

​

A biofilm is a microbial aggregate tightly enveloped in an extra polymeric substance matrix that gets attached to the wound surface. A biofilm indirectly affects chronic wound healing by producing destructive enzymes and toxins which can promote a chronic inflammatory state within the wound.

​

Biofilms and wound chronicity are interlinked. Studies suggest a correlation between polymicrobial biofilm formation and non-healing chronic wounds. Nearly 60% to 80% of chronic wounds have been shown to be covered with bacterial biofilms (1) whereas a recent study has shown them to be present in 78% of chronic wounds.  (1).

​

Biofilm infections could be frustrating to treat as they are resistant to the effects of antibiotics. Experts agree that such infections need not be treated with antibiotics but with effective biofilm busters. Unfortunately, this is not as easy as it sounds because biofilm bursting and disruption of its matrix may lead to the desegregation of pathogens and further destabilization of biofilm structure. This may give rise to a new infection that is more severe. Specific probiotic combinations have been discovered to have a marked utility in the human field, and data on their anti biofilm activity on various respiratory, genito-urinary, wound, and tissue pathogens, are starting to become convincing.

Probiotics have different underlying mechanisms to affect the pathogenic activity of microbes. The most important one includes the production of fatty acids, lipase enzymes, bacteriocins, surfactants, EPS, hydrogen peroxide, and organic acids. All of these compounds hinder the microbe’s pathogenic potential and their adhesion to the host surface. Probiotics also interfere with microbe’s survival by preventing QS (Quorum Sensing) biofilm formation and its integrity, finally leading to biofilm eradication. (2)

​

The unfavorable environmental conditions generated by probiotics constitute the second most important mechanism against biofilm formation. They competitively adhere themselves to the host surface or medical devices like catheters, stunts, prostheses etc. which prevent the formation of harmful bacterial colonies. Bacteriocins produced by probiotics exhibit a variety of actions against pathogens. These include permeating the cell membrane, damaging microbial cell’s integrity, and genome irreversibly.

​

Additionally, modulating host immune responses, growth inhibition, co aggregation, and nonpathogenic biofilm formation by probiotics take over the pathogenic bacterial biofilms. (1)

​

The probiotic strains can be isolated from numerous sources such as lactic acid fermented soybean. Lactobacillus (lactic Acid Bacteria, LAB) and Bifidobacterium are most commonly used for probiotic preparation. Their advantages for host include a balanced immune response, healthy GI flora, and improved nutrient absorption. The main antimicrobial substances produced by probiotic cells are SCFAs (lactic, acetic, propionic, and succinic acid), hydrogen sulfide and peroxide, ethanol, carbon dioxide, EPS, biosurfactants, and bacteriocins. (3)

​

Studies have shown that short-chain fatty acids (SCFAs) have appeared to play a role in biofilm management.(4) Short-chain fatty acids (SCFAs) are the main metabolites produced by the gut microbiota via the fermentation of complex carbohydrates and fibers. Evidence suggests that SCFAs play antimicrobial role in the control of infections through direct action both on microorganisms and on host signaling. Short chain tatty acids commonly produced by gut microbiota influence Salmonella enterica motility, biofilm Formation, and gene expression. (5) In a study, a solution of SCAFs i.e. acetic acid was shown to eradicate 85.9% of the biofilm formed. (6)

​

Similarly, free amino acids and antimicrobial peptides (AMPs) have been shown to control the biofilm formation and to eradicate mature biofilms. Naturally occurring or synthetic antimicrobial peptides have been shown to prevent microbial colonization of surfaces, to kill bacteria in biofilms and to disrupt the biofilm structure. (7)

Post biotics are also the ideal film busting agents that also show excellent antimicrobial activity against pathogens. Postbiotics have a blend of short-chain fatty acids lipopolysaccharides,  exopolysaccharides enzymes ,cell wall fragments bacterial lysates (a mixture made from bacterial components), cell-free supernatants (a mixture of compounds produced by bacteria and yeast) ,various other metabolites such as vitamins and amino acids.

​

Take away:

​

The next thing to move on to is a formula rich in probiotics and soybean to promote biofilm inhibition and wound healing. Bao Geng Biotech is bringing you an advanced formula i.e. Sanaverer wound healing spray, based on all such ingredients that have been proven to inhibit biofilm formation in most microbial and chronic film infections. Our research against skin diseases and wounds also includes biofilm. Clinical application of probiotics is made more complex by their viability and stability maintenance during production, processing and storage.  (8)

​

Different strains of probiotics have different effects. Multi-strain probiotics appear to show greater efficacy than single strains, including strains that are components of the mixtures themselves .Based on this concept, we developed a perfect formula based on a perfect blend of 16 species of probiotics to ferment with soybean that affects wound healing. (9)

​

Typically, a biofilm on wound need mechanical or sharp debridement that causes pain and discomfort to the patient and decreases treatment effectiveness and patient compliance. Even after debridement, biofilm reforms in an hour. One of the most important feature of Sanaverer as a biofilm buster is its ability to prevent biofilm reformation which makes it an ideal choice for home based wound care.​