The Role of Bacterial Biofilms in Infections and Effective Prevention Strategies for Biofilm Formation in Urinary Catheters

Biofilm formation is a complicated microbiological process and one of the distinctive features of pathogenic bacteria. Biofilms are a cluster of bacterial cells enclosed in extra polymeric substances and irreversibly attached onto a surface. Biofilms have a major impact on public health as biofilm associated bacteria are able to survive and populate in indwelling medical devices, causing severe nosocomial and recurrent infections. Biofilm-embedded bacteria have unique characteristics which are harder to destroy than the planktonic forms. Especially biofilm bacteria are highly resistant to antimicrobial agents. Treating patients undergoing long term urinary catheterization is becoming complicated by encrustation and blockage due to crystalline biofilm formation inside the lumen of catheters. Further, all types of indwelling catheters including silver or nitrofurazone‐coated devices are vulnerable to biofilm formation. Therefore, there is an urgent requirement to develop either urinary catheters with other alternative coatings or new urinary drainage systems which may lead to reduction of infections and morbidity. Other than that, controlling biofilm formation is a necessary requirement during both manufacturing and usage of catheters. Antifouling and biocidal coatings on the catheters are currently being investigated and it is proved that herbal products also express anti-biofilm activity. This review is largely based on previous literature describing biofilm formation and their role in catheter associated urinary tract infection. Further, mechanism of biofilm formation in indwelling urinary catheters, antibiotic resistance patterns, and the detection methods of biofilm are briefly described. Understanding the mechanisms of biofilm formation and the antibiotic resistance patterns is of utmost importance which will result in the development of new remedies for biofilm infection.