title: Current Hypotheses in Cardiac Surgery: Biofilm in Infective Endocarditis.
abstract: Despite recent advances in diagnostics and treatments, infective endocarditis is still associated with substantial morbidity and mortality. Even prolonged courses of broad-spectrum antimicrobials often fail to eradicate the infection, making surgical intervention necessary in many cases. In this review, we present recent advances in molecular microbiology techniques that have uncovered a plausible explanation for this resistance to treatment: the recently discovered social behavior of some microbes, in which colonies form a nearly impenetrable barrier around themselves called a biofilm. These biofilm structures isolate the colony from the body׳s immune response and antimicrobial drugs. We also present current thinking about possible ways biofilms can be destroyed.
authors: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.
authors: Haytham
authors: H
authors: Elgharably
authors: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.
authors: Syed T
authors: ST
authors: Hussain
authors: Department of Infectious Disease, Medicine Institute, Cleveland Clinic, Cleveland, OH.
authors: Nabin K
authors: NK
authors: Shrestha
authors: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH; Department of Quantitative Health Sciences, Research Institute, Cleveland Clinic, Cleveland, OH.
authors: Eugene H
authors: EH
authors: Blackstone
authors: Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH. Electronic address: petterg@ccf.org.
authors: Gösta B
authors: GB
authors: Pettersson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification / Q000187:drug effects / Q000254:growth & development* / Q000472:pathogenicity; D018441:Biofilms / Q000187:drug effects / Q000254:growth & development*; D006348:Cardiac Surgical Procedures; D024881:Drug Resistance, Bacterial; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006351:Heart Valves / Q000187:drug effects / Q000382:microbiology* / Q000601:surgery; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents
keywords: biofilm; infective endocarditis; pathology; resistance; surgical treatment