title: Approaches to biofilm-associated infections: the need for standardized and relevant biofilm methods for clinical applications.
abstract: The concept of biofilms in human health and disease is now widely accepted as cause of chronic infection. Typically, biofilms show remarkable tolerance to many forms of treatments and the host immune response. This has led to vast increase in research to identify new (and sometimes old) anti-biofilm strategies that demonstrate effectiveness against these tolerant phenotypes. Areas covered: Unfortunately, a standardized methodological approach of biofilm models has not been adopted leading to a large disparity between testing conditions. This has made it almost impossible to compare data across multiple laboratories, leaving large gaps in the evidence. Furthermore, many biofilm models testing anti-biofilm strategies aimed at the medical arena have not considered the matter of relevance to an intended application. This may explain why some in vitro models based on methodological designs that do not consider relevance to an intended application fail when applied in vivo at the clinical level. Expert commentary: This review will explore the issues that need to be considered in developing performance standards for anti-biofilm therapeutics and provide a rationale for the need to standardize models/methods that are clinically relevant. We also provide some rational as to why no standards currently exist.
authors.affiliation: a Molecular Microbiology Research Group, Faculty of Medicine , Western Sydney University , Sydney , Australia.|b Liverpool Diabetes Collaborative Research Group , Ingham Institute of Applied Medical Research , Liverpool , Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Malone
authors.affiliation: c Center for Biofilm Engineering , Montana State University , Bozeman , MT , USA.
authors.forename: Darla M
authors.initials: DM
authors.lastname: Goeres
authors.affiliation: a Molecular Microbiology Research Group, Faculty of Medicine , Western Sydney University , Sydney , Australia.
authors.forename: Iain
authors.initials: I
authors.lastname: Gosbell
authors.affiliation: d Surgical Infection Research Group, Faculty of Medicine and Health Sciences , Macquarie University , Sydney , Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Vickery
authors.affiliation: a Molecular Microbiology Research Group, Faculty of Medicine , Western Sydney University , Sydney , Australia.
authors.forename: Slade
authors.initials: S
authors.lastname: Jensen
authors.affiliation: e Departments of Microbial Infection and Immunity, Orthopedics, Center for Microbial Interface Biology , The Ohio State University , Columbus , OH , USA.|f National Centre for Advanced Tribology (nCATS), Engineering Sciences , University of Southampton , Southampton , UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Stoodley
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D035843:Biomedical Research / Q000379:methods / Q000592:standards; D002908:Chronic Disease; D003140:Communicable Disease Control / Q000379:methods* / Q000592:standards; D003141:Communicable Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D006801:Humans; D008954:Models, Biological
chemical_list: D000890:Anti-Infective Agents
keywords: Biofilm; MBEC; effectiveness; standard methods