Probiotics and Biofilms

  • Kushan Sengupta
  • Piramaayagam ParamasivanEmail author


Probiotics are live microorganisms which when administered in adequate amounts confer health benefit on the host. Biofilm is a microbially derived sessile community in which the bacteria are attached to a substratum or interface or to each other and are embedded in a matrix of extracellular polymeric substances that they have produced. Probiotics can be used for the treatment of biofilm-forming pathogens in various organ systems of the body. Lactobacilli and Bifidobacteria have been found to help in the treatment of dental caries. In the gastrointestinal tract, probiotics have been used to treat disorders like antibiotic-associated diarrhea, inflammatory bowel disease, and irritable bowel syndrome wherein by biofilm formation, they alter the pathogenic milieu. For better delivery of the probiotics to the intestine and to prevent degradation by gastric acid, probiotics have been capsulated with chitosan and alginate. Probiotics containing Lactobacillus in combination with antimicrobials have been found to be effective in the treatment of recurrent urinary tract infection and bacterial vaginosis. In nonhealing wound infections caused by biofilms formed by Staphylococcus aureus and Pseudomonas, probiotics appear as a promising tool because when topically applied, they helped in the treatment. Recently, novel treatment strategies like coadministration of antibiotics and biofilm inspired encapsulated probiotics have been used to treat chronic wound infections while also avoiding emergence of antimicrobial resistance.


Probiotics Biofilms Antibiotics 


  1. Anal A, Bhopatk D, Tokura S, Tamura H, Stevens W (2003) Chitosan-alginate multilayer beads for gastric passage and controlled intestinal release of protein. Drug Dev Ind Pharm 29:713–724CrossRefGoogle Scholar
  2. Anukam KC, Osazuwa E, Osemene GI et al (2006a) Clinical study comparing probiotic Lactobacillus GR-1 and RC-14 with metronidazole vaginal gel to treat symptomatic bacterial vaginosis. Microbes Infect 8(12/13):2772–2776CrossRefGoogle Scholar
  3. Anukam K, Osazuwa E, Ahonkhai I et al (2006b) Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect 8(6):1450–1454CrossRefGoogle Scholar
  4. Arora S, Budhiraja R (2012) Chitosan-alginate microcapsules of amoxicillin for gastric stability and mucoadhesion. J Adv Pharm Technol Res 3:68–74PubMedPubMedCentralGoogle Scholar
  5. Borges S, Barbosa J, Silva J et al (2013) Evaluation of characteristics of Pediococcus spp. to be used as a vaginal probiotic. J Appl Microbiol 115(2):527–538Google Scholar
  6. Bucior I, Pielage JF, Engel JN (2012) Pseudomonas aeruginosa pili and flagella mediate distinct binding and signalling events at the apical and basolateral surface of airway epithelium. PLoS Pathog 8:e1002616. Scholar
  7. Candela M, Perna F, Carnevali P et al (2008) Interaction of probiotic Lactobacillus and Bifidobacterium strains with human intestinal epithelial cells: adhesion properties, competition against enteropathogens and modulation of IL-8 production. Int J Food Microbiol 125(3):286–292CrossRefGoogle Scholar
  8. Cheow W, Kiew T, Hadinoto K (2014) Controlled release of Lactobacillus rhamnosus biofilm probiotics from alginate-locust bean gum microcapsules. Carbohydr Polym 103:587–595CrossRefGoogle Scholar
  9. Collado MC, Jalonen L, Meriluoto J et al (2006) Protection mechanism of probiotic combination against human pathogens: in vitro adhesion to human intestinal mucus. Asia Pac J Clin Nutr 15(4):570–575PubMedGoogle Scholar
  10. Comelli EM, Guggenheim B, Stingele F et al (2002) Selection of dairy bacterial strains as probiotics for oral health. Eur J Oral Sci 110(3):218–224CrossRefGoogle Scholar
  11. Donlan RM, Costerton JW (2002) Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev 15:167–193CrossRefGoogle Scholar
  12. Du J, Dai J, Liu J, Dankovich T (2006) Novel pH-sensitive polyelectrolyte carboxymethyl Konjac glucomannan-chitosan beads as drug carriers. React Funct Polym 66:1055–1061CrossRefGoogle Scholar
  13. FAO/WHO (2002) Joint FAO/WHO Working Group report on drafting guidelines for the evaluation of probiotics in food. FAO/WHO, London, UKGoogle Scholar
  14. Floch MH, Walker WA, Guandalini S et al (2008) Recommendations for probiotic use—2008. J Clin Gastroenterol 42(Suppl 2):S104–S108Google Scholar
  15. Gionchetti P, Rizzello F, Helwig U et al (2003) Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology 124(5):1202–1209CrossRefGoogle Scholar
  16. Grin PM, Kowalewska PM, Alhazzan W et al (2013) Lactobacillus for preventing recurrent urinary tract infections in women: meta-analysis. Can J Urol 20(1):6607–6614PubMedGoogle Scholar
  17. Guandalini S, Pensabene L, Zikri MA et al (2000) Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J Pediatr Gastroenterol Nutr 30(1):54–60CrossRefGoogle Scholar
  18. Hillier SL, Krohn MA, Rabe LK et al (1993) The normal vaginal flora, H2O2-producing lactobacilli, and bacterial vaginosis in pregnant women. Clin Infect Dis 16(Suppl 4):S273–S281CrossRefGoogle Scholar
  19. Kaewnopparat S, Dangmanee N, Kaewnopparat N et al (2013) In vitro probiotic properties of Lactobacillus fermentum SK5 isolated from vagina of a healthy woman. Anaerobe 22:6–13CrossRefGoogle Scholar
  20. Khalil M, El-Sheekh M, El-Adawi H, El-Deeb N, Hussein M (2015) Efficacy of microencapsulated lactic acid bacteria in Helicobacter pylori eradication therapy. J Res Med Sci 20:950–957CrossRefGoogle Scholar
  21. Kim Y, Oh S, Kim SH (2009) Released exopolysaccharide (r-EPS) produced from probiotic bacteria reduce biofilm formation of enterohemorrhagic Escherichia coli O157:H7. Biochem Biophys Res Commun 379(2):324–329Google Scholar
  22. Klebanoff SJ, Hillier SL, Eschenbach DA et al (1991) Control of the microbial flora of the vagina by H2O2-generating lactobacilli. J Infect Dis 164(1):94–100CrossRefGoogle Scholar
  23. Krasaekoopt W, Bhandari B, Deeth H (2003) Evaluation of encapsulation techniques of probiotics for yoghurt. Int Dairy J 13:3–13CrossRefGoogle Scholar
  24. Kumar S, Bansal A, Chakrabarti A et al (2013) Evaluation of efficacy of probiotics in prevention of candida colonization in a PICU—a randomized controlled trial. Crit Care Med 41(2):565–572CrossRefGoogle Scholar
  25. Lang C, Böttner M, Holz C et al (2010) Specific Lactobacillus/Mutans Streptococcus co-aggregation. J Dent Res 89(2):175–179Google Scholar
  26. Larsson PG, Stray-Pedersen B, Ryttig KR et al (2008) Human lactobacilli as supplementation of clindamycin to patients with bacterial vaginosis reduce the recurrence rate; a 6-month, double-blind, randomized, placebo-controlled study. BMC Womens Health 8:3CrossRefGoogle Scholar
  27. Laverty G, Alkawareek MY, Gilmore BF (2014) The in vitro susceptibility of biofilm forming medical device related pathogens to conventional antibiotics. Dataset Pap Sci 2014Google Scholar
  28. Madden-Fuentes RJ, Arshad M, Ross SS, Seed PC (2015) Efficacy of fluoroquinolone/probiotic combination therapy for recurrent urinary tract infection in children: a retrospective analysis. Clin Ther 37:2143–2147CrossRefGoogle Scholar
  29. Marttinen AM, Haukioja AL, Keskin M et al (2013) Effects of Lactobacillus reuteri PTA 5289 and L. paracasei DSMZ16671 on the adhesion and biofilm formation of Streptococcus mutans. Curr Microbiol 67(2):193–199Google Scholar
  30. Mastromarino P, Brigidi P, Macchia S et al (2002) Characterization and selection of vaginal Lactobacillus strains for the preparation of vaginal tablets. J Appl Microbiol 93(5):884–893CrossRefGoogle Scholar
  31. Mastromarino P, Macchia S, Meggiorini L et al (2009) Effectiveness of Lactobacillus containing vaginal tablets in the treatment of symptomatic bacterial vaginosis. Clin Microbiol Infect 15(1):67–74CrossRefGoogle Scholar
  32. Mastromarino P, Vitali B, Mosca L (2013) Bacterial vaginosis: a review on clinical trials with probiotics. New Microbiol 36(3):229–238PubMedGoogle Scholar
  33. McMillan A, Dell M, Zellar MP et al (2011) Disruption of urogenital biofilms by lactobacilli. Colloids Surf B Biointerfaces 86(1):58–64CrossRefGoogle Scholar
  34. Miyazaki Y, Kamiya S, Hanawa T et al (2010) Effect of probiotic bacterial strains of Lactobacillus, Bifidobacterium, and Enterococcus on enteroaggregative Escherichia coli. J Infect Chemother 16(1):10–18CrossRefGoogle Scholar
  35. Mortazavian A, Ehsani M, Azizi A, Razavi S, Sohrabvandi S, Reinheimer J (2008) Viability of calcium-alginate-microencapsulated probiotic bacteria in Iranian yogurt drink (Doogh) during refrigerated storage and under simulated gastrointestinal conditions. Aust J Dairy Technol 63:25–30Google Scholar
  36. O’Toole PW, Cooney JC (2008) Probiotic bacteria influence the composition and function of the intestinal microbiota. Interdiscip Perspect Infect Dis 2008:175285PubMedPubMedCentralGoogle Scholar
  37. Parent D, Bossens M, Bayot D et al (1996) Therapy of bacterial vaginosis using exogenously applied Lactobacilli acidophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneim-Forsch 46(1):68–73Google Scholar
  38. Petricevic L, Witt A (2008) The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis. BJOG 115(11):1369–1374CrossRefGoogle Scholar
  39. Reid G, Habash M (1998) Urogenital microflora and urinary tract infections. In: Tannock GW (ed) Medical importance of the normal microflora. Kluwer, London, pp 423–440Google Scholar
  40. Reid G, McGroarty JA, Gil Domingue PA et al (1990) Coaggregation of urogenital bacteria invitro and in vivo. Curr Microbiol 20:47–52CrossRefGoogle Scholar
  41. Sadowska B, Walencka E, Wieckowska-Szakiel M et al (2010) Bacteria competing with the adhesion and biofilm formation by Staphylococcus aureus. Folia Microbiol Praha 55(5):497–501CrossRefGoogle Scholar
  42. Saunders S, Bocking A, Challis J et al (2007) Effect of Lactobacillus challenge on Gardnerella vaginalis biofilms. Colloids Surf B Biointerfaces 55(2):138–142CrossRefGoogle Scholar
  43. Secinti KD, Ozalp H, Attar A, Sargon MF (2011) Nanoparticle silver ion coatings inhibit biofilm formation on titanium implants. J Clin NeurosciGoogle Scholar
  44. Senok AC, Verstraelen H, Temmerman M et al (2009) Probiotics for the treatment of bacterial vaginosis. Cochrane Database Syst Rev (4):CD006289Google Scholar
  45. Sikorska H, Smoragiewicz W (2013) Role of probiotics in the prevention and treatment of meticillin-resistant Staphylococcus aureus infections. Int J Antimicrob Agents 42(6):475–481CrossRefGoogle Scholar
  46. Tahmourespour A, Salehi R, Kermanshahi RK et al (2011) The anti-biofouling effect of Lactobacillus fermentum-derived biosurfactant against Streptococcus mutans. Biofouling 27(4):385–392CrossRefGoogle Scholar
  47. Teanpaisan R, Piwat S, Dahlen G (2011) Inhibitory effect of oral Lactobacillus against oral pathogens. Lett Appl Microbiol 53(4):452–459Google Scholar
  48. Twetman L, Larsen U, Fiehn NE et al (2009) Coaggregation between probiotic bacteria and caries-associated strains: an in vitro study. Acta Odontol Scand 67(5):284–288CrossRefGoogle Scholar
  49. Valdez JC, Peral MC, Rachid M et al (2005) Interference of Lactobacillus plantarum with Pseudomonas aeruginosa in vitro and in infected burns: the potential use of probiotics in wound treatment. Clin Microbiol Infect 11(6):472–479Google Scholar
  50. Varma P, Nisha N, Dinesh KR et al (2011) Anti-infective properties of Lactobacillus fermentum against Staphylococcus aureus and Pseudomonas aeruginosa. J Mol Microbiol Biotechnol 20(3):137–143CrossRefGoogle Scholar
  51. Verstraelen H, Swidsinski A (2013) The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment. Curr Opin Infect Dis 26(1):86–89CrossRefGoogle Scholar
  52. Vuotto C, Barbanti F, Mastrantonio P et al (2013) Lactobacillus brevis CD2 inhibits Prevotella melaninogenica biofilm. Oral Dis. Scholar
  53. Walencka E, Różalska S, Sadowska B et al (2008) The influence of Lactobacillus acidophilus-derived surfactants on staphylococcal adhesion and biofilm formation. Folia Microbiol Praha 53(1):61–66Google Scholar
  54. Wong VW, Martindale RG, Longaker MT et al (2013) From germ theory to germ therapy: skin microbiota, chronic wounds, and probiotics. Plast Reconstr Surg 132(5):854e–886eCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of MedicineApollo HospitalsChennaiIndia

Personalised recommendations