Abstract
Biofilms are composed of microcolonies encased in an extracellular polymeric substance (EPS) matrix. Wide-ranging differences exist between the biofilm and planktonic states in growth, structure, behavior, and physiology, all of which can have profound effects on their susceptibility to antimicrobials. Other factors that can contribute to the decreased susceptibility of biofilm microorganisms to antimicrobial agents include provision of a physical barrier to antimicrobial agents by the EPS matrix, facilitation of horizontal gene transfer (HGT) of DNA trapped within the extracellular matrix, quorum sensing and stress responses resulting in the recruitment and expression of resistance determinants such as multidrug resistance efflux pumps, the presence of persister cells that survive antibiotic treatment, and metabolic heterogeneity throughout the biofilm resulting in slow growth and protection against antibiotics active on rapidly growing bacteria. While further work is needed to fully understand antimicrobial resistance in biofilm communities, including the multispecies biofilms found in root canal infections, the accumulative effects of various processes, rather than individual involvement, are likely to be important. It is clear that much remains to be learned about the critical events in the development of antimicrobial resistance in biofilm communities.
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Sedgley, C., Dunny, G. (2015). Antimicrobial Resistance in Biofilm Communities. In: Chávez de Paz, L., Sedgley, C., Kishen, A. (eds) The Root Canal Biofilm. Springer Series on Biofilms, vol 9. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47415-0_3
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