Biofilm-Based Nosocomial Infections

The well-known persistence in the nosocomial environment of multidrug resistant bacterialand fungal species, today responsible for a wide variety of healthcare-associated infections, isbelieved to be greatly promoted by the ability of most of them to adhere and to grow in sessilemode on mucosal and soft tissues of hospitalized patients, as well as on the inner and outersurfaces of indwelling medical devices, including intravenous catheters, orthopaedic, cardiacvalves, intrauterine devices, and contact lenses.In this regard, a large number of these microorganisms, such as Acinetobacter baumannii,Candida albicans, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, andStaphylococcus aureus, give rise to highly organized, sessile community defined biofilms, inwhich microbes grow encased in a hydrated matrix of extracellular polymeric substancesproduced by themselves and are well protected from the attack of antimicrobial molecules andfrom the host immune response, by resisting phagocytosis and other body's defense systems.The great influence of the sessile growth on the effectiveness of the antibiotic therapies is dueto both the structure and function of these microbial communities, making these also 1000times more tolerant to antibiotics and disinfectants. Thus, alternative approaches to thecommon antibiotic treatments are emerging for preventing and treating both the mono-speciesand the most frequent multi-species biofilms, including enzymes able to disrupt maturebiofilms and new biomaterials for the coating of medical devices to counteract microbialadhesion and biofilm formation.The aim of this Special Issue is to report on the state-of-art of the basic and applied researchin the field of biofilm-based nosocomial infections that can be acquired by patients in bothgeneral hospitals and long-term care settings. Particularly, the involvement of microbialbiofilms in medical device-related infections and other healthcare-associated infections, so farunderestimated and/or scarcely investigated, has been considered, reviewed, and discussed.