Medical device-associated infections (MDAI) are a critical problem due to the increasing usage of medical devices in the aging population. The inhibition of biofilm formation through the use of probiotics has received attention from the medical field in the last years. However, this sparse knowledge has not been properly reviewed, so that successful strategies for biofilm management can be developed. This study aims to summarize the relevant literature about the effect of probiotics and their metabolites on biofilm formation in medical devices using a PRISMA-oriented (Preferred Reporting Items for Systematic reviews and Meta-Analyses) systematic search and meta-analysis. This approach revealed that the use of probiotics and their products is a promising strategy to hinder biofilm growth by a broad spectrum of pathogenic microorganisms. The meta-analysis showed a pooled effect estimate for the proportion of biofilm reduction of 70% for biosurfactants, 76% for cell-free supernatants (CFS), 77% for probiotic cells and 88% for exopolysaccharides (EPS). This review also highlights the need to properly analyze and report data, as well as the importance of standardizing the in vitro culture conditions to facilitate the comparison between studies. This is essential to increase the predictive value of the studies and translate their findings into clinical applications.

Novel technologies to prevent biofilm formation on urinary tract devices (UTDs) are continually being developed, with the ultimate purpose of reducing the incidence of urinary infections. Probiotics have been described as having the ability to displace adhering uropathogens and inhibit microbial adhesion to UTD materials. This work aimed to evaluate the effect of pre-established Lactobacillus plantarum biofilms on the adhesion of Escherichia coli to medical-grade silicone. The optimal growth conditions of lactobacilli biofilms on silicone were first assessed in 12-well plates. Then, biofilms of L. plantarum were placed in contact with E. coli suspensions for up to 24 h under quasi-static conditions. Biofilm monitoring was performed by determining the number of culturable cells and by confocal laser scanning microscopy (CLSM). Results showed significant reductions of 76%, 77% and 99% in E. coli culturability after exposure to L. plantarum biofilms for 3, 6 and 12 h, respectively, corroborating the CLSM analysis. The interactions between microbial cell surfaces and the silicone surface with and without L. plantarum biofilms were also characterized using contact angle measurements, where E. coli was shown to be thermodynamically less prone to adhere to L. plantarum biofilms than to silicone. Thus, this study suggests the use of probiotic cells as potential antibiofilm agents for urinary tract applications.

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The low efficacy of conventional treatments and the interest in finding natural-based approaches to counteract biofilm development on urinary tract devices have promoted the research on probiotics. This work evaluated the ability of two probiotic strains, Lactobacillus plantarum and Lactobacillus rhamnosus, in displacing pre-formed biofilms of Escherichia coli and Staphylococcus aureus from medical-grade silicone. Single-species biofilms of 24 h were placed in contact with each probiotic suspension for 6 h and 24 h, and the reductions in biofilm cell culturability and total biomass were monitored by counting colony-forming units and crystal violet assay, respectively. Both probiotics significantly reduced the culturability of E. coli and S. aureus biofilms, mainly after 24 h of exposure, with reduction percentages of 70% and 77% for L. plantarum and 76% and 63% for L. rhamnosus, respectively. Additionally, the amount of E. coli biofilm determined by CV staining was maintained approximately constant after 6 h of probiotic contact and significantly reduced up to 67% after 24 h. For S. aureus, only L. rhamnosus caused a significant effect on biofilm amount after 6 h of treatment. Hence, this study demonstrated the potential of lactobacilli to control the development of pre-established uropathogenic biofilms.

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In recent years, abundant research has been performed on biofilms for the production of compounds with biotechnological and industrial relevance. The use of biofilm platforms has been seen as a compelling approach to producing fine and bulk chemicals such as organic acids, alcohols, and solvents. However, the production of recombinant proteins using this system is still scarce. Biofilm reactors are known to have higher biomass density, operational stability, and potential for long-term operation than suspended cell reactors. In addition, there is an increasing demand to harness industrial and agricultural wastes and biorefinery residues to improve process sustainability and reduce production costs. The synthesis of recombinant proteins and other high-value compounds is mainly achieved using suspended cultures of bacteria, yeasts, and fungi. This review discusses the use of biofilm reactors for the production of recombinant proteins and other added-value compounds using bacteria and fungi.

Microorganisms tend to adhere to food contact surfaces and form biofilms, which serve as reservoirs for bacteria that can contaminate food. As part of a biofilm, bacteria are protected from the stressful conditions found during food processing and become tolerant to antimicrobials, including traditional chemical sanitisers and disinfectants. Several studies in the food industry have shown that probiotics can prevent attachment and the consequent biofilm formation by spoilage and pathogenic microorganisms. This review discusses the most recent and relevant studies on the effects of probiotics and their metabolites on pre-established biofilms in the food industry. It shows that the use of probiotics is a promising approach to disrupt biofilms formed by a large spectrum of foodborne microorganisms, with Lactiplantibacillus and Lacticaseibacillus being the most tested genera, both in the form of probiotic cells and as sources of cell-free supernatant. The standardisation of anti-biofilm assays for evaluating the potential of probiotics in biofilm control is of extreme importance, enabling more reliable, comparable, and predictable results, thus promoting significant advances in this field.