Bacterial Interactions in the Context of Chronic Wound Biofilm: A Review

Abstract

Chronic wounds, defined by their resistance to care after four weeks, are a major concern, affecting millions of patients every year. They can be divided into three types of lesions: diabetic foot ulcers (DFU), pressure ulcers (PU), and venous/arterial ulcers. Once established, the classical treatment for chronic wounds includes tissue debridement at regular intervals to decrease biofilm mass constituted by microorganisms physiologically colonizing the wound. This particular niche hosts a dynamic bacterial population constituting the bed of interaction between the various microorganisms. The temporal reshuffle of biofilm relies on an organized architecture. Microbial community turnover is mainly associated with debridement (allowing transitioning from one major representant to another), but also with microbial competition and/or collaboration within wounds. This complex network of species and interactions has the potential, through diversity in antagonist and/or synergistic crosstalk, to accelerate, delay, or worsen wound healing. Understanding these interactions between microorganisms encountered in this clinical situation is essential to improve the management of chronic wounds.

There Is More to Wounds than Bacteria: Fungal Biofilms in Chronic Wounds

“…With a myriad of different organisms inhabiting chronic wounds, understanding the interactions between these organisms is crucial in understanding their roles in disease. There are numerous bacteria-bacteria interactions that take place within wound environments, which have been well documented elsewhere [41]. However, fungal-bacterial interactions are less well known.…”

A Simple In-Vivo Method for Evaluation of Antibiofilm and Wound Healing Activity Using Excision Wound Model in Diabetic Swiss Albino Mice

“…Several acute and chronic infections are known to induce biofilm formation and delay wound healing. Biofilm is reported to impair epithelization and formation of granulation tissue along with inflammation to interfere with wound healing [ 2 , 3 ].…”

Differential Susceptibility of Mixed Polymicrobial Biofilms Involving Ocular Coccoid Bacteria (Staphylococcus aureus and S. epidermidis) and a Filamentous Fungus (Fusarium solani) on Ex Vivo Human Corneas

“…In nature, polymicrobial biofilms involving multiple species of the same genus or mixed polymicrobial biofilms involving taxa from the bacterial and fungal kingdoms are dominant [ 18 , 19 ]. Polymicrobial biofilms were first described in the oral cavity [ 20 , 21 ] and in chronic wounds [ 22 ], but compared to monomicrobial and polymicrobial biofilms, mixed polymicrobial biofilms have rarely been monitored [ 23 , 24 , 25 , 26 ] as in dental caries involving C. albicans and S. mutans [ 27 , 28 ], in chronic wounds involving P. aeruginosa and S. aureus [ 29 , 30 , 31 ], and in cystic fibrosis patients involving Aspergillus fumigatus and P. aeruginosa [ 32 , 33 , 34 ]. Such mixed polymicrobial biofilms are all the rarer on the ocular surface.…”