What Is A Biofilm?

In the past six years I’ve learned a lot about bugs. Microbes comprise 70% of all living organisms in the world. And we have ten times more bacteria than human cells. So why ponder these peculiar facts? In short, how we understand the myriad interactions between humans and microbes decides how we treat – or fail to treat – a range of human diseases.

My first unexpected foray into the pathology of bacterial disease started in 2005, as I became increasingly ill with an odd constellation of symptoms that eluded doctors. Looking back, it seems possible I visited every medical specialty in western medicine! My shortness of breath, fatigue, cardiovascular troubles and neck pains puzzled my PCP, ENTs, orthopedic surgeons, chiropractors, a physiatrist and an interventional radiologist. And that’s not the complete list. I knew I wasn’t crazy as my health spiraled downward into an indescribable hell.

It took two years to reach a diagnosis of systemic infection from mycoplasma pneumonia. Left untreated or unchecked by the immune system, most microbes can proliferate, communicate with others and create sequestered bacterial communities called biofilms. But for me, finding treatment was difficult, since there is no standard of care for treating chronic bacterial infections.

This troubling but convincing lesson eventually led to a challenging program of low dose, pulsed antibiotics and other naturopathic remedies that helped me get well enough to start my second film devoted to the slippery topic of bacterial biofilms. While the first part of my journey was personal and unwelcome, my learnings prepared me for interviews with biofilm pioneers and thought leaders from academia, government, entrepreneurs and physicians – all of whom offered deep insights into the problems associated with diagnosing and treating biofilm infections.

The experts I interviewed generally agreed on the basics of biofilms: they are communities of opportunistic microbes living together, communicating and sequestering themselves in a slimy matrix to help them survive the challenges from the host immune system. These bacterial biofilms can be highly diverse with myriad species of bacteria and non-bacteria and even exchange complex biological programs like antibiotic resistance. And sometimes these communities can become pathogenic and lead to chronic bacterial infections. Indeed, the biofilm becomes the pathogen.

Among all the amazing things I learned as a layman, the most profound lesson is the most disturbing: though Leeuwenhoek  discovered biofilms 328 years ago, the notion of bacterial communities is still anathema to many medical professionals. But incredible progress has been made in the past thirty years in both diagnosing and treating pathogenic biofilms. To get a better sense of this progress, and hear succinct definitions of biofilms, view our six minute montage packed with new insights from biofilm experts.

I now marvel at the inner workings of the human machine and all the complex ecosystems within it – especially biofilm communities.  And I deeply respect and admire the pioneers devoted to diagnosing and treating these highly adapative, complex living systems that may cause insidious chronic bacterial infections. More on that in future columns.

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