Biofilm in Endoscopy

Biofilm in the Human Body

The National Institutes of Health estimates that more than 80% of microbial infections in the human body are caused by biofilm, many of them creating chronic and reoccurring problems. Infections from biofilm are extremely difficult to treat. An important attribute of a biofilm is its ability to harbor and protect the organisms within it making them resistant to most antibiotics. The following illustration demonstrates just a few of the many ways biofilm may have an effect on our bodies.

Sites of Primary and Secondary Infection

Photo from Center for Biofilm Engineering, Montana State University, P. Dirckx. Used with permission.

Dental plaque may lead to mouth infections, periodontal disease, gingivitis and dental decay. Oral bacteria which enter the bloodstream can affect the heart, attaching to fatty plaques in the coronary arteries. The inflammation caused by periodontal disease increases plaque buildup, which may contribute to swelling of the arteries. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Primary infections may also occur in the presence of intravenous catheters, urinary catheters and implantable devices.  Secondary infections from a biofilm source may affect the brain, kidneys, joints and intervertebral spaces. 

In cystic fibrosis, excess mucus production in the airways hosts bacteria such as Pseudomonas aeruginosa, which mop up dead white blood cells from the immune system, enabling them to construct their protective biofilm coat.

Biofilm is involved in the heart condition, endocarditis, a rare but serious disease in which one of the four heart valves, the heart lining, or heart muscle are infected by bacteria, usually comprising streptococci, and become inflamed. The formation of the endocarditic plaque is unique, involving bacteria, platelets, coagulation factors and leucocytes, and is considered a rather special kind of biofilm. Since the biofilm is resistant to antibiotics and the immune system’s white blood cells, often the only option is surgery to replace a damaged valve. Greater knowledge may allow new drugs to be developed that break up the biofilm.

Chronic ear infections and tonsillitis in children have been linked to biofilm formation as the causative agent. Other chronic biofilm infections include prostatitis, Legionnaire’s disease and peritonitis.


Mouth infections, such as gingivitis and dental decay may lead to cardiac disease and vascular inflammation.

Cystic Fibrosis

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