Biofilm-Based Infections in Long-term Care Facilities

Gianfranco Donelli; Claudia Vuotto


Future Microbiol. 2014;9(2):175-188. 

In This Article


Increasing attention has been devoted, in recent years, to the infections occurring among patients admitted to LTCFs, especially because of the growing number of patients resident in these clinical settings, both as first hospitalization or after a previous admittance to a general hospital.

Knowledge on the causative agents and pathogenesis of these infections, mostly associated with growth as biofilm of the involved microorganisms, has been recently gained. In fact, in both the urinary and intravascular catheter-associated infections, and the infected pressure ulcers, the colonizing microbes have been demonstrated to be able to grow as multicellular communities on wounds and the polymeric surfaces of devices.

Not only the intrinsic multidrug resistance emerging for most of these microorganisms but also the up to 1000-fold higher antibiotic resistance acquired when they grow in a sessile mode are noteworthy issues to be faced by clinicians when they have to decide the schedule for antibiotic treatment of patients suffering from these biofilm-based infections.

Thus, it will be of great interest in the near future to further investigate the antibiotic-related infections often affecting patients hospitalized in LTCFs, such as C. difficile infection,[135] of which little is known about the possible relationship between severity, persistence and recurrence, and the recently demonstrated ability of some C. difficile strains to develop as biofilm.[131,136,137]