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      Pseudomonas aeruginosa Biofilms: Host Response and Clinical Implications in Lung Infections

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          Abstract

          Pseudomonas aeruginosa is a major health challenge that causes recalcitrant multidrug-resistant infections, especially in immunocompromised and hospitalized patients. P. aeruginosa is an important cause of nosocomial and ventilator-associated pneumonia characterized by high prevalence and fatality rates. P. aeruginosa also causes chronic lung infections in individuals with cystic fibrosis. Multidrug- and totally drug-resistant strains of P. aeruginosa are increasing threats that contribute to high mortality in these patients. The pathogenesis of many P. aeruginosa infections depends on its ability to form biofilms, structured bacterial communities that can coat mucosal surfaces or invasive devices. These biofilms make conditions more favorable for bacterial persistence, as embedded bacteria are inherently more difficult to eradicate than planktonic bacteria. The molecular mechanisms that underlie P. aeruginosa biofilm pathogenesis and the host response to P. aeruginosa biofilms remain to be fully defined. However, it is known that biofilms offer protection from the host immune response and are also extremely recalcitrant to antimicrobial therapy. Therefore, development of novel therapeutic strategies specifically aimed at biofilms is urgently needed. Here, we review the host response, key clinical implications of P. aeruginosa biofilms, and novel therapeutic approaches to treat biofilms relevant to lung infections. Greater understanding of P. aeruginosa biofilms will elucidate novel avenues to improve outcomes for P. aeruginosa pulmonary infections.

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          Author and article information

          Journal
          Am J Respir Cell Mol Biol
          Am. J. Respir. Cell Mol. Biol
          ajrcmb
          American Journal of Respiratory Cell and Molecular Biology
          American Thoracic Society
          1044-1549
          1535-4989
          April 2018
          April 2018
          : 58
          : 4
          : 428-439
          Affiliations
          [ 1 ]Atlanta Veterans Affairs Medical Center, Decatur, Georgia; and
          [ 2 ]Department of Medicine Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, Georgia
          Author notes
          Correspondence and requests for reprints should be addressed to Ruxana T. Sadikot, M.D., M.R.C.P., Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Atlanta Veterans Affairs Medical Center, Emory University, 1670 Clairmont Road, Decatur, GA 30033. E-mail: ruxana.sadikot@ 123456emory.edu .
          Article
          PMC5894500 PMC5894500 5894500 2017-0321TR
          10.1165/rcmb.2017-0321TR
          5894500
          29372812
          25b91034-7a08-4750-9c2a-d074d1bfd139
          Copyright © 2018 by the American Thoracic Society
          History
          : 07 September 2017
          : 25 January 2018
          Page count
          Figures: 4, Tables: 1, Pages: 12
          Categories
          Translational Review

          anti-infective agents,cystic fibrosis,ventilator-associated pneumonia,biofilms, Pseudomonas aeruginosa

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