Biofilms--a microbial life perspective: a critical review.

Microorganisms attach to surfaces, start multiplying, and develop biofilms. Biofilm-associated cells can be differentiated from their suspended counterparts by the generation of an extracellular polymeric substance (EPS) matrix, reduced growth rates, and up- and downregulation of their specific genes. The attachment of microorganisms is a complex process regulated by diverse characteristics--growth medium, substratum, and cell surfaces. An established biofilm structure comprises microbial cells and EPS, has a defined architecture, and provides an optimal environment for the exchange of genetic material between cells. Cells may also communicate via quorum sensing, which may in turn affect biofilm processes such as detachment. Biofilms have great importance for public health because of their role in certain infectious diseases and their importance in a variety of device-related infections. Because many antibiotics are unable to eradicate dense biofilms, much work is required to devise ways to prevent their occurrence and clear them from the host. A greater understanding of biofilm processes should lead to novel, effective strategies for biofilm control and improvement in patient care and management.