Targeting the Pseudomonas aeruginosa biofilm to combat infections in patients with cystic fibrosis

SUMMARY Patients with cystic fibrosis are susceptible to lung infection with the bacterium Pseudomonas aeruginosa. Chronic infection cannot be eradicated and leads to lung destruction and an increased mortality. Treatment of infections caused by P. aeruginosa is made challenging by the organism’s heterogeneity, adaptability, antibiotic resistance and the significant antibiotic tolerance it achieves from existing within biofilms. Biofilms are composed of aggregates of bacteria living and communicating within an extracellular matrix, often within mucus plugs. The use of conventional antibiotics against this bacterium is often ineffective and the conventional antibiotic pipeline is running dry, and so novel strategies are required. Planktonic free-swimming bacteria are significantly more susceptible to antibiotics compared to those living within the biofilm. Candidate strategies that target the biofilm, prompting its dispersal or increasing the susceptibility of the bacteria within to antibiotics, may therefore yield new opportunities to treat these destructive infections.