The European Infectious Disease Society’s subcommittee on biofilm in 2014 concluded that microbes (bacterial and fungal) growing as biofilm cause chronic infections. Chronic infections are becoming an overwhelming drain on health care resources because chronic infections are increasing exponentially and our ability to adequately manage chronic infections is lacking. Acute infections are caused primarily by planktonic (single cell) microbes and respond to relatively low dose single agent antibiotic regimens. The microbes that form a biofilm community are polymicrobial, act cooperatively (synergy), develop colony defenses (self-secreted matrix, quorum sensing, anoxic core) by up regulating usually one third of its genome dedicated to biofilm structure and function. Biofilms are tolerant of host immunity and usual antimicrobial treatment regimens
. In the host, biofilms produce a parasitic infection associated with persistent inflammation. The persistent inflammation of biofilm infection is evidenced by excessive senescent neutrophils and macrophages along with excessive inflammatory cytokines (interleukin’s, interferons, TNF alpha) which are adequate to induce antimicrobial peptides. Amyloid beta, is one such antimicrobial peptide, which in elevated concentrations is well documented to seed and then developed fibrils which eventually leads to a steady state amyloid plaque. The amyloid cascade leading to amyloid plaques and neurofibrillary tangles may be the direct downstream effect of biofilm infection. Biofilm structures have been identified on heart valves and in atherosclerotic plaques demonstrating biofilm’s ability to infect intravascular structures. Deceased patients with Alzheimer’s disease have been shown to have increased amounts of bacterial DNA in their brain substance. Bacteria is present in the brains of patients with Alzheimer’s disease and that bacteria producing a biofilm infection offers a viable explanation for the pathogenesis of Alzheimer’s disease.
Dr. Wolcott has been a wound care provider for over 25 years and is the Founder of the Southwest Regional Wound Care Center in Lubbock Texas. He has been the Principal Investigator on multiple studies and was part of an NIH grant with the Center for Biofilm Engineering at Montana State. Dr. Wolcott has numerous publications focusing on biofilm in wounds and other diseases such as atherosclerosis, cystic fibrosis, catheter related blood stream infections and amyloid disease such as Alzheimer’s disease.