Biofilms In Respiratory Infections and Beyond: A Review

Biofilms In Respiratory Infections and Beyond: A Review 150 150 Emily Siebenmorgen

Researchers from Nationwide Children’s recently published a landmark piece in Frontiers in Cellular and Infection Microbiology reviewing everything known about biofilm aggregates and their role in respiratory tract infections to date.

Biofilms create sticky situations for several diseases. These microbial communities are formed when bacterial cells stick to each other and attach themselves to a surface, like your tissues. Their jelly-like consistency provides a unique form of protection for different viruses and makes them difficult to treat.

While the interest in biofilms is innately tied to conditions like cystic fibrosis, these organisms have many more hosts. In addition to patients with other pulmonary diseases like sinopulmonary disease, primary ciliary dyskinesia and non-cystic fibrosis bronchiectasis, it’s not uncommon to see these organisms thrive in patients with surgical and burn sites.

“An incision site might not have as large of a surface area as your lungs, but it’s just as susceptible to a serious infection,” says Karen McCoy, MD, chief of Pulmonary Medicine at Nationwide Children’s Hospital and co-author of the review.

The severity of these infections can increase because of common coinfections in all patient types. Staphylococcus and pseudomonas may also be residing in these microbial communities, and they have a relationship of accidentally helping the other create a place for infection to go wild.

“In many cases, it’s not just the organism that’s fighting medications, it’s the biofilm’s matrix,” says Dr. McCoy. The matrix – a shared space for microbes, lipids, proteins and other substances – is key to creating a protective environment for microbes to grow. “In this matrix, these organisms develop novel protection mechanisms to avoid the effects of antibiotics.”

Managing these infections with antibiotics can come with complicated administration methods, creating a need for more accessible treatment options and toxicity in the patient.

“The problem with this organism is that treatments often involve IV-administered medicines,” Dr. McCoy says. “Not everyone can go home and give themselves an IV, let alone monitor for early side effects and minimize them.”

Understanding how these biofilms work and developing a novel compound that can destroy their matrices could make them much more vulnerable to traditional antibiotic use.

Dr. McCoy emphasizes the broad implications of continued research on these biofilms and environments and the need for continued research. “Other patient groups benefit from our advancements and knowledge of cystic fibrosis because they’re fighting the same organisms. The importance of this research in this area cannot be overstated.”


Hall-Stoodley L, McCoy KS. Biofilm aggregates and the host airway-microbial interface. Frontiers in Cellular and Infection Microbiology. 2022; 12: 969326. doi: 10.3389/fcimb.2022.969326.

About the author

Science Communication Specialist at Nationwide Children's Hospital | Website

Emily Siebenmorgen is a Science Communication Specialist at Nationwide Children's Hospital with a passion for making research findings accessible. From her time writing at Battelle and AWRI's Center for Injury Research and Policy, she has experience distilling complex topics into simple takeaways for both professional and consumer audiences. Emily earned her BS in Psychology and BA in Strategic Communication from The Ohio State University.