Bacterial biofilm in upper respiratory tract infections

The upper respiratory tract is of easy access to pathogens, and although it has evolved a number of defensive barriers to avoid invasion, acute and chronic infections of the ears, nose, and throat are common and present a huge challenge to the health-care system. Though most infections are viral, mild, and self-limiting, bacterial infection is responsible for considerable morbidity and has potential for life-threatening sequelae. Biofilms form when free-floating planktonic organisms adhere to a surface. Within a polymicrobial, biofilm organisms interact, exchanging metabolites, enzymes, and genetic material. The colony is protected, allowing bacteria to thrive in otherwise unfavorable conditions. A role for the biofilm in upper respiratory tract infections has been proposed because infections often run a persistent, remitting course, samples are sometimes difficult to culture, and resistance to medical management is common. This review presents recently published evidence of bacterial biofilms in established upper respiratory tract infections.