Biofilms in Otolaryngology: Relation to clinical disease needs more study, experts say

Until more clinically applicable studies are done, Dr. Darrow thinks any discussion of treatment is premature. “Before treating biofilms, we have to prove they cause a problem,” he said, adding that current treatment of biofilms on the adenoids or tonsils requires simply removing them. “If the biofilms are pathogenic, removing these tissues will theoretically fix the problem,” he said.

Otitis Media

Craig Derkay, MD, professor and vice chairman of otolaryngology-head and neck surgery at Eastern Virginia Medical School in Norfolk, Va., who moderated the session, highlighted specific types of pathogens found in biofilms that are associated with OM, in particular Streptococcus pneumoniae.

According to Dr. Derkay, bacteria such as Streptococcus pneumoniae within a biofilm differ from bacteria growing in suspension in many ways, including reduced growth rate, distinct gene expression and increased resistance to antibiotics. He said the difficulty of culturing bacteria in biofilms in the lab, and their resistance to antibiotics, may explain the conflicting features of OM in a patient with symptoms of chronic OM who responds poorly to antibiotics and in whom their culture is negative.

“Since biofilms are resistant to many antibiotics, we suspect that biofilm formation may explain why infections by Streptococcus pneumoniae and other organisms may be so difficult to treat in some children,” he said, adding that new therapies are needed to overcome these hardy infections.