Antifungal Biofilm Strategies: A Less Explored Area in Wound Management

Abstract

Background: The treatment of wound-associated infections has always remained a challenge for clinicians, with the major deterring factor being microbial biofilms, majorly bacterial or fungal. Biofilm infections are becoming a global concern owing to resistance to antimicrobials. Various fungal pathogens form fungal biofilms, namely Candida sp., Aspergillus fumigates, Trichosporon sp., Saccharomyces cerevisiae, Cryptococcus neoformans, among others. The rising cases of fungal biofilm resistance add to the burden of wound care. Additionally, with an increase in the number of surgical procedures, transplantation, and the exponential use of medical devices, the fungal bioburden is rising.

Objectives: The review discusses the methods of biofilm formation and the resistance mechanisms against conventional treatments. The potential of novel delivery strategies and the mechanisms involved therein are also highlighted. Further, the prospects of nanotechnology-based medical devices to combat fungal biofilm resistance have been explored. Some clinical trials and up-to-date patent technologies to eradicate biofilms are also mentioned.

Conclusion: Due to the many challenges faced in preventing/eradicating biofilms, only a handful of approaches have made it to the market. Eradication of fungal biofilms are a fragmentary area that needs further exploration.

Keywords: Antifungal; biofilm; medical devices; novel drug delivery; resistance; wound healing.