In many natural and clinical settings, bacteria are associated with some type of biotic or abiotic surface that enables them to form biofilms, a multicellular lifestyle with bacteria embedded in an extracellular matrix. Staphylococcus aureus and Staphylococcus epidermidis, the most frequent causes of biofilm-associated infections on indwelling medical devices, can switch between an existence as single free-floating cells and multicellular biofilms. During biofilm formation, cells first attach to a surface and then multiply to form microcolonies. They subsequently produce the extracellular matrix, a hallmark of biofilm formation, which consists of polysaccharides, proteins, and extracellular DNA. After biofilm maturation into three-dimensional structures, the biofilm community undergoes a disassembly process that leads to the dissemination of staphylococcal cells. As biofilms are dynamic and complex biological systems, staphylococci have evolved a vast network of regulatory mechanisms to modify and fine-tune biofilm development upon changes in environmental conditions. Thus, biofilm formation is used as a strategy for survival and persistence in the human host and can serve as a reservoir for spreading to new infection sites. Moreover, staphylococcal biofilms provide enhanced resilience toward antibiotics and the immune response and impose remarkable therapeutic challenges in clinics worldwide. This review provides an overview and an updated perspective on staphylococcal biofilms, describing the characteristic features of biofilm formation, the structural and functional properties of the biofilm matrix, and the most important mechanisms involved in the regulation of staphylococcal biofilm formation. Finally, we highlight promising strategies and technologies, including multitargeted or combinational therapies, to eradicate staphylococcal biofilms.

中文翻译：

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葡萄球菌生物膜的发展：结构、调节和治疗策略。


在许多自然和临床环境中，细菌与某种类型的生物或非生物表面相关，使它们能够形成生物膜，这是一种细菌嵌入细胞外基质中的多细胞生活方式。金黄色葡萄球菌和表皮葡萄球菌是留置医疗器械上生物膜相关感染的最常见原因，它们可以在单个自由漂浮细胞和多细胞生物膜的存在之间切换。在生物膜形成过程中，细胞首先附着在表面，然后繁殖形成微菌落。随后它们产生细胞外基质，这是生物膜形成的标志，由多糖、蛋白质和细胞外 DNA 组成。生物膜成熟为三维结构后，生物膜群落经历分解过程，导致葡萄球菌细胞的传播。由于生物膜是动态且复杂的生物系统，葡萄球菌已经进化出庞大的调节机制网络，可以根据环境条件的变化来修改和微调生物膜的发育。因此，生物膜的形成被用作人类宿主生存和持久的策略，并且可以作为传播到新感染部位的储存库。此外，葡萄球菌生物膜增强了对抗生素和免疫反应的抵抗力，并给全世界的诊所带来了巨大的治疗挑战。本综述提供了葡萄球菌生物膜的概述和最新观点，描述了生物膜形成的特征、生物膜基质的结构和功能特性以及参与葡萄球菌生物膜形成调节的最重要机制。 最后，我们强调了有前途的策略和技术，包括多靶点或组合疗法，以根除葡萄球菌生物膜。