Biofilm research has grown exponentially over the last decades, arguably due to their contribution to hospital acquired infections when they form on foreign body surfaces such as catheters and implants. Yet, translation of the knowledge acquired in the laboratory to the clinic has been slow and/or often it is not attempted by research teams to walk the talk of what is defined as ‘bench to bedside’. We therefore reviewed the biofilm literature to better understand this gap. Our search revealed substantial development with respect to adapting surfaces and media used in models to mimic the clinical settings, however many of the models were too simplistic, often discounting the composition and properties of the host microenvironment and overlooking the biofilm-implant-host interactions. Failure to capture the physiological growth conditions of biofilms results in major differences between lab-grown- and clinically-relevant biofilms, particularly with respect to phenotypic profiles, virulence, and antimicrobial resistance, and they essentially impede bench-to-bedside translatability. In this review, we describe the complexity of the biological processes at the biofilm-implant-host interfaces, discuss the prerequisite for the development and characterization of biofilm models that better mimic the clinical scenario, and propose an interdisciplinary outlook of how to bioengineer biofilms by converging tissue engineering concepts and tools.

中文翻译：

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研究植入物相关生物膜的体外模型——生物工程3D微环境视角的综述


过去几十年来，生物膜研究呈指数级增长，这可能是由于它们在导管和植入物等异物表面形成时导致医院获得性感染。然而，将实验室获得的知识转化为临床的速度一直很慢，并且/或研究团队通常不会尝试将其定义为“从实验室到临床”。因此，我们回顾了生物膜文献，以更好地理解这一差距。我们的研究揭示了在适应模型中使用的表面和介质以模仿临床环境方面取得了实质性进展，但是许多模型过于简单化，经常忽视宿主微环境的组成和特性，并忽视生物膜-植入物-宿主相互作用。未能捕获生物膜的生理生长条件会导致实验室生长的生物膜和临床相关的生物膜之间存在重大差异，特别是在表型特征、毒力和抗菌素耐药性方面，并且它们从本质上阻碍了实验室到临床的可转化性。在这篇综述中，我们描述了生物膜-植入物-宿主界面的生物过程的复杂性，讨论了更好地模拟临床场景的生物膜模型的开发和表征的先决条件，并提出了如何通过生物工程生物膜的跨学科前景融合组织工程概念和工具。