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Microbial Biofilms
http://www.100md.com 《新英格兰医药杂志》
     Since the discovery of microorganisms several hundred years ago, our study of the microbial world has largely concentrated on characterization of planktonic (free-living) organisms. Adherence to Koch's postulates and the use of standard microbiologic culture techniques have allowed us to understand and successfully control many acute epidemic infectious diseases. However, more recently, there is an increasing appreciation that planktonic microbes account for only a very small proportion of microbial life, and in both natural environments and human disease, the bulk of microbes are found in a sessile form in biofilms.

    A biofilm is a community of microorganisms that are associated with a surface and typically enveloped in an extracellular matrix. Examples of biofilms are extensive, ranging from the slippery mat of organisms found on rocks in a pristine mountain stream to the complex microbial milieu of the plaque on human teeth.

    Mahmoud Ghannoum and George O'Toole have assembled 50 well-recognized authors to write an authoritative 21-chapter textbook on the subject, the first of its kind. The book describes well-accepted, biofilm-associated infections that are related to biomaterials and implants, such as infection associated with intravascular catheters and prosthetic-valve endocarditis, and infections that only recently have been thought of as involving biofilms, such as osteomyelitis, prostatitis, and otitis media. The importance of biofilms in infections that are associated with health care is also discussed. This comprehensive, yet concise, book covers biofilms of ecologic, industrial, and medical importance and also describes specific organisms (pseudomonas, staphylococci, and candida) that are commonly encountered in biofilms. Other topics discussed are mathematical modeling of biofilms and biofilms of agricultural importance.

    As the authors relate, the tools of laser confocal microscopy, fluorescent imaging, and molecular biology have greatly expanded our ability to characterize biofilms, and we now view them not as static, monolithic entities but as dynamic, architecturally complex environments in which single-cell organisms cooperate, communicate, exchange genetic material, and behave in coordinated groups. The microbial biofilm constitutes an optimal environment for cell-to-cell processes, such as genetic exchange and intercellular signaling. One of the most important features of microbes that are found in biofilms is their profound resistance to antimicrobial agents — the same agents that are quite effective against their planktonic brethren. Our level of understanding of this medically important phenomenon is well described in several areas of the book. Future therapeutic methods that may be effective against biofilm-associated microbes may take advantage of this burgeoning volume of knowledge and may include interference with cell-to-cell signaling and communication with the use of so-called antipathogenic drugs.

    Microbial Biofilms will have widespread appeal and is written at a level appropriate for students and scientists wishing to gain a broad exposure to the field. The illustrations and figures, including some in color, are adequate. Some chapters have sacrificed references in favor of brevity. This excellent book fills a real need and is enthusiastically recommended. In their introductory comments, the editors say that they hope to repeat this task in 15 to 20 years. However, it appears that the fast pace of the biofilm field will make a second edition a necessity much sooner.

    Mark E. Rupp, M.D.

    University of Nebraska Medical Center

    Omaha, NE 68198

    merupp@unmc.edu(Mahmoud Ghannoum and Geor)