An update on recent developments in the prevention and treatment of Staphylococcus aureus biofilms

Staphylococcus aureus (S. aureus) readily forms biofilms on prosthetic devices such as the pacemakers, heart valves, orthopaedic implants, and indwelling catheters. Its biofilms are recalcitrant to antibiotic therapy and pose a serious burden in the healthcare setting as they drastically increase the treatment cost and morbidity of the patient. Prevention and treatment of staphylococcal biofilms has therefore been an area of active research for the past two decades. While catheters coated with different antiseptics and antibiotics capable of preventing S. aureus biofilm formation have been developed, an effective therapy for the dispersal and treatment of established staphylococcal biofilms is not yet available. Hence, many studies have focused on developing novel therapeutic strategies that can tackle established S. aureus biofilm associated infections. This has led to the identification of different phytochemicals (e.g., tannic acid, ellagic acid, xanthohumol etc), enzymes (e.g., Dnases, lysostaphin, alpha-amylase, hyaluronidase and proteases etc.), sulfahydrl compounds (e.g., dithiothreitol, 2-mercaptoethanol), nanoparticles (e.g., gold, silver, iron, copper and selenium), phage cocktails, antibodies and metal chelators. Apart from the conventional techniques, the therapeutic effects of ultra sound, shock waves and photodynamic therapy for treating S. aureus biofilms are also being investigated. Clinical validation of these studies will equip the medical field with alternate preventive and treatment methods against staphylococcal biofilm infections. This review provides recent updates on the preventive and therapeutic strategies explored to eradicate staphylococcal biofilm formation and related infections.