Before we go any further, you may be wondering what are biofilms and why are they implicated in chronic infections?  Keep reading!

What are biofilms?

Biofilms are formations that occur when a group of microorganisms such as bacteria, fungi, parasites and viruses attach themselves to a surface and create a colony. These biofilms form themselves into a type of ‘shield’ that has a glue-like consistency, often referred to as ‘slime’. Biofilms then act as a barrier and help the colony to defend itself against antimicrobial treatments (such as antibiotics) and our immune cells. In fact, biofilm communities can be 1000 times more resistant to antibiotics than free-floating bacteria.

Biofilms can form part of the reason that some wounds may be difficult to heal, and why persistent infections may keep recurring. However, biofilms aren’t always undesirable. They can also play home to our healthy bacteria, such as that within our digestive system and on our skin.

Where are biofilms found?

A biofilm colony secretes material that provides a structural matrix, similar to cement. These structures can adhere to surfaces such as the lining of the gastrointestinal tract (GIT), urinary tract, respiratory system, heart, mouth (including the teeth), sex organs, eyes, the middle ear and skin.

Biofilms can also form on medical materials such as catheters, joint replacements, heart valves and they commonly occur in hospital environments.

Under a biofilm, many different species of pathogens can work collaboratively together to survive anti-microbial treatment and re-emerge to create symptoms over and over again, which can contribute to a roller-coaster of symptoms that wax and wane.

Common biofilms

One of the best examples of a commonly understood biofilm is the accumulation of plaque (or biofilm) on the teeth. Treating and breaking down plaque can sometimes be challenging. Infections can ‘hide’ in plaques well away from antiseptic treatments and the immune system, sometimes causing gingivitis (inflammation of the gums).

Another commonly known biofilm is sinusitis (sinus infection). In fact, up to 60% of people suffering with a sinus infection has a sinus bacterial biofilm. Ear infections, often found in children, have been found to be associated with the presence of middle ear biofilms.

Other conditions associated with biofilms include chronic fatigue syndrome, post viral fatigue, fibromyalgia, Lyme disease, systemic candida overgrowth, heartburn or GERD (gastroesophageal reflux), IBS, inflammatory bowel disease (Crohn’s disease and ulcerative colitis),  chronic bacterial prostatitis, infective endocarditis, periodontitis, arthritis, acne, and other skin conditions.

Biofilms are good at ‘hiding’ microbes

Up to 80% of infections in the body affecting the body systems mentioned above are associated with biofilm formation. Once formed, these biofilms can make it challenging for antimicrobial treatments to penetrate the biofilm. A microbial biofilm is continuously changing, stimulating inflammation, and acting as an obstacle for the action of the immune system. These types of persistent infections may be correlated to a range of health complaints including middle ear infections, urinary tract infections (UTIs), GIT infections, fungal overgrowth and more.

Biofilm communication

The life cycle of the biofilm includes the microbes communicating via a sophisticated process called ‘quorum sensing’. Microbes send messages to each other to start the formation of the matrix (cement) of the biofilm.  The microbes then communicate with each other as to their total number, and when they distinguish that there is a large colony, they start working as a community. Once the biofilm has been formed, channels are developed to allow nutrients in to enhance the development of the colony.

Naturopathic medicine to help break down biofilms

There are a number of natural compounds that may help to breakdown microbial biofilms. Some can preferentially target overgrowth of ‘bad’ microbes in biofilms, while enhancing ‘good’ bacterial biofilms such as:

  • Garlic has been found to be effective against fungal biofilms
  • Oregano
  • Cinnamon
  • Curcumin found in turmeric
  • N-acetylcysteine (NAC), particularly for upper respiratory tract infections
  • Cranberry can be used to treat UTI-associated biofilms
  • Ginger
  • Enzymes such as lumbrokinase (enzymes from earthworms), cellulase, glucoamylase, amylase, invertase, protease, and serrapeptase.
  • Other herbs such as Andrographis and baical skullcap
  • Xylitol and saccharomyces bourlardii as a nasal flush for chronic sinus infections
  • L-arginine powder on toothbrushes is effective for oral biofilms.
Li H, Wang D, Sun X, et al. Relationship between bacterial biofilm and clinical features of patients with chronic rhinosinusitis. Eur Arch Otorhinolaryngol 2012;269(1):155-163.

L-arginine reference: