XXXX biofilms-formation, biology, and clinical relevance.

@entity1 @entity66 @entity19 @entity4195 @entity204
@entity4195 (group A streptococci, GAS) is an exclusive @entity1 bacterial pathogen. The virulence potential of this species is tremendous. Interactions with @entity1 range from asymptomatic carriage over mild and superficial infections of skin and mucosal membranes up to systemic purulent @entity66 manifestations. Particularly the latter are a severe threat for predisposed @entity1 and lead to significant @entity204 tolls worldwide. This places GAS among the most important Gram-positive bacterial pathogens. Many recent reviews have highlighted the GAS repertoire of virulence factors, regulators and regulatory circuits/networks that enable GAS to colonize the host and to deal with all levels of the host immune defense. This covers in vitro and in vivo studies, including animal infection studies based on @entity19 and more relevant, macaque monkeys. It is now appreciated that GAS, like many other bacterial species, do not necessarily exclusively live in a planktonic lifestyle. GAS is capable of microcolony and biofilm formation on host cells and tissues. We are now beginning to understand that this feature significantly contributes to GAS pathogenesis. In this review we will discuss the current knowledge on GAS biofilm formation, the biofilm-phenotype associated virulence factors, regulatory aspects of biofilm formation, the clinical relevance, and finally contemporary treatment regimens and future treatment options.
