According to the study of bacterial biofilm, Jamal et al., (2015) stated that the beginning of formation of bacterial biofilms is when the bacteria started to adhere to the surface and will form a “micro-colony” developing a “three-dimensional structure”, along with the research of Thomen et al., (2017), these “three-dimensional structure” are usually drenched in an aqueous fluid in motion, subjected to hydrodynamic forces and later on it will end with maturation until detachment. Bacterial biofilms are somewhat a big threat to public health because antibiotics and immune system of a human body is less attainable to it. On the other hand, Bryers in 2008 stated that some health problems including impotent species, impaired wound healing, chronic inflammation, spread of infectious emboli, and the rapidly acquired antibiotic resistance infections are one of those biofilm infections that can occur as “recurrent or chronic infections” and are flagrantly crucial to resolve. Bryers (2008) also stated that nowadays, anti-infective agents that is generally used are now outstanding, considering that those resistant bacteria were only familiar in intensive-care units before, but now in these latter-day, such organisms have been retrieved from non-intensive care hospital inpatient areas and are now isolated in extended-care facilities, home health care sites, ambulatory surgical units, and other health care settings, which is somewhat tells that it is now increasing and multiplying.
These serves that the antimicrobial resistance of bacteria is a major worldwide healthcare issue. Based on one of the headlines of Centers for Disease Control and Prevention Report in 2007, healthcare associated infections (i.e., nosocomial infections) estimated approximately 1.7 million infections and 99,000 associated deaths each year.
32% of all healthcare-associated infections are urinary tract infections; 22% are surgical site infections; 15% are pneumonia; and 14% are bloodstream infections which is conducted in American hospitals, while according to the report of The European Centre for Disease Prevention and Control (ECDC) in June 2007, they stated that every year some 3 million people in European Union countries catch an infectious disease associated with healthcare and that around 50,000 die as a result (Bryers, 2008).Another statement Bryers was proved on his studies was that Gram-negative bacteria have developed “secretory proteins” that can deteriorate their binding components, or that prove antichemotactic or toxic to immune cells. However, a study about Gram-positive bacteria conducted by Li et al., in 2007 conveyed that it can somewhat sense “antimicrobial peptides” that is distributed by neutrophils and macrophage and can perform a controlled response for defensive purposes.
A discovery by them which is an “antimicrobial peptide sensor system” functions as a control of major specific resistance mechanisms, and is consisted of a classical two-component signal transducer and an unusual third protein; in addition, they are all indispensable for signal transduction and antimicrobial peptide resistance (Bryers, 2008). Meanwhile, Jesaitis et al. in 2003 performed an examination on Pseudomonas aeruginosa biofilms to neutrophils and know how it will react on an in vitro oxygen consumption, morphology of cell, and how will the host’s defensive process react. According to their report, the consumption of oxygen in both the neutrophils and bacteria increases, but with a tiny accumulation of H2O2 when leukocytes settled on established biofilm. Upon the examination, motility or characteristic polarized morphology of motile cells did not show or manifest from neutrophils, but the engagement in phagocytosis is capable while retaining a roughly spherical shape and modest membrane ruffling.
Biofilm bacteria can impliedly operate immune responses while reactions of immune cells may aggravate biofilm formation and reinforce virulence (Bryers, 2008).