An overview of the antimicrobial strategies to combat prevention and treatment of urinary tract infections caused by bacterial biofilms

Urinary tract infections (UTIs) are one of the most common bacterial infections, particularly in women and children, which are often treated with antibiotics. Bacterial biofilms play an important role in persistent and recurrences of UTIs. A catheter-associated UTI (CA-UTI) caused by biofilm constitute a high percentage of nosocomial infections. Increasing antibiotic resistance is a serious threat to the treatment of these infections. Antibiotic resistance is an important and topical issue, which refers to the situation where antibiotics that usually kill bacteria no longer do so. Patients infected with resistant bacteria will manifest symptoms for a longer time, and the chances of the conditions getting worse will be higher. The main causes of antibiotic resistance are their incorrect use: either empirical treatment is performed (without performing antibiotic susceptibility testing); strong antibiotics are prescribed for infections that could be treated with simple antibiotics; or administration is in too small amounts, for too short a period, or at too long intervals. Therefore, alternative strategies for the prevention and treatment of UTIs caused by bacterial biofilm are needed. In the present study, a review of these new therapeutic approaches is provided including medicinal plants, probiotics, antimicrobial peptides, nanoparticles, and phages.