Methods for studying biofilms: Microfluidics and translation in the clinical context

The presence of biofilms in microbial infections increases the possibility of chronic disease and worsens the infection outcome, since microbes exhibit survival-promoting phenotypic traits when forming biofilms. These traits include antimicrobial resistance mechanisms and defence strategies against the infected host immune system. In addition, biofilm growth is widespread, as it is estimated that more than 90% of the microbial population is found in the context of a biofilm, but the range of possible conditions that allow biofilm formation hinders the establishment of a standardized procedure for growing biofilms in vitro. Therefore, this review aims to summarize the different existing methods for growing biofilms, from simpler static models through more advanced dynamic models to finally focus on microfluidic-based devices. Thus, the properties and advantages of microfluidics technology that enable the growth and study of different biofilm parameters are stated together with their counterparts and limitations. In addition, existing microfluidic devices are enumerated and carefully described. Moreover, this review exhaustively discusses the new technology that enables the translation of biofilm devices to clinics for personalized treatment and better prevention and detection of biofilms and analyses the possible limitations and considerations.