Role of biofilm in children with recurrent upper respiratory tract infections

  • E. Nazzari
  • S. Torretta
  • L. Pignataro
  • P. Marchisio
  • S. EspositoEmail author


Recurrent respiratory tract infections (RRTIs) are very common in children and a major challenge for pediatricians. In the last few years, bacterial biofilms have been linked to RRTIs and antibiotic resistance, and have raised serious concerns regarding the therapeutic management of recurrent middle ear diseases, chronic rhinosinusitis, and recurrent pharyngotonsillitis. This paper aims to review the new insights into biofilm-related upper respiratory tract infections in children and possible therapeutic strategies. It focuses on the clinical implications for recurrent disease and on studies in pediatric patients. Analysis of the literature showed that the involvement of bacterial biofilm in recurrent upper airway tract infections is an emerging problem that may lead to serious concerns about infection control. Despite the large amount of research within this field, detailed insight into the complex structure of bacterial biofilms and the ultrastructural and biochemical mechanisms responsible for its evasion of the immune system and resistance to treatments is currently lacking. In the future, additional emphasis should be placed on biofilm management as a component of therapeutic strategies. This goal can be attained by finding feasible methods for detecting biofilms in vivo and identifying effective methods for administering treatments that eradicate preexisting bacterial biofilms or hinder bacterial adhesion to respiratory cells.


Obstructive Sleep Apnea Syndrome Eustachian Tube Bacterial Adhesion Chronic Rhinosinusitis Obstructive Sleep Apnea Syndrome Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors are financially supported by Bando Giovani Ricercatori 2009 (Italian Ministry of Health).

Conflict of interest

The authors have no conflict of interest to declare.


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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • E. Nazzari
    • 1
  • S. Torretta
    • 2
  • L. Pignataro
    • 2
  • P. Marchisio
    • 1
  • S. Esposito
    • 1
    Email author
  1. 1.Pediatric Highly Intensive Care Unit, Department of Pathophysiology and TransplantationUniversità degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  2. 2.Otorhinolaryngology Unit, Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly

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