A biofilm is a layer of slime in which microorganisms – bacteria and fungi – form a functioning, living amalgamation. The biofilm offers microorganisms the advantages of easier nutrition and growth, greater resistance to antibiotics and better protection against combatants from the human immune system. Biofilms represent a reservoir of often multiresistant pathogens that is continually being renewed. According to the National Institute of Health, some 80 percent of all infections can be traced to biofilms.

Biofilms are assumed to be the oldest amalgamations of life on earth and they are everywhere. For people with a healthy immune system the risk of contracting an infection via a biofilm is relatively small. For individuals who are sick or injured, however, biofilms can represent a fatal risk. The pathogens can no longer be combated by the immune system. Therefore they are often a non-treatable danger for patients on intensive care units and patients who have undergone organ transplantation, chemotherapy or other procedures.

The Biofilm Center, headed by Dr. Annette Moter serves to research and diagnose biofilm infections and other infections that are difficult to identify. The Center carries out practical basic science research to decode the nature and functionality of biofilms and to develop therapy concepts to combat biofilms more effectively.
This requires innovative laboratory procedures for the rapid, precise identification of pathogens. Following identification the pathogens can be better reduced or eradicated and biofilms prevented.

In terms of diagnostics the Biofilm Center performs microbiological examination of heart valves explanted at the German Heart Center Berlin and suspected of showing endocarditis, ventricular assist devices and pacemaker cables. In many cases infections are found that are not seen in routine diagnostic procedures. This is because some microorganisms cannot be cultivated in the laboratory or their cultivation is difficult. Other reasons lie in the very nature of biofilms and in previous antibiotic treatment of the patient, which makes it difficult to detect pathogens by standard culture methods. Successful pathogen identification makes targeted antibiotic treatment of the patient possible, thereby improving the chances of recovery.

Dr. Moter also heads the Robert Koch Institute reference laboratory for Tropheryma whipplei at the German Heart Center Berlin. T. whipplei is a bacterium that in rare cases causes Whipple’s disease, an infectious disease that leads to death if not treated and can also affect the heart valves.

On the research side, funding was acquired from several large programs, with a total funding sum of over one million euro. The consortium project iSOLID (Integrated Solutions for Infection Detection) started in July 2017 with the aim of being able to diagnose biofilm infections quicker and more accurately using digital imaging, and making therapy recommendations.

The consortium project unites HB Technologies AG, CHILI GmbH, the Biofilm Center of the German Heart Center Berlin and the Fraunhofer Institute for Integrated Circuits. The project has received funding for three years from the Federal Ministry for Education and Research via the project executing agency VDI Technology Center Düsseldorf.

As part of the program EXIST Research Transfer, funded by the Federal Ministry of Economic Affairs, the Biofilm Center is being supported to prepare the foundation of a subsidiary institution for improved biofilm diagnosis. Dr. Judith Kikhney of the Biofilm Center is heading this project. Continued funding has been secured.

Further research projects are the development of a machine for fluorescence in situ hybridization (FISH) in cooperation with the Cologne firm Intavis, the combination of FISH and histology, and the investigation of biofilms in international cooperation in further areas of disease such as wounds and implants.

As part of the EU program of the European COST Action ipromedai (“Improved protection of medical devices against infection”), the Biofilm Center heads the working group on Cardiovascular Devices and thus plays a leading role in the development and improvement of cardiovascular implants.

• Schönrath et al. 2017 Life on the driveline - molecular detection and FISH-based visualization of microbial species in patients with left ventricular assist devices Journal of Heart and Lung Transplantation, in press
• Stewart PS, Zhang T, Xu R, Pitts B, Walters MC, Roe F, Kikhney J, Moter A.Reaction-diffusion theory explains hypoxia and heterogeneous growth within microbial biofilms associated with chronic infections. NPJ Biofilms Microbiomes. 2016 Jun 22;2:16012. doi: 10.1038/npjbiofilms.
• Xu Y, Larsen LH, Lorenzen J, Hall-Stoodley L, Kikhney J, Moter A, Thomsen TR. Microbiological diagnosis of device-related biofilm infections. APMIS. 2017 Apr;125(4):289-303. doi: 10.1111/apm.12676. Review.
• Frickmann H, Zautner AE, Moter A, Kikhney J, Hagen RM, Stender H, Poppert S. Fluorescence in situ hybridization (FISH) in the microbiological diagnostic routine laboratory: a review. Crit Rev Microbiol. 2017 May;43(3):263-293. doi: 10.3109/1040841X.2016.1169990. Epub 2017 Jan 27. Review.
• Kumpf O, Dohmen P, Ertmer M, Knebel F, Wiessner A, Kikhney J, Moter A, Treskatsch S. Rapid molecular diagnosis of infective aortic valve endocarditis caused by Coxiella burnetii. Infection. 2016 Dec;44(6):813-817. Epub 2016 Jun 23.
• Hall-Stoodley L, Stoodley P, Kathju S, Høiby N, Moser C, Costerton JW, Moter A, Bjarnsholt T. Towards diagnostic guidelines for biofilm-associated infections. FEMS Immunol Med Microbiol. 2012 Jul;65(2):127-45. doi: 10.1111/j.1574-695X.2012.00968.x. Epub 2012 May 2. Review.
• Geissdörfer W, Moos V, Moter A, Loddenkemper C, Jansen A, Tandler R, Morguet AJ, Fenollar F, Raoult D, Bogdan C, Schneider T. High frequency of Tropheryma whipplei in culture-negative endocarditis. J Clin Microbiol. 2012 Feb;50(2):216-22. doi: 10.1128/JCM.05531-11. Epub 2011 Nov 30
• Moter A, Musci M, Schmiedel D. Molecular methods for diagnosis of infective endocarditis. Curr Infect Dis Rep. 2010 Jul;12(4):244-52. doi: 10.1007/s11908-010-0111-6.