Biofilms are structured groups of different bacterial species that are responsible for most chronic and recurrent infections. Biofilm-related infections reoccur in approximately 65–80% of cases. Bacteria associated with the biofilm are highly resistant to antibiotics. Knowledge of biofilm formation, its propagation and the resistance associated with it is scant and a multidisciplinary approach is followed to understand the science and develop strategies to address this problem. This article discusses the role of various biochemical factors, molecular mechanisms and altered host environment causes associated with bacterial resistance in biofilm. It also reveals the target sites and different multidisciplinary strategies adapted for destroying or preventing the formation of biofilms.

Colonization of bacteria around native host cells or polymeric implant surfaces results in a dense growth on the surface, which leads to infection. The change of a bacterium from a motile planktonic to a nonmotile long chain of growing cells is a complex, regulated process that depends on several factors. The probability of a biofilm-related infection occurrence is between 65 and 80%. This review critically evaluates the mode of biofilm formation on native tissues and orthopedics, dental, cardiac, and urological implants and vascular grafts. The combination of biochemical advancements with conventional microbiological techniques and the use of radio-labeled monoclonal antibodies in imaging techniques, with recent developments in the detection of these biofilm in vivo, would help in designing biomaterials that prevent bacterial adhesion and biofilm formation, and dislodge the formed biofilm, thereby accelerating the product development phase.

Ureteral stents find wide application in urology. The majority of patients with indwelling ureteral stents are at an increased risk of urinary tract infection. Stent encrustation and its associated complications lead to significant morbidity. This review critically evaluates various polymers that find their application as ureteral stents with regard to various issues such as encrustation, bacterial colonization, urinary tract infections, and related clinical issues. A complete literature survey was performed, and all the relevant articles were scrutinized thoroughly. We discuss issues of encrustation/biofilm formation, new approaches to their testing, polymers currently available for use, new biomaterials, coatings, and novel ureteral stent designs, thereby providing a complete update on recent advances in the development of stents. Finally, we discuss the future of biomaterial use in the urinary tract.