Wasfi, RehamZarkan, AshrafHamed, Samira M2023-08-262023-08-262023-08doi: 10.3389/fcimb.2023.1264346http://repository.msa.edu.eg/xmlui/handle/123456789/5681Numerous microbes use biofilm formation as a mean of survival. Biofilms are multicellular communities in which microorganisms are encased in a protective matrix that enables them to endure challenging environments and resist traditional therapies. The widespread existence of biofilm-forming bacteria in various settings, including healthcare facilities, is made possible by their capacity to colonize a variety of biotic and abiotic surfaces. They pose a serious threat to human health because they can develop increasing resistance to traditional antibiotics and spread morbidity through both device- and non- device (tissue)-associated infections, as reviewed by Zhao et al. This microbial phenotype consequently became a significant concern in several fields, including public health and medicine. Biofilms are involved in the pathogenicity of infectious diseases as well as the establishment of healthy microbiomes. Many bacterial species within the gut microbiome grow as biofilms, and disease outcome is greatly impacted by the location of the biofilms within the gastrointestinal tract (Miller et al., 2021). Hammouda et al. reported that hormonal drugs affect biofilm formation by selected gut microbiota such as Bifidobacterium longum, Limosilactobacillus reuteri, Bacteroides fragilis, and Escherichia coli, representing the four main phyla in the gut. Despite increasing the adhesion of L. reuteri to Caco-2/HT-29 cell line coculture, progesterone inhibited the biofilm development of the Gram-positive bacteria. In contrast, it increased the ability of Gram- negative bacteria to form biofilms and increased the adherence of B. fragilis to the cell lines coculture. Both estradiol and thyroxine displayed antibiofilm activity against L. reuteri. In the meantime, thyroxine boosted the capacity of E. coli to develop a biofilm. The implication of biofilm-related multi-drug resistance (MDR) in hospital-acquired infections is a significant issue with increased rates of patient mortality and morbidity as well as economic burden, including high healthcare expenses and extended hospital stays (Assefa and Amare, 2022). Hu et al. reported the ability of the emerging opportunistic nosocomial pathogen Elizabethkingia anophelis to form biofilms. MDR phenotype was also exhibited by all isolates. The authors concluded that biofilm development and antibioticenbiofilm, microbiome, hospital-acquired infection (HAI), implanted medical devices, multidrug resistance (MDR), biofilm associated infections, cathetersArticledoi: 10.3389/fcimb.2023.1264346