Clinical implications of interkingdom fungal and bacterial biofilms

This chapter aims to critically evaluate the available evidence as a means of appraising the clinical importance of fungi in polymicrobial environments. Fungal biofilms, in particular Candida albicans, remain an important healthcare issue as a consequence of ineffectual clinical management strategies. The lung mycobiome has been suggested to have a significant impact on clinical outcome of chronic respiratory diseases (CRD) such as asthma, chronic obstructive pulmonary disease, cystic fibrosis (CF), and bronchiectasis. CF is an autosomal recessive disease caused by a mutation in the CF transmembrane conductance regulator [CFTR] protein, which is responsible for maintaining airway homeostasis and mucociliary clearance. Interactions of the CF lung, and elsewhere, may lead to adverse clinical outcomes. Interkingdom interactions within biofilms are an important clinical entity. The mucosa of the gastrointestinal (GI) tract is heavily laden with bacterial microbiota, growing as healthy biofilm communities.