Biofilms as Battlefield Armor for Bacteria against Antibiotics: Challenges and Combating Strategies.

Bacterial biofilms are formed by communities, which are encased in a matrix of extracellular polymeric substances (EPS). Notably, bacteria in biofilms display a set of 'emergent properties' that vary considerably from free-living bacterial cells. Biofilms help bacteria to survive under multiple stressful conditions such as providing immunity against antibiotics. Apart from the provision of multi-layered defense for enabling poor antibiotic absorption and adaptive persistor cells, biofilms utilize their extracellular components, e.g., extracellular DNA (eDNA), chemical-like catalase, various genes and their regulators to combat antibiotics. The response of biofilms depends on the type of antibiotic that comes into contact with biofilms. For example, excessive production of eDNA exerts resistance against cell wall and DNA targeting antibiotics and the release of antagonist chemicals neutralizes cell membrane inhibitors, whereas the induction of protein and folic acid antibiotics inside cells is lowered by mutating genes and their regulators. Here, we review the current state of knowledge of biofilm-based resistance to various antibiotic classes in bacteria and genes responsible for biofilm development, and the key role of quorum sensing in developing biofilms and antibiotic resistance is also discussed. In this review, we also highlight new and modified techniques such as CRISPR/Cas, nanotechnology and bacteriophage therapy. These technologies might be useful to eliminate pathogens residing in biofilms by combating biofilm-induced antibiotic resistance and making this world free of antibiotic resistance.

Practical Implications of Online Learning with Nurses During Coronavirus Disease 2019.

This study explores how teaching practices were impacted by coronavirus disease 2019 (COVID-19) in a fully online nursing program. In-depth interviews were conducted of faculty in an online nursing program. The findings of the study suggest that the COVID-19 pandemic was challenging for the faculty members, but still they considered it an opportunity for personal and professional growth; they used this disruption to humanize their teaching practices by focusing on self-care to support their students in the challenging times of a global pandemic. The members also mentioned institutional support was crucial for their perseverance, growth, and job satisfaction.