Biofilms - a P.A.K. Approach

Text Box: Michael Lebowitz, D.C.; Jeff Robinson, D.C.


Biofilms are a new discovery in treating the chronically ill patient. An Applied Kinesiology (AK) screening procedure is now available to help discern if they are an issue with your patients. Dietary modification along with ingestion or topical application of certain nutritional substances can help facilitate biofilm degradation thus exposing the pathogens which can then also can be eradicated with the appropriate remedies.


A biofilm is a negatively charged group of sticky cells which produce a matrix of extracellular polymeric substances. Biofilms, also referred to as “bacterial slime”, are generally composed of extracellular DNA, proteins, polysaccharides, microbes, minerals, and heavy metals. 

Biofilms are observed on most stable non-sterile surfaces in an aquatic environment. They are found in natural environments such as hot springs, rivers and streams, lakes, subterranean stromatolites, and tidal pools. They are also in man-made and industrial environments such as water and drainage pipes, sanitation systems, house-hold sinks, toilets, and showers, and even in the water tanks of nuclear power plants.

Dental plaque is an example of a biofilm.  The “plaque” material that adheres to the teeth is made up of bacterial cells (mainly Streptococcus mutans and Streptococcus sanguinis), salivary polymers and bacterial extracellular products. 

A biofilm can be comprised of multiple microbes; bacteria, virus, protozoa, parasites, and fungi that cohabitate and engage in "quorum sensing", an evolutionarily old form of bacterial communication. A Lyme disease researcher in New York also demonstrated that Borrelia species not only produce biofilm, but can live in the community in any form (i.e., spirochete, L form, spheroblast, and cyst).  Additionally, other zoonotic bacteria such as Babesia, Bartonella, Ehrlichia, Anaplasma, and Mycoplasma species inhabit these communities as well.  The biofilm is used to both protect the bacteria from the hosts' immune system, while also serving as a nutritional reservoir in times of harsh environmental conditions.  It's a very evolutionarily old and efficient way to ensure that many bacteria and other microbes survive, thrive and replicate. 

Biofilms are said to be anchored at certain places by positively charged ions including: calcium, magnesium, mercury, lead, etc. This may be one of the reasons why when a patient undergoes heavy metal chelation, they often experience an exacerbation of symptoms.  Chelation of minerals and metals essentially destabilizes the biofilm, rendering the inhabiting bacteria more vulnerable to the hosts' immune system and antimicrobials. 

Biofilms have been found to be involved in large percentages of all infections in the body.  Chronic sinusitis patients undergoing surgery present with biofilms most of the time. The NIH estimates that 80% of all human infections have biofilm involvment.   Other infectious processes in which biofilms have been implicated include common problems such as urinary tract infections, catheter infections, middle-ear infections, endocarditis, infections in cystic fibrosis, and infections of permanent indwelling devices such as joint prostheses and heart valves.  More recently it has been noted that bacterial biofilms may impair cutaneous wound healing and reduce topical antibacterial efficiency in healing or treating infected skin wounds.  Biofilms can also be formed on the inert surfaces of implanted devices such as catheters, prosthetic cardiac valves and intrauterine devices.

Research has shown that sub-therapeutic levels of β-lactam antibiotics induce biofilm formation in Staphylococcus aureus. This sub-therapeutic level of antibiotic may result from the use of antibiotics as growth promoters in agriculture, or during the normal course of antibiotic therapy. The most prevalent fungal biofilm-forming pathogen is Candida albicans, which can cause both superficial and systemic infections. 

Humans are host to various "friendly" bacteria, we carry them around with us in tissues and biofilms and they normally exist in balance within our bodies. The number of bacteria living within the body of the average healthy adult human is estimated to outnumber human cells 10 to 1. We need bacteria to create enzymes for various body processes, communicate with the immune system, prevent the growth of harmful species, produce vitamins (such as biotin and vitamin K), and produce needed hormones. It is not realistic to remove all the biofilms from the body. We are designed to live in harmony with one another, unless infection and other problems create an imbalance.  Humans are "symbiotes" with various organisms. 

It is when Spirochetes/parasites/protozoa and strong antibiotics enter the picture that the normal, symbiotic biofilm arrangement in the body can most likely be tipped over the edge into more pathogenic ("bad") biofilm communities.

The goal then, is to re-establish the healthy balance and symbiotic relationship to the natural biofilms and organisms in the body.


One of the authors of this paper postulates that he ended up in the hospital with infection induced pulmonary emboli by degrading biofilms with certain proteolytic enzymes thus unknowingly releasing microbes that caused a hypercoagulable state. It is our belief that biofilms should only be treated with substances that not only degrade the biofilm but also have broad spectrum anti-microbial effects. At the same time the patient should be monitored to see if they are releasing any “new” microbes or toxic metals as a result of the degradation and these should be treated concurrently.

AK Application

With the advent of new test kits, it is possible to screen for Biofilms with Applied Kinesiology. Positive findings are very common in patients we have already cleared of dysbiosis as eliminating the dysbiosis may be a “false” negative as pathogens remain in “hiding” behind biofilms.

1. See if the Biofilm vial (Supreme Nutrition 1-800-922-1744)  causes either a “strong muscle” to “weaken” or become “hypertonic”. If it does, it is a positive test.

2. See if the positive vials are negated by any of the following and supplement as indicated: BFB-1 and/or BFB-2 (Supreme Nutrition 1-800-922-1744). These have been developed by one of the authors as a result of academic research coupled with clinical investigation with AK.

a) BFB1- 1 drop 3x/day (start with one drop daily topically)

b) BFB2 - 1 drop 3x/day (start with one drop daily topically)

Be aware that some patients with massive biofilm formations may undergo Herxheimer reactions from this and need to have some detoxification protocols added.

Prevention/ Lifestyle and Treatment Considerations

1.                  Limit oils from diet, Oils/Fats have been felt to increase biofilm formation in some patients.

2.                  On some patients giving magnesium and B vitamins may encourage biofilm formation and they should be contraindicated when treating biofilms

3.                  Don’t neglect to clear dysbiosis, toxins, metals and food toxins to bring the most satisfactory results.


It is the authors opinions that screening for biofilms should routinely be done on chronic patients as well as screening for dysbiosis, food reactions, toxic metals and chemicals, nutrient deficiencies etc. The few minutes of time it takes is well worth the information you will elicit and will positively influence the clinical outcome


1. Hall-Stoodley L, Costerton JW, Stoodley P (February 2004).   "Bacterial biofilms: from the natural environment to infectious diseases". Nature Reviews. Microbiology 2 (2): 95–108. doi:10.1038/nrmicro821. PMID 15040259.

 2. Lear, G; Lewis, GD (editor) (2012). Microbial Biofilms: Current Research and Applications. Caister Academic Press. ISBN 978-1-904455-96-7.

 3. Karatan E, Watnick P (June 2009).   "Signals, regulatory networks, and materials that build and break bacterial biofilms". Microbiology and Molecular Biology Reviews 73 (2): 310–47. doi:10.1128/MMBR.00041-08. PMC 2698413. PMID 19487730.

 4. Hoffman LR, D'Argenio DA, MacCoss MJ, Zhang Z, Jones RA, Miller SI (August 2005). "Aminoglycoside antibiotics induce bacterial biofilm formation". Nature 436 (7054): 1171–5. doi:10.1038/nature03912. PMID 16121184. (primary source)

 5.  An D, Parsek MR (June 2007).  "The promise and peril of transcriptional profiling in biofilm communities". Current Opinion in Microbiology 10 (3): 292–6. doi:10.1016/j.mib.2007.05.011. PMID 17573234.

 6. JPG Images:

 7.  Donlan, Rodney M. 2002. Biofilms: Microbial Life on Surfaces. Emerging Infectious Diseases. Vol. 8, No. 9: pg. 881-890.

8.  Kaplan JB, Ragunath C, Ramasubbu N, Fine DH (August 2003). "Detachment of Actinobacillus actinomycetemcomitans biofilm cells by an endogenous beta-hexosaminidase activity". Journal of Bacteriology 185 (16): 4693–8. doi:10.1128/JB.185.16.4693-4698.2003. PMC 166467. PMID 12896987.

 9. Izano EA, Amarante MA, Kher WB, Kaplan JB (January 2008). "Differential roles of poly-N-acetylglucosamine surface polysaccharide and extracellular DNA in Staphylococcus aureus and Staphylococcus epidermidis biofilms". Applied and Environmental Microbiology 74 (2): 470–6. doi:10.1128/AEM.02073-07. PMC 2223269. PMID 18039822.

 10. Kaplan JB, Ragunath C, Velliyagounder K, Fine DH, Ramasubbu N (July 2004). "Enzymatic detachment of Staphylococcus epidermidis biofilms". Antimicrobial Agents and Chemotherapy 48 (7): 2633–6. doi:10.1128/AAC.48.7.2633-2636.2004. PMC 434209. PMID 15215120.

 11. Xavier JB, Picioreanu C, Rani SA, van Loosdrecht MC, Stewart PS (December 2005).  "Biofilm-control strategies based on enzymic disruption of the extracellular polymeric substance matrix--a modelling study". Microbiology 151 (Pt 12): 3817–32. doi:10.1099/mic.0.28165-0. PMID 16339929.

 12.  Davies DG, Marques CN (March 2009). "A fatty acid messenger is responsible for inducing dispersion in microbial biofilms". Journal of Bacteriology 191 (5): 1393–403. doi:10.1128/JB.01214-08. PMC 2648214. PMID 19074399.

 13. Barraud N, Hassett DJ, Hwang SH, Rice SA, Kjelleberg S, Webb JS (2006).  "Involvement of nitric oxide in biofilm dispersal of Pseudomonas aeruginosa". Journal of Bacteriology 188: 7344–7353.

 14. Barraud N, Storey MV, Moore ZP, Webb JS, Rice SA, Kjelleberg S (2009).  "Nitric oxide-mediated dispersal in single- and multi-species biofilms of clinically and industrially relevant microorganisms". Microbial Biotechnology 2: 370–378.

 15. "Dispersal of Biofilm in Cystic Fibrosis using Low Dose Nitric Oxide". University of Southampton. Retrieved 20 January 2012.

 16. Nadell, Carey D.; Xavier, Joao B.; Foster, Kevin R. (1 January 2009).  "The sociobiology of biofilms". FEMS Microbiology Reviews 33 (1): 206–224. doi:10.1111/j.1574-6976.2008.00150.x.

 17.  Stoodley, Paul; Dirk deBeer andZbigniew Lewandowski (August 1994).  "Liquid Flow in Biofilm Systems". Appl Environ Microbiol. 60 (8): 2711–2716.

 18. Stewart PS, Costerton JW (July 2001).   "Antibiotic resistance of bacteria in biofilms". Lancet 358 (9276): 135–8. doi:10.1016/S0140-6736(01)05321-1. PMID 11463434.

 19.  Molin S, Tolker-Nielsen T (June 2003). "Gene transfer occurs with enhanced efficiency in biofilms and induces enhanced stabilisation of the biofilm structure". Curr. Opin. Biotechnol. 14 (3): 255–61. doi:10.1016/S0958-1669(03)00036-3. PMID 12849777.

 20.  Spoering AL, Lewis K (December 2001). "Biofilms and planktonic cells of Pseudomonas aeruginosa have similar resistance to killing by antimicrobials". Journal of Bacteriology 183 (23): 6746–51. doi:10.1128/JB.183.23.6746-6751.2001. PMC 95513. PMID 11698361.

 21.  Characklis, WG; Nevimons, MJ; Picologlou, BF (1981).  "Influence of Fouling Biofilms on Heat Transfer". Heat Transfer Engineering 3: 23. doi:10.1080/01457638108939572.

 22.  Schwermer CU, Lavik G, Abed RM, et al. (May 2008). "Impact of nitrate on the structure and function of bacterial biofilm communities in pipelines used for injection of seawater into oil fields". Applied and Environmental Microbiology 74 (9): 2841–51. doi:10.1128/AEM.02027-07. PMC 2394879. PMID 18344353.

 23.  Martins dos Santos VAP, Yakimov MM, Timmis KN, Golyshin PN (2008).   "Genomic Insights into Oil Biodegradation in Marine Systems". In Díaz E. Microbial Biodegradation: Genomics and Molecular Biology. Horizon Scientific Press. p. 1971. ISBN 978-1-904455-17-2.

 24. "Introduction to Biofilms: Desirable and undesirable impacts of biofilm". (primary source)

 25.  Andersen PC, Brodbeck BV, Oden S, Shriner A, Leite B (September 2007). "Influence of xylem fluid chemistry on planktonic growth, biofilm formation and aggregation of Xylella fastidiosa". FEMS Microbiology Letters 274 (2): 210–7. doi:10.1111/j.1574-6968.2007.00827.x. PMID 17610515.

 26.  "Research on microbial biofilms (PA-03-047)".  NIH, National Heart, Lung, and Blood Institute. 2002-12-20.

 27.  Rogers A H (2008).   Molecular Oral Microbiology. Caister Academic Press. pp. 65–108. ISBN 978-1-904455-24-0.

 28.  Imamura Y, Chandra J, Mukherjee PK, et al. (January 2008). "Fusarium and Candida albicans biofilms on soft contact lenses: model development, influence of lens type, and susceptibility to lens care solutions". Antimicrobial Agents and Chemotherapy 52 (1): 171–82. doi:10.1128/AAC.00387-07. PMC 2223913. PMID 17999966.

 29.  Lewis K (April 2001). "Riddle of biofilm resistance". Antimicrobial Agents and Chemotherapy 45 (4): 999–1007. doi:10.1128/AAC.45.4.999-1007.2001. PMC 90417. PMID 11257008.

 30. Parsek MR, Singh PK (2003). "Bacterial biofilms: an emerging link to disease pathogenesis". Annual Review of Microbiology 57: 677–701. doi:10.1146/annurev.micro.57.030502.090720. PMID 14527295.

 31.  Davis SC, Ricotti C, Cazzaniga A, Welsh E, Eaglstein WH, Mertz PM (2008).  "Microscopic and physiologic evidence for biofilm-associated wound colonization in vivo". Wound Repair and Regeneration 16 (1): 23–9. doi:10.1111/j.1524-475X.2007.00303.x. PMID 18211576.

 32.  Sanclement J, Webster P, Thomas J, Ramadan H (2005).  "Bacterial biofilms in surgical specimens of patients with chronic rhinosinusitis". Laryngoscope 115 (4): 578–82. doi:10.1097/01.mlg.0000161346.30752.18. PMID 15805862.

 33.  Sanderson AR, Leid JG, Hunsaker D (July 2006).  "Bacterial biofilms on the sinus mucosa of human subjects with chronic rhinosinusitis". The Laryngoscope 116 (7): 1121–6. doi:10.1097/01.mlg.0000221954.05467.54. PMID 16826045.

 34.  Auler ME, Morreira D, Rodrigues FF, et al. (April 2009). "Biofilm formation on intrauterine devices in patients with recurrent vulvovaginal candidiasis". Medical Mycology: 1–6. doi:10.1080/13693780902856626. PMID 19353374.

 35.  Leevy WM, Gammon ST, Jiang H, et al. (December 2006).  "Optical imaging of bacterial infection in living mice using a fluorescent near-infrared molecular probe". Journal of the American Chemical Society 128 (51): 16476–7. doi:10.1021/ja0665592. PMC 2531239. PMID 17177377.

 36. Kaplan JB, Izano EA, Gopal P, et al. (2012).  "Low Levels of B-Lactam Antibiotics Induce Extracellular DNA Release and Biofilm Formation in Staphylococcus aureus". mBio 3 (4). doi:10.1128/mBio.00198-12.

 37. Augustin Mihai, Carmen Balotescu-Chifiriuc, Veronica Lazăr, Ruxandra Stănescu, Mihai Burlibașa, Dana Catrinel Ispas (Dec 2010).  "Microbial biofilms in dental medicine in reference to implanto-prostethic rehabilitation". Revista de chirurgie oro-maxilo-facială și implantologie (in (Romanian)) 1 (1): 9–13. ISSN 2069-3850. 8. Retrieved 2012-06-03.(webpage has a translation button)

 38.  Murga R, Forster TS, Brown E, Pruckler JM, Fields BS, Donlan RM (November 2001). "Role of biofilms in the survival of Legionella pneumophila in a model potable-water system". Microbiology 147 (Pt 11): 3121–6. PMID 11700362.

 39. Ramadan HH, Sanclement JA, Thomas JG (March 2005).  "Chronic rhinosinusitis and biofilms". Otolaryngology--Head and Neck Surgery 132 (3): 414–7. doi:10.1016/j.otohns.2004.11.011. PMID 15746854.

 40. Bendouah Z, Barbeau J, Hamad WA, Desrosiers M (June 2006). "Biofilm formation by Staphylococcus aureus and Pseudomonas aeruginosa is associated with an unfavorable evolution after surgery for chronic sinusitis and nasal polyposis". Otolaryngology--Head and Neck Surgery 134 (6): 991–6. doi:10.1016/j.otohns.2006.03.001. PMID 16730544.

41.  Lynch AS, Robertson GT (2008).  "Bacterial and fungal biofilm infections". Annual Review of Medicine 59: 415–28. doi:10.1146/ PMID 17937586.

 42. Vo P, Nunez M (2010). "Bdellovibrio bacteriovorus Predation in Dual-Species Biofilms of E. coli Prey and M. luteus Decoys". arXiv:1005.3582 [q-bio.PE].

43.  Allison, D. G. (2000).  Community structure and co-operation in biofilms. Cambridge, UK: Cambridge University Press. ISBN 0-521-79302-5.

 44.  Lynch, James F.; Lappin-Scott, Hilary M.; Costerton, J. W. (2003). Microbial biofilms. Cambridge, UK: Cambridge University Press. ISBN 0-521-54212-X.

 45.  Fratamico, M. (2009).  Biofilms in the food and beverage industries. Woodhead Publishing Limited. ISBN 978-1-84569-477-7. Unknown parameter |isbn-status= ignored (help)

46.  Khan MS, Zahin M, Hasan S, Husain FM, Ahmad I.  Inhibition of quorum sensing regulated bacterial functions by plant essential oils with special reference to clove oil.  Department of Agricultural Microbiology, Faculty of Agricultural Sciences, Aligarh Muslim University, Aligarh, India.

47.  Dr A Swidsinski, Innere Klinik, Gastroenterologie, Charité, 10098 Berlin, Germany; Bacterial biofilm within diseased pancreatic and biliary tracts. 21 April 2004

48 Fry, Stephen  personal communication 2013