Table 2.

Exclusion studies in medical devices.

Antibiofilm Substances and Probiotic Strains		Abiotic Surface	Biofilm Forming Pathogens	Percentages of Reduction	Ref.	Major Conclusions
Biosurfactants	L. acidophilus L. brevis L. casei L. delbrueckii L. fermentum L. helveticus L. paracasei L. plantarum L. reuteri L. rhamnosus Lact. lactis Strep. thermophilus	PDMS discs Polystyrene Silicone elastomeric discs Silicone rubber	Bac. cereus Bac. subtilis C. albicans C. tropicalis Ent. faecalis E. coli K. pneumoniae Lis. innocua Lis. monocytogenes Pr. mirabilis Pr. vulgaris Prov. stuartii P. aeruginosa P. putida R. dentocariosa Sal. typhi Ser. marcescens Sh. flexneri S. aureus S. epidermidis Strep. salivarius	87% 79% 50%–85% 56%–67% N.A. 50%–59% N.A. 82% 84% N.A. 65%–75% N.A. 49%–70% 65% 78%–89% 56% 60% 40% 61%–96% 85%–94% 90%–93%	[81] [99] [57,62,100,101] [61,62] [101] [81,99,101] [101] [81] [81] [101] [99,100] [101] [81,99,101] [99] [61,62] [81] [102] [81] [61,62,81,99,100] [61,62,81,101] [61,62]	Pre-adsorbed biosurfactants displayed high anti-adhesive activity against both Gram-positive (61–97%) and Gram-negative (40%–75%) bacteria. Pre-adsorbed biosurfactant reduced the adhesion of yeasts to silicone by 50%–85%.
Bacteriocins	L. fermentum L. plantarum	Foley silicone catheter pieces Polystyrene	P. aeruginosa S. aureus	99% N.A.	[103] [59,103]	Pre-coating with bacteriocins reduced the number of biofilm culturable cells by 99%.
EPS	L. fermentum Leu. citreum Leu. mesenteroides Leu. pseudo-mesenteroides Ped. pentosaceus	Polystyrene	Ent. faecalis E. coli P. aeruginosa S. aureus	88% 90% 96% 87%	[86] [86] [103] [86]	Pre-coating with EPS reduced the number of biofilm culturable cells of P. aeruginosa by 96% and inhibited the adhesion of bacteria in a dose-dependent manner (87%–90%).
Cells	E. coli Nissle 1917 L. acidophilus L. casei L. casei rhamnosus L. fermentum L. paracasei L. rhamnosus Lact. lactis Lact. lactis ssp. lactis Strep. thermophilus	Denture surface Foley silicone catheter pieces Glass Saliva-coated hydroxyapatite discs Polystyrene Saliva-conditioned titanium discs Silicone Silicone latex	A. naeslundii C. albicans Ent. faecalis E. coli F. nucleatum Klebsiella ssp. Non-mutans streptococci strains P. aeruginosa S. aureus Strep. mutans Strep. oralis Strep. sobrinus V. dispar	33% 99% 99% 99% 60% N.A. 8% N.A. 99% 30%-99% 79%-99% 89% 68%	[104] [65] [12] [105] [104] [105] [106] [105] [94,105,107] [96,106] [96,104] [104] [104]	Probiotics reduced the adhesion of pathogens up to 3 Log CFU and biofilm biomass by 8%–30%. Pre-coating with EcN biofilms reduced the adherence of Ent. faecalis on silicone up to 2 Log CFU.
Collagen-binding protein (p29)	L. fermentum	Polyisobutylene-polystyrene (PIB-PS) copolymerSilicone rubber	Ent. faecalis E. coli	47% 75%	[58] [58]	Coating with p29 resulted in a reduction of 34% and 75% in E. coli adhesion, and 47% and 18% in Ent. faecalis adhesion to silicone rubber and PIB-PS, respectively.
Lipoteichoic acid (LTA)	L. plantarum	Polystyrene	Strep. mutans	40%	[98]	Biofilm formation was inhibited, but to a lesser degree in comparison with co-incubation.

Abbreviations: CFU, Colony-Forming Units; EcN, E. coli Nissle 1917; EPS, Exopolysaccharides; PDMS, Polydimethylsiloxane; N.A., Not Available. A., Actinomyces; Bac., Bacillus; C., Candida; Ent., Enterococcus; E., Escherichia; F., Fusobacterium; K., Klebsiella; L., Lactobacillus; Lact., Lactococcus; Leu., Leuconostoc; Lis., Listeria; Ped., Pediococcus; Pr., Proteus; Prov., Providencia; P., Pseudomonas; R., Rothia; Sal., Salmonella; Ser., Serratia; Sh., Shigella; S., Staphylococcus; Strep., Streptococcus; V., Veillonella.