Why are opportunistic pathogens that form biofilms on indwelling devices particularly difficult to eradicate and a common cause of device-associated HAIs?

Biofilm-forming bacteria are inherently unable to adhere to device surfaces and therefore are an unlikely source of infection, making device-associated HAIs mostly a myth.

Because biofilms make bacteria grow faster and be more visible to cleaning staff, they are easy to identify and therefore rarely cause persistent infections.

Biofilms only form in soil and environmental waters and never on medical devices because hospital materials repel microbes completely.

Biofilms protect bacteria from disinfectants and antibiotics, reduce penetration of host immune effectors, and create a reservoir on device surfaces that continuously seeds infection, so standard surface cleaning is often insufficient without device removal or specific reprocessing.