Medical device-related infections

Habash M, Reid G. Microbial biofilms their development and significance for medical device-related infections. Journal of Clinical Pharmacology 1999, 39, 887-898. 

Francolini I, Donelh G. Prevention and control of biofilm based medical device related infections. FEMS Immunol Med Microbiol 2010 59 227-38. 

Hogan S, Stevens NT, Humphreys H, O Gara JP, O Neill E. Current and future approaches to the prevention and treatment of staphylococcal medical device-related infections. Curr Pharm Des 2015 21 100-13. 

The last method of prevention represents one of the most promising strategies developed in recent years since the antimicrobial agent adsorbed on the catheters is released directly at the infection site. Recently, inhinsicaUy antimicrobial polymers have emerged as promising candidates to address biofilm-based medical device-related infections. 

O Grady NP, Alexander M, Bums LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control May 2011 39(4 Suppl. l) Sl-34. Francolini 1, Donelli G. Prevention and control of biofilm-based medical-device-related infections. FEMS Immunol Med Microbiol August 2010 59(3) 227-38. 

The use is discussed of antimicrobial coatings for medical devices to reduce the occurrence of device-related infections. Antimicrobial coatings provide a low cost... 

In the final chapter, biofilm formation is reviewed, covering knowledge about structure and biosynthesis of polysaccharide intercellular adhesins (PIAs) which are central to biofilm formation. This comprehensive chapter explains all PIA-related principles of medical device-associated infections. 

This chapter will be focused on antimicrobial PUs for intravascular applications. First, a classification of the types of PU intravascular devices and their impact in the medical held will be inhoduced. Then, a survey of infections associated with intravascular devices in terms of incidence, etiology, and pathogenesis will be presented. Next, management of device-related infections and the role of modified PUs in preventing intravascular device-related infections will be discussed. Finally, the future direction of novel antimicrobial polymers as biomaterials for the development of devices preventing biofilm-based infections will be described. 

The final consideration to be addressed in this chapter on the choice of a polymer fortrsein medical devices is cost. Biomedical polymers can range from inexpensive (PVC, polyethylene) to extremely expensive (e.g., polymers with peptide components). A disposable catheter intended for minutes or hotus use in the body will not jrrstily an expensive polymer. On the other hand, a device implanted with the intent of a lifetime of acceptable performance might rrse an expensive polymeric component if long-term performance benefit can be demonstrated. Also, a higher priced polymer might be justified based on reduced complications. For example, as catheter-related bloodstream infections can add over 56000 to a hospital stay, a more expensive antibacterial catheter should be justified. ... 

It is now widely accepted that nuCTobial biofihns play a key role in all types of health-care-associated infections and especially in those related to medical devices. Particularly, biofilm formation on the device surfaces contributes to the severity of these infections. Indeed the development of biofilm is responsible for the chronic nature of related infections, and for the inherent resistance to antibiotic therapy. Raad et al. were among the first investigators who isolated biofilm-producing microorganisms from the intraluminal surface of CVCs, which r ained in situ for more than 30 days. 

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