Cell Biology and Molecular Mechanisms in Artificial Device Infections

Abstract

Biomaterials are being used with increasing frequency for tissue substitution. Complex devices such as total joint replacement and the total artificial heart represent combinations of polymers and metal alloys for system and organ replacement. The major barrier to the extended use of these devices is bacterial adhesion to biomaterials, which causes biomaterial-centered infection, and the lack of successful tissue integration or compatibility with biomaterial surfaces. Adhesion-mediated infections are extremely resistant to antibiotics and host defenses and frequently persist until the biomaterial or foreign body is removed. The pathogenesis of adhesive infections is related, in part, to preferential colonization of "inert" substrate whose surfaces are not integrated with healthy tissues composed of living cells and intact extracellular polymers. Tissue integration is an interesting parallel to microbial adhesion and is a desired phenomenon for the biocompatibility of certain implants and biomaterials. Tissue integration requires a form of eukaryocytic adhesion or compatibility with possible chemical integration to an implant surface. Many of the fundamental principles of interfacial science apply to both microbial adhesion and to tissue integration and are general to and independent of the substratum materials involved. Interactions of biomaterials with bacteria and tissue cells are directed not only by specific receptors and outer membrane molecules on the cell surface, but also by the atomic geometry and electronic state of the biomaterial surface. An understanding of these mechanisms is important to all fields of medicine and is derived from and relevant to studies in microbiology, biochemistry, and physics.(ABSTRACT TRUNCATED AT 250 WORDS)

The outcome of bacterial arthritis. A prospective community‐based study

“…The ability of bacteria to attach themselves to synthetic material and the difficulty in eradicating them in that situation are well-known (40). The site of the prosthesis may be important.…”

<em>Vibrio fischeri</em> and <em>Escherichia coli</em> adhesion tendencies towards photolithographically modified nanosmooth poly (<em>tert</em>-butyl methacrylate) polymer surfaces

“…The solid/liquid interface between a surface and an aqueous medium has been seen to be a common location for biofi lm formation. This can cause contamination in areas as diverse as dentistry (eg, formation of plaque) (Busscher and van der Mei 1997;Marsh and Bradshaw 1997), biomedicine (eg, implants and other biopolymers) (Gristina et al 1993;Hendricks et al 1999), and water treatment facilities (Percival et al 2000). This solid/liquid interface becomes almost immediately conditioned from the aqueous medium, in which it is immersed, resulting in a chemical or physical modifi cation which is thought to aid in bacterial attachment (Loeb and Neihof 1975).…”

Ultrasonically Controlled Release of Ciprofloxacin from Self-Assembled Coatings on Poly(2-Hydroxyethyl Methacrylate) Hydrogels forPseudomonas aeruginosaBiofilm Prevention

“…Various device-related infections have been well documented on vascular catheters, prosthetic hips, knees, and other orthopedic implants (8,23,29). Increasingly, biofilm formation is recognized as a significant virulence factor in many of these infections (4,5,9,26,29,30,31).…”

“…In recent years biomaterial scientists (8) have devoted significant efforts to creating biocompatible materials that prevent or minimize biofilm infection by inhibiting the formation and survival of biofilms. One strategy is to incorporate drug delivery into the device, which targets the site at which biofilm formation is likely to occur (1,6,7,25).…”