Biofilm and Medical Devices

Microorganisms in a sessile phase exhibit a distinct phenotype with respect to gene transcription, growth rate and ability to resist antimicrobial or

Table 1. Medical devices associated with biofilm infections

Catheters

Implants

Devices

Central venous catheters Pacemakers

Arteriovenous shunts

Biliary stents

Arterial catheters Spinal implants

Pulmonary artery catheters Penile implants

Umbilical catheters Breast implants

Peritoneal dialysis catheters Orthopedic prostheses

Urinary catheters Cochlear implants

Nasogastric tubes Neurosurgical stimulators

Gastrostomy tubes Middle ear implants

Enteral feeding tubes Dental implants

Endotracheal tubes Voice prostheses

Tracheostomy tubes Implanted monitors

Ureteral stents Mechanical heart valves Fracture fixation devices Joint prostheses

Vascular grafts and assist devices Intrauterine devices Intraocular and contact lenses Coronary stents Intracranial pressure devices Suture material disinfection treatments from planktonic (freely suspended) organisms and therefore pose a public health problem.

Biofilm, as a matter of fact, is involved in acute and chronic infectious diseases and has been described in human and experimental pathology such as native valve endocarditis, otitis media, bacterial chronic rhinosinusitis, COPD, chronic urinary infections, bacterial prostatitis, osteomyelitis, dental caries, biliary tract infections, Legionnaire's disease and amyloidosis.

Modern medicine is largely based on medical devices support and their surfaces, even if from many different materials, represent a possible site of microorganism adhesion with biofilm formation. Table 1 reports medical devices documented to be biofilm contaminated with consequent clinical sequelae. When a medical device is microbiologically contaminated, biofilm formation depends on several variables, bacteria and non-bacteria dependent. Main variables are: type and number of microorganism, type and physicochem-ical characteristics of surface, flow rate, components (nutrients, antimicrobials) and temperature of liquid through the device. The rapid growing of scientific knowledge on the matter is documented by an increasing number of published reviews dealing with biofilm and related problems [4-11].

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