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In situ treatment strategies for medical device associated infections

The underlying pathobiology of medical device associate infection is related to biofilm formation on device surfaces. Biofilms are communities of sessile bacteria enclosed within an extracellular matrix which offers constituent bacteria protection from antibiotics and host response. While microbiologists consider biofilms from a purely biological perspective, we view biofilms as soft matter or complex fluids. This allows us to consider and develop novel physical treatments (e.g., thermal and mechanical) in conjunction with traditional chemical and biological treatments.

While preventive strategies reduce, they cannot eliminate bacterial adhesion and colonization of implanted medical devices over time. Current in situ treatment strategies fail to overcome the physical and metabolic defenses afforded by microbial biofilms, which ultimately disseminate to the bloodstream and distal sites. As a consequence of this resilience and risk of metastasis, surgical removal remains the most effective treatment but adds significant morbidity, mortality, and cost. This motivates the search for in situ anti-biofilm strategies.

Background: Confocal microscope sample, showing stained C. Albicans cell membrane  

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