Anti-biofilm Agents in Control of Device-Related Infections

The persistence and relative impermeability of biofilm matrices make the treatment of biofilm-producing organisms much more challenging than the treatment of their planktonic counterparts. However, the challenge is one worth rising towards, as the incidence of biofilm related infectious continues to increase, comprising up to 75 % of all bacterial infections. With the aging of the global population, the number of implanted medical devices is rising, from the seemingly innocuous temporary urinary catheter to the bridge-to-transplant ventricular assist device. Several strategies and agents are under active examination for their potential to prevent and/or treat biofilm device related infections. These strategies each focus on specific organisms known to be associated with particular devices. Skin flora such as staphylococcal species, including Staphylococcus aureus and coagulase-negative staphylococci are the most common organisms to create biofilms on central venous catheters, prosthetic joints or orthopedic hardware, and prosthetic heart valves. Genitourinary flora comprise the majority of culprit organisms for biofilm-associated urinary catheter infections. Pseudomonas aeruginosa colonizes implanted devices in the airway, including tracheostomy tubes and bronchial stents.