Biomaterials Associated Infection: Immunological Aspects and Antimicrobial Strategies

563 Pages·2013·6.77 MB·English

by  Werner Zimmerli M.D.

Biomaterials Associated Infection
wwwwwwwwww
T. Fintan Moriarty (cid:129) Sebastian A.J. Zaat
Henk J. Busscher
Editors
Biomaterials Associated
Infection
Immunological Aspects and Antimicrobial
Strategies
Editors
T. Fintan Moriarty Sebastian A.J. Zaat
AO Research Institute Davos Department of Medical Microbiology
Davos Platz Center for Infection and Immunity
Switzerland Amsterdam (CINIMA)
University of Amsterdam
Henk J. Busscher Amsterdam, The Netherlands
Department of Biomedical Engineering
University Medical Center Groningen
Groningen
Netherlands
ISBN 978-1-4614-1030-0 ISBN 978-1-4614-1031-7 (eBook)
DOI 10.1007/978-1-4614-1031-7
Springer New York Heidelberg Dordrecht London
Library of Congress Control Number: 2012942190
© Springer Science+Business Media New York 2013
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection
with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and
executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this
publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s
location, in its current version, and permission for use must always be obtained from Springer. Permissions
for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to
prosecution under the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of
publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for
any errors or omissions that may be made. The publisher makes no warranty, express or implied, with
respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Preface
The use of biomaterials in modern medicine has greatly contributed to patient care
allowing less-invasive patient monitoring, improvements in the administration of
medicines, and enhanced patient mobility contributing to improvements in quality
of life. Relatively early in the evolution of medical devices, however, it was realized
that the use of implanted biomaterials also results in an increased susceptibility to
infection. This increase in infection susceptibility appears to be present across all
biomaterials classes, regardless of form or function and has remained to this day as
one of the most common, yet unresolved problems associated with the use of
implanted biomaterials. With an aging society, and increasing use of biomaterials to
ensure restoration of function and quality of life, the problem of biomaterials asso-
ciated infection (BAI) may be expected to increase in the coming decades. In this
book we aim to provide the reader with an overview of the problem of BAI with a
particular emphasis on the pathogenesis of BAI and opportunities available through
biomaterials research for reducing its incidence.
Medical devices and the biomaterials from which they are composed are clearly
central players in the pathogenesis of BAI. The presence of an implanted biomate-
rial causes a local defect in host immune defenses that contributes to the failure of
the host to ef fi ciently clear contaminating bacteria in a certain percentage of cases.
The processes of BAI then progress from bacterial adhesion to the biomaterial and
colonization of adjacent tissues through to formation of an antibiotic recalcitrant
bacterial bio fi lm. A better understanding of this process from microbiological, phar-
macological, immunological, and biomaterials science perspectives is required if
signi fi cant reduction in BAI incidence is to be achieved.
One area in which considerable research has been performed is that of bacterial
virulence and the pathogenesis of BAI. This theme is discussed in depth in the fi rst
part of the book, with a number of chapters dedicated to the pathogenic process of
BAI for the most common causative microorganisms S taphylococcus aureus and
Staphylococcus epidermidis, as well as a focus upon the increasingly acknowledged
opportunistic pathogen in BAI, P ropionibacterium acnes. There is also a growing
body of data available on the host response to biomaterials, although a clearer
understanding of the interplay between the local immune activation resulting from
the biomaterials and subsequent impact upon the contaminating bacteria are required
if we are to fully elucidate the pathogenic process of BAI and develop successful
v
vi Preface
interventions. The immune response to biomaterials is also discussed in the book
with contributions discussing the role of the foreign body response and dendritic
cell activation by biomaterials.
Biomaterials research presents the single largest target, with most potential for
clinical impact, in achieving reductions in BAI. Modern biomaterials science has
provided a vast array of modi fi cation and activation strategies to impart anti-infec-
tive properties upon biomaterials. In this book some of the most commonly applied
approaches to anti-infective biomaterials design are discussed, such as antibiotic-
loaded materials and coatings, anti-adhesive surfaces, surface-functionalization
with silver, and also a more novel and contemporary approach, prevention of infec-
tion by medical-grade honey. Furthermore, with clinicians and insurance providers
demanding reductions in BAI incidence, research into new anti-infective biomateri-
als and the clinical introduction of devices with anti-infective properties represent
the front line in modern translational research. Ultimately, the most promising anti-
infective biomaterials solutions must be tested in the clinics and hospital wards,
where treatment outcomes and ef fi cacy information may be collated. Clinical data
is already available for some antimicrobial devices such as catheters, endotracheal
tubes, periodontal implants, and orthopedic devices. The case histories of several of
these devices are presented in this book together with a frank discussion of their
impact on reducing or preventing BAI and potential future use based on the latest
clinical data. Careful attention to, and continuous observation of, the clinical results
associated with the use of antimicrobial devices is expected to provide the necessary
direction for future biomaterials research. In this book we have aimed to provide an
overview of the most crucial parameters in both preclinical and clinical fi elds allow-
ing the reader to obtain a complete understanding of the problem of BAI from all of
the most important perspectives.
The Editors
April 2012
Contents
Part I The Pathogenesis of Medical Device-Associated Infection
1 Biomaterial-Associated Infection: A Perspective
from the Clinic ......................................................................................... 3
Werner Zimmerli and Andrej Trampuz
2 Staphylococcus epidermidis in Biomaterial-Associated
Infections .................................................................................................. 25
Dietrich Mack, Angharad P. Davies, Llinos G. Harris,
Rose Jeeves, Ben Pascoe, Johannes K.-M. Knobloch, Holger Rohde,
and Thomas S. Wilkinson
3 Staphylococcal Virulence Factors .......................................................... 57
Christine Heilmann and Friedrich Götz
4 Propionibacterium acnes: An Emerging Pathogen
in Biomaterial-Associated Infection ...................................................... 87
Sheila Patrick and Andrew McDowell
5 Bridging the Gap Between In Vitro and In Vivo
Evaluation of Biomaterial-Associated Infections ................................. 107
Guruprakash Subbiahdoss, Joana F. da Silva Domingues,
Roel Kuijer, Henny C. van der Mei, and Henk J. Busscher
6 Biomaterial-Dependent Characteristics of the Foreign
Body Response and S. epidermidis Biofilm Interactions ...................... 119
James M. Anderson and Jasmine D. Patel
7 Dendritic Cell–Biomaterial Interactions: Implications
for the Onset and Development of the Foreign Body Response .......... 151
Antonio S. Sechi and Behnaz Shokouhi
vii
viii Contents
8 Tissue Colonization in Biomaterial-Associated Infection ................... 175
Sebastian A.J. Zaat
9 Systemic Treatment Options for Medical
Device-Associated Infection ................................................................... 209
Oscar Murillo, Jaime Lora-Tamayo, and Javier Ariza
10 Preventive Measures Against Transcutaneous
Device Infections ..................................................................................... 229
Paul H.S. Kwakman and Sebastian A.J. Zaat
11 Infections Associated with Implanted Dental Devices ......................... 249
Georgios N. Belibasakis, Thomas Thurnheer, and Nagihan Bostanci
12 Animal Models of Orthopedic Implant-Related Infection .................. 273
Lorenzo Calabro, Cameron Lutton, Ahmed Fouad Seif El Din,
R. Geoff Richards, and T. Fintan Moriarty
Part II Biomaterial-Based Strategies to Reduce Medical
Device-Associated Infection
13 Antimicrobial Medical Devices in Preclinical
Development and Clinical Use ............................................................... 307
Benjamin D. Brooks, Amanda E. Brooks, and David W. Grainger
14 Silver Containing Biomaterials .............................................................. 355
Neil Poulter, Krasimir Vasilev, Stefani S. Griesser,
and Hans J. Griesser
15 Quaternary Ammonium Compounds ................................................... 379
J.A. Loontjens
16 Anti-adhesive and Antibacterial Polymer Brushes .............................. 405
K.G. Neoh, Z.L. Shi, and E.T. Kang
Part III Clinical Applications, Case Studies
17 Infection in Fracture Fixation: Device Design
and Antibiotic Coatings Reduce Infection Rates ................................. 435
Gerhard Schmidmaier, Abhay D. Gahukamble,
T. Fintan Moriarty, and R. Geoff Richards
18 The Indwelling Bladder Catheter: Attempts to Prevent
Infection and the Development of Bacterial Biofilms .......................... 455
David Stickler and Roger Feneley
19 Antimicrobial-Modified Vascular Catheters ........................................ 485
Rabih O. Darouiche
Contents ix
20 Topical Antimicrobial-Containing Biomaterials
for Peri-Implant Infections in the Oral Cavity ..................................... 505
Stefan Renvert and G. Rutger Persson
21 Preventive Strategies in VAP: Focus on Silver-Coated
Endotracheal Tubes ................................................................................ 531
Marin Kollef
Index ................................................................................................................. 557
wwwwwwwwww