de Cueto-López Marina, Del Pozo-León Jose Luis, Franco-Álvarez de Luna Francisco, Marin-Arriaza Mercedes
Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Sevilla, España.
Área de Enfermedades Infecciosas y Microbiología Clínica, Clínica Universidad de Navarra, Pamplona, España.
Enferm Infecc Microbiol Clin. 2016 Dec;34(10):655-660. doi: 10.1016/j.eimc.2015.02.012. Epub 2015 Mar 29.
The use of surgically implanted medical devices has increased greatly over the last few years. Despite surgical advances and improvements in the materials and design of devices, infection continues to be a major complication of their use. Device-associated infections are produced mainly during their implantation and, are caused by microorganisms that are part of the skin flora. Biofilm development on device surfaces is the most important factor to explain the pathophysiological aspects of infection. Microbiological diagnosis is difficult and can often only be achieved after removal of the device. Sonication of the removed device may be a useful tool, since this procedure dislodges and disaggregates biofilm bacteria from the device. Molecular techniques, especially PCR, applied to the tissues and material obtained after sonication have shown to have a high sensitivity and specificity for the diagnosis of cardiovascular device infections.
在过去几年中，外科植入式医疗设备的使用大幅增加。尽管手术技术有所进步，设备的材料和设计也有所改进，但感染仍然是其使用过程中的主要并发症。与设备相关的感染主要在植入过程中发生，由皮肤菌群中的微生物引起。设备表面生物膜的形成是解释感染病理生理方面的最重要因素。微生物学诊断困难，通常只有在移除设备后才能实现。对移除的设备进行超声处理可能是一种有用的工具，因为该程序可使生物膜细菌从设备上脱落并分解。应用于超声处理后获得的组织和材料的分子技术，尤其是聚合酶链反应（PCR），已显示出对心血管设备感染诊断具有高灵敏度和特异性。
