Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia.
Future Industries Institute, University of South Australia, Mawson Lakes Blvd, Mawson Lakes, Adelaide, SA 5000, Australia; School of Agriculture Food & Wine, The University of Adelaide, Waite Campus, Adelaide, SA 5000, Australia.
Biotechnol Adv. 2018 Jan-Feb;36(1):264-280. doi: 10.1016/j.biotechadv.2017.11.010. Epub 2017 Dec 2.
In recent years, increasing evidence has been collated on the contributions of fungal species, particularly Candida, to medical device infections. Fungal species can form biofilms by themselves or by participating in polymicrobial biofilms with bacteria. Thus, there is a clear need for effective preventative measures, such as thin coatings that can be applied onto medical devices to stop the attachment, proliferation, and formation of device-associated biofilms. However, fungi being eukaryotes, the challenge is greater than for bacterial infections because antifungal agents are often toxic towards eukaryotic host cells. Whilst there is extensive literature on antibacterial coatings, a far lesser body of literature exists on surfaces or coatings that prevent attachment and biofilm formation on medical devices by fungal pathogens. Here we review strategies for the design and fabrication of medical devices with antifungal surfaces. We also survey the microbiology literature on fundamental mechanisms by which fungi attach and spread on natural and synthetic surfaces. Research in this field requires close collaboration between biomaterials scientists, microbiologists and clinicians; we consider progress in the molecular understanding of fungal recognition of, and attachment to, suitable surfaces, and of ensuing metabolic changes, to be essential for designing rational approaches towards effective antifungal coatings, rather than empirical trial of coatings.
近年来，越来越多的证据表明真菌（尤其是假丝酵母）物种对医疗器械感染有贡献。真菌可以单独形成生物膜，也可以与细菌一起形成多微生物生物膜。因此，显然需要有效的预防措施，例如可以涂覆在医疗器械上的薄膜，以阻止设备相关生物膜的附着、增殖和形成。然而，由于真菌是真核生物，挑战比细菌感染更大，因为抗真菌药物通常对真核宿主细胞有毒。虽然有大量关于抗菌涂层的文献，但关于防止真菌病原体附着和在医疗器械上形成生物膜的表面或涂层的文献要少得多。在这里，我们回顾了具有抗真菌表面的医疗器械的设计和制造策略。我们还调查了关于真菌在天然和合成表面上附着和传播的基本机制的微生物学文献。该领域的研究需要生物材料科学家、微生物学家和临床医生之间的密切合作；我们认为，在分子水平上理解真菌对合适表面的识别和附着以及随后的代谢变化，对于设计有效的抗真菌涂层的合理方法至关重要，而不是对抗真菌涂层进行经验性试验。
