Pathogen Molecular Genetics Section, Laboratory of Bacteriology, National Institute of Allergy and Infectious Diseases, U.S. National Institutes of Health, Bethesda, MD, USA.
Environ Microbiol. 2018 Sep;20(9):3141-3153. doi: 10.1111/1462-2920.14129. Epub 2018 May 6.
The use of medical devices in modern medicine is constantly increasing. Despite the multiple precautionary strategies that are being employed in hospitals, which include increased hygiene and sterilization measures, bacterial infections on these devices still happen frequently. Staphylococci are among the major causes of medical device infection. This is mostly due to the strong capacity of those bacteria to form device-associated biofilms, which provide resistance to chemical and physical treatments as well as attacks by the host's immune system. Biofilm development is a multistep process with specific factors participating in each step. It is tightly regulated to provide a balance between biofilm expansion and detachment. Detachment from a biofilm on a medical device can lead to severe systemic infection, such as bacteremia and sepsis. While our understanding of staphylococcal biofilm formation has increased significantly and staphylococcal biofilm formation on medical devices is among the best understood biofilm-associated infections, the extensive effort put in preclinical studies with the goal to find novel therapies against staphylococcal device-associated infections has not yet resulted in efficient, applicable therapeutic options for that difficult-to-treat type of disease.
在现代医学中,医疗器械的使用不断增加。尽管医院采取了多种预防策略,包括加强卫生和消毒措施,但这些设备上的细菌感染仍然频繁发生。葡萄球菌是医疗器械感染的主要原因之一。这主要是由于这些细菌形成与器械相关的生物膜的能力很强,生物膜对化学和物理处理以及宿主免疫系统的攻击具有抵抗力。生物膜的形成是一个多步骤的过程,每个步骤都有特定的因素参与。它受到严格的调控,以在生物膜的扩张和脱落之间提供平衡。从医疗器械上的生物膜脱落会导致严重的全身感染,如菌血症和败血症。虽然我们对葡萄球菌生物膜形成的理解有了显著提高,并且医疗器械上的葡萄球菌生物膜形成是最被理解的与生物膜相关的感染之一,但为了寻找针对葡萄球菌器械相关感染的新型治疗方法而进行的广泛的临床前研究并没有为这种难以治疗的疾病提供有效的、适用的治疗选择。