Antimicrobial Medical Devices in Preclinical Development and Clinical Use

  • Benjamin D. Brooks
  • Amanda E. Brooks
  • David W. Grainger
Chapter

Abstract

Medical devices are increasingly used worldwide for an expanding ­repertoire of patient clinical needs. Biomaterials and medical device designs have become progressively more complex to accommodate diverse demands for performance and safety in vivo. While a majority of these implants satisfy their clinical expectations with safety and efficacy in their specific applications, a minority of implants induce serious adverse events with substantial health and economic consequences. One recognized challenge is the growing clinical problem with implant-associated infections. Increasing number and types of implants used in patients have resulted in increasing numbers of biomaterial-associated infections. Researchers and medical device manufacturers have responded to this challenge with intensified attention to innovating device designs, surgical implantation protocols, and biomaterials to minimize infection opportunities. Medical devices with claims to limit microbial adhesion and colonization using combinations of pharmacological, topological, and materials chemistry approaches have been brought into clinical use with the intent of reducing device-related infections. Many types of catheters, stents, orthopedic devices, contact lenses, surgical meshes, shunts, sutures, cardiovascular replacements, and many other device categories offer antimicrobial enhancements. Approaches include different biomaterials chemistries that intrinsically resist microbial colonization or that deter active growth on contact, surface modifications that produce topologies observed to limit pathogen attachment, medicinal, antiseptic or bioactive coatings, direct antimicrobial attachment to surfaces, or drug impregnation within the biomaterial, and extended release strategies that control antimicrobial agent release from the device over time after implantation.

Keywords

TiO2 Zeolite Marketing Sponge Hydrocephalus 

Notes

Acknowledgments

The authors acknowledge support from the University of Utah Technology Commercialization Office and from NIH grant EB01473 and EB00894.

Glossary

Antimicrobial

A pharmaceutical agent used to mitigate, eradicate, and/or prevent microbial infections.

Biomaterial

Material, either synthetic or natural, that is suitable for contact with living tissue or bodily fluid as a part of a medical device.

Biomaterial Associated Infection (BAI)

A microbial infection on, around, or ­resulting from biomaterial contact with human tissues or fluids.

Biofilm

An interface-associated colony or colonies of microbes embedded in a complex extracellular matrix (ECM) that is composed primarily of polymers and proteins. Microbes in biofilms have additional resistance to antimicrobials due to reduced metabolism and the protective features of the ECM.

Hospital acquired infection (HAI)

Microbial infections without evidence of ­inoculation or incubation at before admission to a healthcare environment.

Implanted device

Medical device that is completely inserted or grafted into the body.

Medical Device (US FDA standard definition)

An instrument, apparatus, implement, ­machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is:

Recognized in the official National Formulary, or the US Pharmacopoeia, or any supplement to them,

Intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals, or

Intended to affect the structure or any function of the body of man or other animals, and which does not achieve any of its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of any of its primary intended purposes.

Microbe

A microorganism, especially bacteria, fungi, viruses, and protozoa, that causes infection.

Nosocomial

See Hospital-acquired infections.

Percutaneous Implants

A medical device that traverses the epithelial layer.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Benjamin D. Brooks
    • 1
  • Amanda E. Brooks
    • 1
  • David W. Grainger
    • 1
    • 2
  1. 1.Department of Pharmaceutics and Pharmaceutical ChemistryUniversity of UtahSalt Lake CityUSA
  2. 2.Department of BioengineeringUniversity of UtahSalt Lake CityUSA

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