Skip to main content

Perspectives on Biomaterial-Associated Infection: Pathogenesis and Current Clinical Demands

  • Chapter
  • First Online:
Racing for the Surface

Abstract

In this chapter, an overview of current medical implant devices and infection problems associated with implantation is provided, bridging the gap between material engineering and clinical practice. The pathogenesis, common pathogens, and infection sites are listed, alongside the details of up-to-date strategies and guidelines for diagnosis and treatment of biomaterials-associated infections. Through the combined understanding of microbial pathogenicity, drug resistance, patients’ immune response processes, and current clinical practices, we can tackle the problem of biomaterials-associated infection via multidisciplinary approaches. To meet the clinical demands and challenges in future, strategic design of intelligent biomaterials is in need to reduce implantation device-caused infections, improving the patient’s quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Biomaterial industry in China. CCM Data & Business Intelligence 2016

    Google Scholar 

  2. Nana A, Nelson SB, McLaren A, Chen AF (2016) What’s new in musculoskeletal infection: update on biofilms. JBJS 98(14):1226–1234

    Article  Google Scholar 

  3. Europe, Health & Medicine, Pharmaceuticals & Biotech (2019) Asia pacific orthopedic biomaterial market 2019, industry analysis, size, share, trends, product price, profit, forecast to 2023

    Google Scholar 

  4. Patent application trend survey report summary (artificial organs). https://www.jpo.go.jp/shiryou/pdf/gidou-houkoku/h28/28_06.pdf. Accessed 8 May 2019

  5. Kheir MM, Tan TL, Shohat N, Foltz C, Parvizi J (2018) Routine diagnostic tests for periprosthetic joint infection demonstrate a high false-negative rate and are influenced by the infecting organism. JBJS 100(23):2057–2065

    Article  Google Scholar 

  6. US Disease Control and Prevention (CDC). Appropriate antibiotic use in hospitals and long-term care. https://www.cdc.gov/antibiotic-use/healthcare/index.html. Accessed 26 April 2019

  7. Use of International Standard ISO 10993-1. Biological evaluation of medical devices—part 1: evaluation and testing within a risk management process. https://www.iso.org/standard/44908.html. Accessed 26 April 2019

  8. Holzapfel BM, Reichert JC, Schantz JT, Gbureck U, Rackwitz L, Noth U, Jakob F, Rudert M, Groll J, Hutmacher DW (2013) How smart do biomaterials need to be? A translational science and clinical point of view. Adv Drug Deliv Rev 65(4):581–603

    Article  CAS  PubMed  Google Scholar 

  9. Singh B (2018) NanoBioMaterials: nanobiomaterials. CRC Press

    Google Scholar 

  10. Yamamoto R (2017) Changes and prospects of implant materials from the viewpoint of biocompatibility. Materia 56(3):225–228. (in Japanese)

    CAS  Google Scholar 

  11. Gristina AG, Naylor P, Myrvik Q (1989) Infections from biomaterials and implants-a race for the surface. Med Prog Technol 14(3–4):205–224

    CAS  Google Scholar 

  12. Busscher HJ, van der Mei HC, Subbiahdoss G, Jutte PC, van den Dungen JJ, Zaat SA, Schultz MJ, Grainger DW (2012) Biomaterial-associated infection: locating the finish line in the race for the surface. Sci Transl Med 4(153):153rv10

    Article  CAS  PubMed  Google Scholar 

  13. Kapadia BH, Berg RA, Daley JA, Fritz J, Bhave A, Mont MA (2016) Periprosthetic joint infection. Lancet 387(10016):386–394

    Article  PubMed  Google Scholar 

  14. Kannan MB, Walter R, Yamamoto A (2015) Biocompatibility and in vitro degradation behavior of magnesium–calcium alloy coated with calcium phosphate using an unconventional electrolyte. ACS Biomater Sci Eng 2(1):56–64

    Article  CAS  PubMed  Google Scholar 

  15. Baidya AK, Bhattacharya S, Dubey GP, Mamou G, Ben-Yehuda S (2018) Bacterial nanotubes: a conduit for intercellular molecular trade. Curr Opin Microbiol 42:1–6

    Article  CAS  PubMed  Google Scholar 

  16. Bryers JD (2018) Modeling biofilm accumulation. Physiological models in microbiology volume II, Chapter 11

    Google Scholar 

  17. de la Fuente-Nunez C, Reffuveille F, Fernandez L, Hancock REW (2013) Bacterial biofilm development as a multicellular adaptation: antibiotic resistance and new therapeutic strategies. Curr Opin Microbiol 16(5):580–589

    Article  CAS  Google Scholar 

  18. Flemming HC, Wingender J (2010) The biofilm matrix. Nat Rev Microbiol 8(9):623–633

    Article  CAS  PubMed  Google Scholar 

  19. Romling U, Balsalobre C (2012) Biofilm infections, their resilience to therapy and innovative treatment strategies. J Intern Med 272(6):541–561

    Article  CAS  PubMed  Google Scholar 

  20. Sasaki K (2016) Polysaccharide intercellular adhesion (PIA) process also happens which involves staphylococcal surface protein. J Jpn Soc Poweder Powder Metallurgy 63(8). (in Japanese)

    Google Scholar 

  21. Guidelines for Biomaterial Research That Supports Medical Care (2017) Annual meeting of Japan biomaterial engineering committee. (in Japanese)

    Google Scholar 

  22. Wolfmeier H, Pletzer D, Mansour SC, Hancock REW (2018) New perspectives in biofilm eradication. ACS Infect Dis 4(2):93–106

    Article  CAS  PubMed  Google Scholar 

  23. Guilhen C, Forestier C, Balestrino D (2017) Biofilm dispersal: multiple elaborate strategies for dissemination of bacteria with unique properties. Mol Microbiol 105(2):188–210

    Article  CAS  PubMed  Google Scholar 

  24. Guo Y, Shao HY. Characteristics and challenges of human implant infection (in Chinese). Beijing-Hong Kong infection Forum 2018

    Google Scholar 

  25. Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, Rao N, Hanssen A, Wilson WR (2013) Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 56(1):e1–e25

    Article  PubMed  Google Scholar 

  26. Elkins JM, Kates S, Lange J, Lange J, Lichstein P, Otero J, Soriano A, Wagner C, Wouthuyzen-Bakker M (2019) General assembly, diagnosis, definitions: proceedings of international consensus on orthopedic infections. J Arthroplast 34(2):S181–S185

    Article  Google Scholar 

  27. Parvizi J, Della Valle CJ (2010) AAOS Clinical Practice guideline: diagnosis and treatment of periprosthetic joint infections of the hip and knee. J Am Acad Orthop Surg 18(12):771–772

    Article  PubMed  Google Scholar 

  28. Drago L, Lidgren L, Bottinelli E, Villafañe JH, Berjano P, Banfi G, Romanò CL, Sculco TP (2016) Mapping of microbiological procedures by the members of the International Society of Orthopaedic Centers (ISOC) for diagnosis of periprosthetic infections. J Clin Microbiol 54(5):1402–1403

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Higuera CA, Zmistowski B, Malcom T, Barsoum WK, Sporer SM, Mommsen P, Kendoff D, Della Valle CJ, Parvizi J (2017) Synovial fluid cell count for diagnosis of chronic periprosthetic hip infection. JBJS 99(9):753–759

    Article  Google Scholar 

  30. Johns Hopkins ABX Guide. 2018

    Google Scholar 

  31. Guidelines for clinical application of antimicrobial agents (2015 edition, in Chinese). National Health and Family Planning Commission

    Google Scholar 

  32. Thoendel M, Jeraldo P, Greenwood-Quaintance KE, Chia N, Abdel MP, Steckelberg JM, Osmon DR, Patel R (2017) A novel prosthetic joint infection pathogen, Mycoplasma salivarium, identified by metagenomic shotgun sequencing. Clin Infect Dis 65(2):332–335

    Article  PubMed  PubMed Central  Google Scholar 

  33. Cabrita HB, Croci AT, de Camargo OP, de Lima A (2007) Prospective study of the treatment of infected hip arthroplasties with or without the use of an antibiotic-loaded cement spacer. Clinics 62(2):99–108

    Article  PubMed  Google Scholar 

  34. Del Pozo JL, Patel R (2009) Infection associated with prosthetic joints. N Engl J Med 361(8):787–794

    Article  PubMed  PubMed Central  Google Scholar 

  35. Wang Y, Cheng LI, Helfer DR, Ashbaugh AG, Miller RJ, Tzomides AJ, Thompson JM, Ortines RV, Tsai AS, Liu H, Dillen CA, Archer NK, Cohen TS, Tkaczyk C, Stover CK, Sellman BR, Miller LS (2017) Mouse model of hematogenous implant-related Staphylococcus aureus biofilm infection reveals therapeutic targets. Proc Natl Acad Sci U S A 114(26):E5094–E5102

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Wang Z, de la Fuente-Nunez C, Shen Y, Haapasalo M, Hancock REW (2015) Treatment of oral multispecies biofilms by an anti-biofilm peptide. PLoS One 10(7):e0132512

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Gao Q, Yu M, Su Y, Xie M, Zhao X, Li P, Ma PX (2017) Rationally designed dual functional block copolymers for bottlebrush-like coatings: in vitro and in vivo antimicrobial, antibiofilm, and antifouling properties. Acta Biomater 51:112–124

    Article  CAS  PubMed  Google Scholar 

  38. Gross MS, Phillips EA, Carrasquillo RJ, Thornton A, Greenfield JM, Levine LA, Alukal JP, Conners WP, Glina S, Tanrikut C, Honig SC, Becher EF, Bennett NE, Wang R, Perito PE, Stahl PJ, Gaya MR, Barbara MR, Cedeno JD, Gheiler EL, Kalejaiye O, Ralph DJ, Kohler TS, Stember DS, Carrion RE, Maria PP, Brant WO, Bickell MW, Garber BB, Pineda M, Burnett AL, Eid JF, Henry GD, Munarriz RM (2017) Multicenter investigation of the micro-organisms involved in penile prosthesis infection: an analysis of the efficacy of the AUA and EAU guidelines for penile prosthesis prophylaxis. J Sex Med 14(3):455–463

    Article  PubMed  Google Scholar 

  39. Habous M, Tal R, Tealab A, Soliman T, Nassar M, Mekawi Z, Mahmoud S, Abdelwahab O, Elkhouly M, Kamr H, Remeah A, Binsaleh S, Ralph D, Mulhall J (2018) Defining a glycated haemoglobin (HbA1c) level that predicts increased risk of penile implant infection. BJU Int 121(2):293–300

    Article  CAS  PubMed  Google Scholar 

  40. Scholz HC, Nockler K, Gollner C, Bahn P, Vergnaud G, Tomaso H, Al Dahouk S, Kampfer A, Cloeckaert M, Maquart MS, Zygmunt AM, Whatmore M, Pfeffer B, Huber P, Busse HJ, De BK (2010) Brucella inopinata sp nov., isolated from a breast implant infection. Int J Syst Evol Microbiol 60:801–808

    Article  CAS  PubMed  Google Scholar 

  41. Hoque J, Haldar J (2017) Direct synthesis of dextran-based antibacterial hydrogels for extended release of biocides and eradication of topical biofilms. ACS Appl Mater Interfaces 9(19):15975–15985

    Article  CAS  PubMed  Google Scholar 

  42. Mao X, Cheng R, Zhang H, Bae J, Cheng L, Zhang L, Deng L, Cui W, Zhang Y, Santos HA, Sun X (2019) Self-healing and injectable hydrogel for matching skin flap regeneration. Adv Sci (Weinh) 6(3):1801555

    Article  CAS  Google Scholar 

  43. Hoque J, Adhikary U, Yadav V, Samaddar S, Konai MM, Prakash RG, Pararnanandham K, Shome BR, Sanyal K, Haldar J (2016) Chitosan derivatives active against multidrug-resistant bacteria and pathogenic fungi: in vivo evaluation as topical antimicrobials. Mol Pharm 13(10):3578–3589

    Article  CAS  PubMed  Google Scholar 

  44. Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, Talan DA, Grp EMINS (2006) Methicillin-resistant S-aureus infections among patients in the emergency department. N Engl J Med 355(7):666–674

    Article  CAS  PubMed  Google Scholar 

  45. Scott VCS, Haake DA, Churchill BM, Justice SS, Kim JH (2015) Intracellular bacterial communities: a potential etiology for chronic lower urinary tract symptoms. Urology 86(3):425–431

    Article  PubMed  Google Scholar 

  46. Minassian AM, Newnham R, Kalimeris E, Bejon P, Atkins BL, Bowler IC (2014) Use of an automated blood culture system (BD BACTEC™) for diagnosis of prosthetic joint infections: easy and fast. BMC Infect Dis 14(1):233

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Heudorf U, Albert-Braun S, Hunfeld KP, Birne FU, Schulze J, Strobel K, Petscheleit K, Kempf VA, Brandt C (2016) Multidrug-resistant organisms in refugees: prevalences and impact on infection control in hospitals. GMS Hyg Infect Control 11

    Google Scholar 

  48. US Public Law 105-230 105th Congress, Biomaterials Access Assurance Act of 1998. https://www.biomaterials.org/sites/default/files/docs/2014/biomaterials_access_assurance_act_of_1998.pdf. Accessed 26 April 2019

Download references

Acknowledgments

This work was financially supported by the National Key R&D Program of China (2018YFC1105402 and 2017YFA0207202), the National Natural Science Foundation of China (21875189 and 81601553), Key R&D Program of Jiangsu Province (BE2017740), the Natural Science Foundation of Zhejiang Province (LGF19H200005), and the Fundamental Research Funds for the Central Universities.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Peng Li .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bai, D., Chen, J., Li, P., Huang, W. (2020). Perspectives on Biomaterial-Associated Infection: Pathogenesis and Current Clinical Demands. In: Li, B., Moriarty, T., Webster, T., Xing, M. (eds) Racing for the Surface. Springer, Cham. https://doi.org/10.1007/978-3-030-34475-7_4

Download citation

Publish with us

Policies and ethics