ABSTRACT

Introduction ...................................................................................................... 59 The statistics on device-related infections .................................................... 61 Bacterial growth characteristics in a biofilm ................................................ 62 Detachment ....................................................................................................... 63 How to analyze for the presence of biofilms on a surface ......................... 64 Surfaces .............................................................................................................. 65 Cohesion ............................................................................................................ 66 Bacterial strains ................................................................................................ 66 In vitro models to study biofilm formation .................................................. 67 Problems with detection of biofilm on implanted devices ........................ 68 Other potential tools for detecting biofilm infections ................................. 69 Resistance to antimicrobials ........................................................................... 70 Evasion of host defenses ................................................................................. 71 Device-associated biofilms.............................................................................. 71

Central venous catheters ............................................................................ 71 Urinary catheters ......................................................................................... 72 Cerebrospinal fluid shunts ......................................................................... 73 Biofilms and diagnostic instruments ........................................................ 73 Transrectal probes ....................................................................................... 73 Sublingual probes ........................................................................................ 74 Endoscopes ................................................................................................... 74

The bottom line ................................................................................................. 74 References .......................................................................................................... 75

Introduction Microorganisms attach to surfaces and form biofilms (Figure 5.1). From an historical perspective, biofilms first became an accepted entity as well as an accepted problem in environmental settings, particularly in industry. The Center for Biofilm Engineering at Montana State UniversityBozeman in 1990, funded through the National Science Foundation’s

Engineering Research Center Program, was established primarily to study environmental biofilms. The fact that biofilms were growing and clogging water pipes and cooling towers was easily accepted because the effects of the biofilms were readily apparent in the reduction and eventual loss of flow through a system.