Biofilm-Related Indwelling Medical Device Infections
Anton van Leeuwenhoek unknowingly was the first person to discover bacterial biofilms causing human disease when he described the presence of “animalcules” while microscopically examining scrapings of his own dental plaque in the seventeenth century (1). Yet it wasn’t until the 1970s that it became widely accepted that bacteria in all natural ecosystems lived in the biofilm state. Biofilms, however, were not acknowledged as an important cause of indwelling medical device (IMD) infections until the early 1990s when electron microscopic examination of explanted IMDs, believed to be the foci of infection, revealed large numbers of bacteria encased in a thick extracellular matrix (2). These findings initiated a rapid increase in the number of investigators studying biofilm-related IMD infection.