ABSTRACT
References................................................................................................................66
Medical device-related infection has become a significant problem for the increasing numbers of patients who otherwise benefit from temporarily inserted or long-term implanted devices (1). The reason for this may be illustrated by a relatively simple analogy whereby the insertion of a urethral catheter is visualized as comparable to building a bridge between the outside world and the sterile bladder, along which bacteria can travel (2). The biofilm mode of growth on medical device biomaterials is of particular importance in device-related infection as this confers a number of advantages on bacteria, not least of which is extreme resistance to therapy with consequent patient detriment (3). These aspects are further detailed elsewhere in this book. Microbial biofilms can form on any medical device ranging from those that are relatively easily inserted and removed such as catheters, endotracheal and nasogastric tubes, and contact lenses to those that are long-term implants such as hip joints, cardiac valves, and intraocular lenses. The greatly increased resistance of microbial biofilms to antimicrobial agents means these device-related infections can often only be treated after removal of the medical device, when this is a viable option, thereby increasing the trauma to the patient and the cost of the treatment (4).
