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Medical devices & Biofilms: STRATEGIES FOR PREVENTION

Medical devices & Biofilms: STRATEGIES FOR PREVENTION. Dr. Kundurthy Shasank (25). Requirements of antimicrobial and antibacterial surfaces for preventing DAI. Introduction.

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Medical devices & Biofilms: STRATEGIES FOR PREVENTION

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  1. Medical devices & Biofilms: STRATEGIES FOR PREVENTION Dr. KundurthyShasank (25)

  2. Requirements of antimicrobial and antibacterial surfaces for preventing DAI

  3. Introduction • Biofilms are surface-attached groups of microbial cells that are embedded in a self-produced extracellular matrix and are highly resistant to antimicrobial agents. • Biofilms can attach to all kinds of surfaces, including metals, plastics, plant and body tissue, medical devices and implant materials. • Biofilm formation on indwelling medical devices and implants such as heart valves, pacemakers, vascular grafts, catheters, prosthetic joints, intrauterine devices, sutures and contact lenses poses a critical problem of infection

  4. 1.7 million hospital-acquired infections annually in US, incurring an annual economic burden of approximately $11 billion. • The most commonly reported HCAIs involve ventilator-associated pneumonia (VAP) and lower respiratory tract infections (22.8 % of cases), catheter-associated urinary tract infections (CAUTIs; 17.2 % of cases) and surgical-site infections (SSIs; 15.7 % of cases

  5. Microbiology The association of biofilms and medical device-related infections was first recognized in 1972 (Johanson et al., 1972), biofilms being commonly associated with a wide range of polymeric medical devices, such as catheters and cardiac pacemakers (Marrie et al., 1982; Peters et al., 1982; Hall-Stoodleyet al., 2004).

  6. Strategies for prevention

  7. Inhibition of biofilm Attachment • Altering chemical properties of biomaterials Antibiotics, biocides, iron coatings • Changing physical properties of biomaterials • Use of hydrophilic polymers, superhydrophobic coatings, hydrogel coatings, heparin coatings

  8. In the Event of a Lab Accident… • (Use this space to discuss procedures to follow in the event of a lab accident.)

  9. Removal of biofilms • Matrix degrading enzymes • Polysaccharide-degrading enzymes (DispersinB,Endolysins); • Nucleases (Deoxyribonuclease I) • Proteases (Proteinase K, trypsin) • Surfactants • Sodium dodecyl sulfate (SDS),Cetyltrimethylammonium bromide (CTAB), • Tween 20, Triton X-100, surfactin, rhamnolipids • Free fatty acids, amino acids and nitric oxide donors • Cis-2-decenoic acid, D-amino acids, nitric oxide generators such as sodium nitroprusside (SNP) • S-nitroso-L-glutathione (GSNO)S-nitroso-N-acetylpenicillamine (SNAP)

  10. Biofilm inhibition by quorum quenching • Degradation of QS signals • Lactonases, acylases and oxidoreductases • Inhibition of signal synthesis • Use of analogues of AHL precursor • S-adenosyl-methionine (SAM), • S-adenosyl-homocysteine (SAH), sinefugin, • 5-methylthioadenosine (MTA), butyryl-SAM; SAM biosynthesis inhibitor cycloleucine, AHL synthesis inhibitors such as nickel and cadmium

  11. Antagonizing signal molecules • AHL analogues (bergamottin, dihydroxybergamottin, cyclic sulphur compounds, phenolic compounds including baicalin hydrate and epigallocatechin); AI-2 analogues (ursolic acid, isobutyl-4,5-dihydroxy-2,3-pentanedione (isobutyl-DPD) • and phenyl-DPD); AIP analogues (cyclic peptides such as cyclo (L-Phe-L-Pro) and cyclo(L-Tyr-L-Pro), RNAIII inhibiting peptide (RIP) and its homologue • Inhibition of signal transduction • Use of halogenated furanone or fimbrolide, cinnamaldehyde, virstatin • Inhibition of signal transport • Use of copper or silver nanoparticles, Phe-Arg-β-naphthylamide (PAβN)

  12. New diagnostic techniques such as sonication of largeimplants and molecular diagnostic methods may improve not only identification ofpathogens, but also reveal greater microbial diversity than previously appreciated. Thank You

  13. References • Wi YM, Patel R. Understanding Biofilms and Novel Approaches to the Diagnosis, Prevention, and Treatment of Medical Device-Associated Infections. Infectious Disease Clinics. 2018 Dec 1;32(4):915-29. • Subhadra B, Kim D, Woo K, Surendran S, Choi C. Control of biofilm formation in healthcare: recent advances exploiting quorum-sensing interference strategies and multidrug efflux pump inhibitors. Materials. 2018 Sep 10;11(9):1676 • Percival SL, Suleman L, Vuotto C, Donelli G. Healthcare-associated infections, medical devices and biofilms: risk, tolerance and control. Journal of medical microbiology. 2015 Apr 1;64(4):323-34. • Rigo S, Cai C, Gunkel‐Grabole G, Maurizi L, Zhang X, Xu J, Palivan CG. Nanoscience‐Based Strategies to Engineer Antimicrobial Surfaces. Advanced Science. 2018 May;5(5):1700892. • Francolini I, Donelli G. Prevention and control of biofilm-based medical-device-related infections. FEMS Immunology & Medical Microbiology. 2010 Aug 1;59(3):227-38. • Medical Device Industry in India The Evolving Landscape, Opportunities and Challenges September 2017

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