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Implications of Biofilm Formation on Urological Devices

机译：生物膜形成对泌尿器械的影响

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Despite millions of dollars and several decades of research targeted at their prevention and eradication, biofilm-associated infections remain the major cause of urological device failure. Numerous strategies have been aimed at improving device design, biomaterial composition, surface properties and drug delivery, but have been largely circumvented by microbes and their plethora of attachment, host evasion, antimicrobial resistance, and dissemination strategies. This is not entirely surprising since natural biofilm formation has been going on for millions of years and remains a major part of microorganism survival and evolution. Thus, the fact that biofilms develop on and in the biomaterials and tissues of humans is really an extension of this natural tendency and greatly explains why they are so difficult for us to combat. Firstly, biofilm structure and composition inherently provide a protective environment for microorganisms, shielding them from the shear stress of urine flow, immune cell attack and some antimicrobials. Secondly, many biofilm organisms enter a metabolically dormant state that renders them tolerant to those antibiotics and host factors able to penetrate the biofilm matrix. Lastly, the majority of organisms that cause biofilm-associated urinary tract infections originate from our own oral cavity, skin, gastrointestinal and urogenital tracts and therefore have already adapted to many of our host defenses. Ultimately, while biofilms continue to hold an advantage with respect to recurrent infections and biomaterial usage within the urinary tract, significant progress has been made in understanding these dynamic microbial communities and novel approaches offer promise for their prevention and eradication. These include novel device designs, antimicrobials, anti-adhesive coatings, biodegradable polymers and biofilm-disrupting compounds and therapies.
机译：尽管数百万美元和几十年的研究旨在预防和根除，但生物膜相关的感染仍然是泌尿外源器件失效的主要原因。旨在改善装置设计，生物材料成分，表面性质和药物递送的若干策略，但在很大程度上被微生物及其过多的附着，宿主逃逸，抗微生物抗性和传播策略所规避。由于天然生物膜形成已持续数百万年，这并不令人惊讶，仍然是微生物生存和进化的主要部分。因此，生物膜在人类的生物材料和组织中产生的事实真的是这种自然倾向的延伸，大大解释了为什么他们对我们来说很难进行打击。首先，生物膜结构和组合物固有地为微生物提供保护环境，从尿液流动，免疫细胞发作和一些抗微生物的剪切应力屏蔽它们。其次，许多生物膜生物进入代谢休眠状态，使它们耐受那些能够穿透生物膜基质的抗生素和宿主因素。最后，导致生物膜相关的泌尿道感染的大多数生物起源于我们自己的口腔，皮肤，胃肠道和泌尿生殖道，因此已经适应了许多我们的宿主防御。最终，虽然生物膜在泌尿道内继续持有经常性感染和生物材料的持续存在的优势，但在了解这些动态微生物社区和新方法提供了预防和根除的重要进展方面取得了重大进展。这些包括新型器件设计，抗微生物，抗粘性涂料，可生物降解的聚合物和生物膜破坏化合物和疗法。

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