Laser-generated shockwave for clearing medical device biofilms

This study aimed to evaluate a laser method of biofilm interruption from the surface of various common medical devices and from surgically removed sinus tissue with adherent biofilms in a timely manner.

Biofilm has emerged as a new threat not amenable to most antibiotic treatments. Biofilms, as opposed to planktonic bacteria, develop an extracellular polymeric slime matrix to facilitate adherence to host tissue or a prosthetic surface and to form a protective shield. A laser-induced biofilms disruption concept was previously described.

Biofilms were grown in the laboratory on metallic and plastic medical device surfaces such as stents. Attempts to remove the biofilms with a laser were undertaken three times for each device. Q-switched Nd:YAG laser-generated shockwaves affecting Pseudomonas aeruginosa biofilms expressing yellow fluorescent protein (YFP) biofilm coating were applied with biologically safe parameters utilizing a fiber delivery system and a special probe. A confocal microscope was used to identify the biofilm structure prior to, during, and after laser application. The amount of biofilm removed from the medical devices in time was measured by quantifying green fluorescence.

The biofilm fluctuated and eventually broke off the surface as shock waves neared the target. The time to remove 97.9 ± 0.4% (mean ± 1SD, n = 3) the biofilm from the surface of a Nitinol (NiTi) stent ranged from 4 to 10 s. The detached biofilm was observed floating in fluid media in various microscopic size particles.

A new treatment modality using laser-generated shockwaves in the warfare against biofilms growing on surgical devices was demonstrated. Q-switched laser pulses stripped biofilm from the surface it adhered to, changing the bacteria to their planktonic form, making them amenable to conventional treatment. This therapeutic modality appears to be rapid, effective, and safe on metallic and plastic medical device surfaces.