Implantable Device-Related Infection.

Area of Science:

• Biomedical Engineering
• Infectious Diseases
• Materials Science

Background:

• Healthcare-associated infections (HAIs) are a significant burden, with over half linked to indwelling medical devices.
• Diagnosing implantable device-related infections is challenging, potentially leading to underestimation of their prevalence.
• Understanding device infection pathogenesis is crucial for developing effective countermeasures.

Purpose of the Study:

• To provide a length-scale conceptualization of device-related infection pathogenesis.
• To review current and developing preventative strategies targeting specific processes in device infections.
• To highlight the need for parallel development of in situ treatment strategies for device infections.

Main Methods:

• Literature review focusing on biofilm formation, host immune, and coagulation systems.
• Development of a length-scale conceptualization framework for device infection pathogenesis.
• Analysis of existing and emerging preventative and treatment strategies within the conceptual framework.

Main Results:

• Device-related infections are complex, involving biofilm formation and host-pathogen interactions.
• Current preventative strategies target various stages of infection along the length-scale.
• A significant time lag exists for developing and translating new preventative technologies.

Conclusions:

• A length-scale conceptualization aids in understanding and addressing device-related infections.
• Both preventative and in situ treatment strategies are essential for managing these infections.
• Future research should focus on integrated approaches combining prevention and treatment informed by the conceptual framework.