Clinical Microbiology and Infection ( IF 10.9 ) Pub Date : 2020-02-29 , DOI: 10.1016/j.cmi.2020.02.027 P S Stewart 1 , T Bjarnsholt 2
|
Background
The use of implanted medical devices is associated with a small but clinically important risk of foreign body infection. A key question is: why do some patients develop chronic infection associated with an implanted device, but most do not?
Aims
The literature on patient-specific risk factors for chronic infections associated with five types of implants was surveyed to glean clues about the etiology of these infections.
Sources
Data were collected from 47 articles through calendar year 2017 for five categories of device-related infections: cardiovascular implantable electronic devices (CIEDs), hernia meshes, prosthetic hip and knee joints, prosthetic shoulder joints and breast implants.
Content
Important risk factors include immunomodulation/steroid therapy, diabetes, smoking, and renal disease/haemodialysis—findings that point to a critical role of a compromised innate immune response in determining vulnerable subpopulations.
Implications
A model of biofilm-related device infection is presented that posits defects in the innate immune response both systemically and locally, in the immediate vicinity of an abiotic biomaterial. The limitations of in vitro and animal models of chronic device-related infections are discussed in this context as are implications for research and clinical practice.
中文翻译：
与植入的医疗设备相关的慢性生物膜相关感染的危险因素。
背景
植入医疗设备的使用与异物感染的风险很小但在临床上很重要。关键问题是：为什么有些患者会发生与植入设备相关的慢性感染，而大多数患者却没有呢？
目的
调查了有关与五种植入物相关的慢性感染的患者特定危险因素的文献，以收集有关这些感染的病因的线索。
资料来源
截至2017日历年，共从47篇文章中收集了五类与设备相关的感染的数据：心血管植入式电子设备（CIED），疝气网，髋关节和膝关节假体，肩关节假体和乳房植入物。
内容
重要的危险因素包括免疫调节/类固醇疗法，糖尿病，吸烟和肾病/血液透析-这些发现指出先天免疫反应受损在确定易感亚群中的关键作用。
含义
提出了一种与生物膜相关的装置感染的模型，该模型在非生物生物材料的紧邻区域内，在系统性和局部性上都存在先天免疫反应中的缺陷。在此背景下讨论了慢性器械相关感染的体外和动物模型的局限性，以及对研究和临床实践的意义。
京公网安备 11010802027423号