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Biofilms and implants: new approaches and challenges

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Biofilms formed on medical implants, including prosthetic joints, catheters, pacemakers, and dental implants are thought to be the major cause of implant-associated infections. Biofilm bacteria show increased tolerance to antibiotics, including those with a “persister” phenotype, making these infections difficult to treat with systemic antibiotics alone. Possible sequelae include implant replacement, lifelong chemotherapy, and additional morbidity or mortality.

Implant-associated infection is dependent on the surgical site and its environment as well as implant-associated factors, including material, surface roughness, and chemical composition. Together, these determine bacterial phenotype and antibiotic sensitivity.  Currently, clinical strategies rely on increased hygiene protocols which include antiseptic and antibiotic rinses as well as systemically administered prophylactic antibiotics and local antibiotic elution systems. Research to prevent biofilm formation focuses on implant factors/modifications, immune system strategies, and modulation of antimicrobial types/amounts/combinations, as well as the use of non-antibiotic approaches, including sometimes unproven approaches (from cranberry juices, garlic decoctions, phototherapy, to magnetic force field). Emerging detection and imaging approaches can also guide the management of implant-associated infections. 

This collection focuses on exploring the different contributions that the implant and its environment play in the establishment of infection. The spectrum of interest includes the influence of microbiome on infection, immunomodulatory and other active biomaterials, animal models, microphysiological systems (organs on chips), and detection (biomarkers, imaging, etc).

This Collection supports and amplifies research related to SDG 3.

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