Biomedical Engineering Reference
In-Depth Information
Implant Related Infections
Wolf-Rainer Abraham
Abstract
The formation of biofilms on implants by bacteria is difficult to treat,
life-threatening, and costly. Hence, alternatives for the prevention of biofilm infec-
tions are urgently needed. The assessment of rhythm management devices revealed
colonization of 47% by asymptomatic biofilm communities. Comparison with
infected implants showed a much higher biodiversity of the infectious biofilm com-
munities which were dominated by pathogenic
Staphylococcus
species. The results
suggest that it is not essential to suppress any biofilm formation but only patho-
genic bacteria species. The situation differed considerably for biofilms on dental
implants. Here parts of the implant are always in a non-sterile environment and on
all implants biofilm communities could be found. More than 60 different species
could be identified from infected dental implants but contrary to the pacemakers no
clear pathogen was found. The results indicate different mechanisms of infections
requiring individual concepts for biofilm prevention on implants.
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Keywords
Implant
Biofilm
Microbial community
Pathogen
Asymptomatic
biofilm
1 Introduction
One of the main threats for implants is the colonization of their surfaces by bacteria
where they attach and form biofilms [
1
]. These biofilms offer protection against, e.g.
noxious agents like oxidants [
2
,
3
], antibiotics [
4
] or antibodies. Especially because
of their superior protection biofilms can be detrimental, e.g. in wounds, on implants,
teeth or catheters, hence, controlling biofilms is one of the fundamental problems
in medicine. They are difficult to treat with antibiotics because of a much higher
resistance of the pathogens inhabiting the biofilms [
5
]. Often the replacement of the
implant is the only solution against these biofilm infections.
