Skin and biomaterial infection - Biomaterial-associated infection (BAI)
5 important questions on Skin and biomaterial infection - Biomaterial-associated infection (BAI)
Which bacteria causes BAI?
Which elements are involved in pathogenesis of biomaterial-associated infection?
- Site of application of biomaterials
- Biomaterial characteristics
- Bacterial virulence factor (bioflim)
- Host factors predisposing for infection
Explain site of application of biomateral
- External: no surgical wound, no porte d’entrée
- Urinary catheters blocked
- Endotracheal tubes
- Transcutaneous: surgical wound and porte d’entrée
- Intravenous catheters, shunts (insertion of needle = porte entrée for bacteria)
- CAPD catheters
- External fixation devices
- Implanted: surgical wound, no porte d’entrée
- Prosthetic joints (hip, knees, heart valves, hearts)
- Pacemakers
- Hydrocephalus shunts
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Explain bacterial virulence factor
- For healthy humans S. epidermidis is a normal innocent skin inhabitant. Adherance to biomaterial surface S. epidermidis adhesins. Production of extracellualr polymeric matrix: biofilm
- Adherence by specific adhesins for host proteins such as fibronectin
- Production of “slime”, polysaccharide intercellular adhesin (PIA)
Biofilm production initiated by quorum sensing (bactreria produes sth and sense a production that they are many and initiate the production of biofilm by PIA)
Explain factors predisposing for infection
- Reduced neutrophil phagocytic / respiratory burst activity
- Due to presence of foreign body: “frustrated phagocytosis”
- Due to bacterial components, such as Staphylococcus epidermidis extracellular polysacharide “slime”:
→ Combined influence of bacteria and biomaterial reduce defense
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