Clinical and Microbiological Aspects of Biofilm-Associated Surgical Site Infections

Charles E. Edmiston, Andrew McBain, Christopher Roberts, David Leaper

    Research output: Chapter in Book/Report/Conference proceedingChapter

    Abstract

    While microbial biofilms have been recognized as being ubiquitous in nature for the past 40 years, it has only been within the past 20 years that clinical practitioners have realized that biofilm play a significant role in both device-related and tissue-based infections. The global impact of surgical site infections (SSIs) is monumental and as many as 80 % of these infections may involve a microbial biofilm. Recent studies suggest that biofilm- producing organisms play a significant role in persistent skin and soft tissue wound infections in the postoperative surgical patient population. Biofilm, on an organizational level, allows bacteria to survive intrinsic and extrinsic defenses that would inactivate the dispersed (planktonic) bacteria. SSIs associated with biomedical implants are notoriously difficult to eradicate using antibiotic regimens that would typically be effective against the same bacteria growing under planktonic conditions. This biofilm-mediated phenomenon is characterized as antimicrobial recalcitrance, which is associated with the survival of a subset of cells including “persister” cells. The ideal method to manage a biofilm-mediated surgical site wound infection is to prevent it from occurring through rational use of antibiotic prophylaxis, adequate skin antisepsis prior to surgery and use of innovative in-situ irrigation procedures; together with antimicrobial suture technology in an effort to promote wound hygiene at the time of closure; once established, biofilm removal remains a significant clinical problem.
    LanguageEnglish
    Title of host publicationBiofilm-based Healthcare-associated Infections
    Subtitle of host publicationVolume 1
    EditorsGianfranco Donelli
    Place of PublicationCham, Switzerland
    PublisherSpringer Verlag
    Pages47-67
    Number of pages21
    ISBN (Electronic)9783319110387
    ISBN (Print)9783319110370
    Publication statusPublished - 9 Oct 2014

    Publication series

    NameAdvances in Experimental Medicine and Biology
    PublisherSpringer Verlag
    Volume830
    ISSN (Electronic)0065-2598

    Fingerprint

    Surgical Wound Infection
    Biofilms
    Bacteria
    Antisepsis
    Skin
    Soft Tissue Infections
    Antibiotic Prophylaxis
    Wound Infection
    Infection
    Hygiene
    Sutures
    Anti-Bacterial Agents
    Technology
    Equipment and Supplies
    Survival
    Wounds and Injuries

    Cite this

    Edmiston, C. E., McBain, A., Roberts, C., & Leaper, D. (2014). Clinical and Microbiological Aspects of Biofilm-Associated Surgical Site Infections. In G. Donelli (Ed.), Biofilm-based Healthcare-associated Infections: Volume 1 (pp. 47-67). (Advances in Experimental Medicine and Biology; Vol. 830). Cham, Switzerland: Springer Verlag.
    Edmiston, Charles E. ; McBain, Andrew ; Roberts, Christopher ; Leaper, David. / Clinical and Microbiological Aspects of Biofilm-Associated Surgical Site Infections. Biofilm-based Healthcare-associated Infections: Volume 1. editor / Gianfranco Donelli. Cham, Switzerland : Springer Verlag, 2014. pp. 47-67 (Advances in Experimental Medicine and Biology).
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    abstract = "While microbial biofilms have been recognized as being ubiquitous in nature for the past 40 years, it has only been within the past 20 years that clinical practitioners have realized that biofilm play a significant role in both device-related and tissue-based infections. The global impact of surgical site infections (SSIs) is monumental and as many as 80 {\%} of these infections may involve a microbial biofilm. Recent studies suggest that biofilm- producing organisms play a significant role in persistent skin and soft tissue wound infections in the postoperative surgical patient population. Biofilm, on an organizational level, allows bacteria to survive intrinsic and extrinsic defenses that would inactivate the dispersed (planktonic) bacteria. SSIs associated with biomedical implants are notoriously difficult to eradicate using antibiotic regimens that would typically be effective against the same bacteria growing under planktonic conditions. This biofilm-mediated phenomenon is characterized as antimicrobial recalcitrance, which is associated with the survival of a subset of cells including “persister” cells. The ideal method to manage a biofilm-mediated surgical site wound infection is to prevent it from occurring through rational use of antibiotic prophylaxis, adequate skin antisepsis prior to surgery and use of innovative in-situ irrigation procedures; together with antimicrobial suture technology in an effort to promote wound hygiene at the time of closure; once established, biofilm removal remains a significant clinical problem.",
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    Edmiston, CE, McBain, A, Roberts, C & Leaper, D 2014, Clinical and Microbiological Aspects of Biofilm-Associated Surgical Site Infections. in G Donelli (ed.), Biofilm-based Healthcare-associated Infections: Volume 1. Advances in Experimental Medicine and Biology, vol. 830, Springer Verlag, Cham, Switzerland, pp. 47-67.

    Clinical and Microbiological Aspects of Biofilm-Associated Surgical Site Infections. / Edmiston, Charles E.; McBain, Andrew; Roberts, Christopher; Leaper, David.

    Biofilm-based Healthcare-associated Infections: Volume 1. ed. / Gianfranco Donelli. Cham, Switzerland : Springer Verlag, 2014. p. 47-67 (Advances in Experimental Medicine and Biology; Vol. 830).

    Research output: Chapter in Book/Report/Conference proceedingChapter

    TY - CHAP

    T1 - Clinical and Microbiological Aspects of Biofilm-Associated Surgical Site Infections

    AU - Edmiston, Charles E.

    AU - McBain, Andrew

    AU - Roberts, Christopher

    AU - Leaper, David

    PY - 2014/10/9

    Y1 - 2014/10/9

    N2 - While microbial biofilms have been recognized as being ubiquitous in nature for the past 40 years, it has only been within the past 20 years that clinical practitioners have realized that biofilm play a significant role in both device-related and tissue-based infections. The global impact of surgical site infections (SSIs) is monumental and as many as 80 % of these infections may involve a microbial biofilm. Recent studies suggest that biofilm- producing organisms play a significant role in persistent skin and soft tissue wound infections in the postoperative surgical patient population. Biofilm, on an organizational level, allows bacteria to survive intrinsic and extrinsic defenses that would inactivate the dispersed (planktonic) bacteria. SSIs associated with biomedical implants are notoriously difficult to eradicate using antibiotic regimens that would typically be effective against the same bacteria growing under planktonic conditions. This biofilm-mediated phenomenon is characterized as antimicrobial recalcitrance, which is associated with the survival of a subset of cells including “persister” cells. The ideal method to manage a biofilm-mediated surgical site wound infection is to prevent it from occurring through rational use of antibiotic prophylaxis, adequate skin antisepsis prior to surgery and use of innovative in-situ irrigation procedures; together with antimicrobial suture technology in an effort to promote wound hygiene at the time of closure; once established, biofilm removal remains a significant clinical problem.

    AB - While microbial biofilms have been recognized as being ubiquitous in nature for the past 40 years, it has only been within the past 20 years that clinical practitioners have realized that biofilm play a significant role in both device-related and tissue-based infections. The global impact of surgical site infections (SSIs) is monumental and as many as 80 % of these infections may involve a microbial biofilm. Recent studies suggest that biofilm- producing organisms play a significant role in persistent skin and soft tissue wound infections in the postoperative surgical patient population. Biofilm, on an organizational level, allows bacteria to survive intrinsic and extrinsic defenses that would inactivate the dispersed (planktonic) bacteria. SSIs associated with biomedical implants are notoriously difficult to eradicate using antibiotic regimens that would typically be effective against the same bacteria growing under planktonic conditions. This biofilm-mediated phenomenon is characterized as antimicrobial recalcitrance, which is associated with the survival of a subset of cells including “persister” cells. The ideal method to manage a biofilm-mediated surgical site wound infection is to prevent it from occurring through rational use of antibiotic prophylaxis, adequate skin antisepsis prior to surgery and use of innovative in-situ irrigation procedures; together with antimicrobial suture technology in an effort to promote wound hygiene at the time of closure; once established, biofilm removal remains a significant clinical problem.

    KW - Biofilm

    KW - Surgical site infections

    KW - Microbiology

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    T3 - Advances in Experimental Medicine and Biology

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    BT - Biofilm-based Healthcare-associated Infections

    A2 - Donelli, Gianfranco

    PB - Springer Verlag

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    ER -

    Edmiston CE, McBain A, Roberts C, Leaper D. Clinical and Microbiological Aspects of Biofilm-Associated Surgical Site Infections. In Donelli G, editor, Biofilm-based Healthcare-associated Infections: Volume 1. Cham, Switzerland: Springer Verlag. 2014. p. 47-67. (Advances in Experimental Medicine and Biology).