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.
Original 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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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

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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.

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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).